Category: Health/Medical

After defeating a repeal-and-replace measure during the first day of debate, the Senate turned down yesterday a straight repeal of the Affordable Care Act by a vote of 45- 54. A myriad of alternatives and amendments are expected to be voted on as the Senate continues its consideration, including a “skinny” repeal, the details of which are not yet final but will most likely include at least the elimination of the individual and employer mandates as well as the tax on medical devices.

The current goal of the Senate leadership appears to be to get even a small legislative package passed by the chamber so that it can go to conference with the House to attempt to craft a new bill.  Some believe that the “skinny” repeal bill could serve as that vehicle.  Whether that is the case remains to be seen.

The debate and votes are expected to last long into the evening.

After agreeing to start debate on healthcare yesterday by a vote of 51-50, a vote on which Vice President Mike Pence cast the tie-breaking vote, the Senate turned back the first option it considered by a vote of 43-57, with nine Republicans joining all 48 Democrats to oppose the measure.

According to the rules governing this issue, the Senate has 20 hours to debate the healthcare legislation.  During the remainder of the issue, the Senate is expected to consider a number of other options, including a repeal-with-a-two-year-delay as well as a more limited package that would eliminate the individual and employer mandates and the medical device tax.

The Senate Republican leadership has decided to schedule a vote on a “motion to proceed” on the healthcare legislation for later this afternoon.  Many observers view the decision by Sen. John McCain (R-AZ) to return to Washington to vote as a positive sign for those pushing to start debate on a healthcare bill.  However, the outcome of the vote, which is basically on a motion to start debate on the issue, still remains up in there.

Later this week, including as soon as tomorrow, the Senate Republican leadership will attempt to move forward on its attempt to repeal the Affordable Care Act, as they try to gather enough votes among Republicans to start floor debate on the issue.  Complicating matters is the fact that Sen. John McCain (R-AZ) is still in Arizona recovering from surgery.

Another complication for the leadership is the lack of clarity on which underlying measure the members are voting on.  As Republican Senators are being pushed to support a “motion to proceed” on a bill, there is no agreement on which bill would proceed if the vote were successful.  No decision has been made on whether a measure to simply repeal Obamacare with a two-year delay or some version of repeal-and-replace bill would serve as the vehicle to start debate.

The outcome of the vote is uncertain at this point.