Reinvigorated US Senate Republicans on Wednesday resumed their marathon effort to uproot Obamacare, but what their health legislation may ultimately look like remained a question mark.
Senate leadership, emboldened by a critical vote Tuesday which allowed the chamber to begin debating health care, intends to pass a bill this week that fulfills President Donald Trump’s pledge to scrap the 2010 Affordable Care Act.
But that path remained murky. Hours after Republicans narrowly advanced the motion to begin debate — with Vice President Mike Pence brought in to break a 50-50 tie — the effort suffered a setback when the Senate voted down a comprehensive Republican plan to repeal and replace Barack Obama’s signature reforms.
Nine Republicans joined all the Democrats in rejecting the amendment.
It was an ominous ending to a whirlwind day that saw Senator John McCain, diagnosed with brain cancer a week earlier, warmly applauded by colleagues as he dramatically returned to the Senate to cast a key vote to open the debate.
While Trump called that initial Tuesday vote “a big step” that could ultimately lead to “truly great health care for the American people,” the victorious moment may prove temporary.
Under pressure to emerge from the months-long process with tangible results, Senate Majority Leader Mitch McConnell announced the chamber would vote Wednesday on another plan, one that repeals Obamacare without a replacement.
That too was expected to fail, as several Republicans have expressed opposition to dismantling existing law without a viable replacement at the ready.
“We’re determined to do everything we can to succeed,” insisted McConnell, suggesting the legislation could go in any number of directions because of the open process that allows any member to offer amendments.
“I know members in both parties have health care ideas they’d like to offer,” he said. “If you’ve got one, bring it to the floor.”
– ‘No good way out’ –
One new approach in order to keep the effort afloat was gaining traction: a limited dismantling of Obamacare.
The so-called “skinny repeal” would ditch the provision that fines individuals for not having insurance and companies that don’t offer it. It also would eliminate a tax on medical-device manufacturers.
The Republican leadership does not expect the pared-down bill to become law. But should it pass the Senate, it would be used as a placeholder, a basis for negotiating broader legislation with the House of Representatives.
The approach drew sharp criticism from Democrats, who have warned that an Obamacare repeal would result in deep cuts to Medicaid, the health insurance program for the poor and the disabled; generous tax breaks for the wealthy; and prohibitively high insurance premiums for people with pre-existing conditions.
“It’s a Trojan horse, designed to get the House and Senate into conference, where the hard right flank of the House Republicans, the Freedom Caucus, will demand full repeal, or something very close to it,” top Senate Democrat Chuck Schumer warned.
“There’s no good way out of this,” he added.
The House passed its Obamacare repeal and replace bill in May, but it stalled in the Senate, which was intent on crafting its own version.
The two would need to be reconciled and a final bill passed by both chambers before it reaches the president’s desk.
But with deep fissures within the Republican Party, it remained possible that the revived Senate is unable to approve any health reform plan.
Trump has sought to cajole and strong-arm several of the Republican skeptics, and he appeared to turn on one of them, a Senate moderate who voted against opening debate Tuesday.
“Senator @lisamurkowski of the Great State of Alaska really let the Republicans, and our country, down yesterday. Too bad!” Trump tweeted.
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