After falling far short of the votes needed to move forward with its sweeping measure to repeal and replace large parts of the Affordable Care Act, the Senate took another vote this afternoon, this time on a bill that simply repeals key aspects of the ACA without including any replacement.
Unlike last night’s vote, which needed to have 60 supporters in order to merit further consideration, the repeal-only measure only needed 50 votes to succeed. However, the GOP was not able to reach that lowered threshold, with seven Republican senators voting against it. Ultimately, the vote went 55-45 in favor of rejecting the bill.
Senators Susan Collins (ME), Lisa Murkowsky (AK), Dean Heller (NV), John McCain (AZ), Lamar Alexander (TN), Shelley Moore Capito (WV), and Rob Portman (OH) were the Republicans who voted no. McCain, Alexander, Capito, and Portman had all voted “yes” last night in support of the repeal-and-replacement bill.
Six GOP senators — Bob Corker (TN), Tom Cotton (AR), Lindsey Graham (SC), Mike Lee (UT), Jerry Moran (KS), and Rand Paul (KY) — who voted against the replacement measure voted for repeal-only, highlighting the Senate’s current difficulties in reaching a consensus on this matter.
The bill — technically introduced as an amendment to the House repeal/replacement legislation that passed earlier this year — was championed by Sen. Paul. The substance of the legislation is largely similar to a bill that Congress passed in late 2015, knowing that it would be (and ultimately was) vetoed by President Obama. It seeks to repeal the most frequently targeted aspects of Obamacare, like the so-called “individual mandate,” which requires that just about everyone has to purchase at least some form of healthcare coverage.
This version of Sen. Paul’s amendment also proposed cutting off federal funding for services like Planned Parenthood because they provide abortions. The Senate is expected to take up a second version of the repeal-only bill that does not include this abortion-related prohibition, though it’s unclear if that will be enough to get the GOP to the 50 votes it needs.
The repeal bill does leave in place aspects of Obamacare that many people like, but which are believed to drive up the price of insurance premiums. These include the ban on plans that charge more (or deny coverage) to customers with pre-existing conditions, and the requirement that adult offspring can remain on their parents’ plan until age 26.
The nonpartisan Congressional Budget Office has twice scored plans similar to what was voted on today and both times concluded that this sort of repeal-but-not-replace proposal would leave some 32 million additional Americans without health insurance.
The CBO also projected that, without people being required to have insurance, there would be little to no financial incentive for some coverage providers to continue offering individual insurance policies. After a decade of repeal, the CBO expects that 75% of the U.S. population would live in areas without any insurers offering policies through the individual marketplace.
The Paul bill attempts to deal with those concerns by building in a two-year delay for repeal. In that time, supporters of repeal-only believe that Congress can hash out an adequate replacement.
“My guess is that we will have impetus from the other side to actually begin to negotiate,” said Sen. Paul early on Wednesday morning.
Many Democrats spoke today to call for the GOP to open up this bill to true bipartisan discussion through the committee process, with Sen. Ron Wyden (OR), noting that “Bipartisanship is not about taking the worst of each other’s ideas.”
Sen. Joe Donnelly of Indiana has asked for a vote on his amendment that would send the matter to the Senate Finance Committee for consideration, in the hope that it would reduce some of the proposed cuts to Medicaid, but that motion was defeated on a strict party-line vote, 52-48.