VP Pence breaks 50-50 tie, votes to proceed on health care debate
WASHINGTON (NBC) -
With Vice President Mike Pence casting a tie-breaking vote, Republicans moved forward on health care reform Tuesday as the Senate successfully passed a key motion to proceed to debate on repealing and possibly replacing Obamacare.
Momentum built over the course of the day as several previously skeptical members announced they would support Senate GOP leaders after they began detailing plans for more votes over the next days to shape the details of the legislation.
Sen. John McCain, who was recently diagnosed with brain cancer, returned to the Senate from Arizona one hour before to cast a key vote and Pence broke the tie after two Republicans — Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska — and all the Democrats voted against it.
The vote was a key moment in the GOP’s seven-year campaign promise to repeal and replace the Affordable Care Act, but the final may fall short of that goal, and could well end up as a “skinny” repeal that disposes of just a few components of the law, known as Obamacare.
The Senate will begin debate and votes on a variety of approaches to the bill, beginning with a vote on the 2015 version of the repeal of Obamacare, senators and aides say. That vote is expected to fail.
After that, the Senate will turn to the current replacement bill, the Better Care Reconciliation Act, with an amendment from Sen. Ted Cruz, R-Texas, that allows the sale of catastrophic plans, and an amendment by Sen. Rob Portman, R-Ohio, that would add $100 billion in additional spending on Medicaid.
But the BCRA amendment is likely to need 60 votes because neither the Cruz nor the Portman amendment has been scored by the Congressional Budget Office. That means it cannot pass under special reconciliation rules allowing a simple majority approval. Since it would need Democratic votes, it is likely to fail.
The plan after those two votes is for senators to proceed to votes on a series of amendments to create what leadership has called a “skinny” repeal, which is a watered-down version of repeal with nothing to replace it.
The goal would be to eliminate Obamacare's individual mandate penalty, the employer mandate penalty, and the tax on medical devices. A broader repeal would also have ended Medicaid's expansion, get rid of or replace the Obamacare subsidies that help people purchase insurance and repeal more — or all — of Obamacare's taxes.
The Senate would then go to conference with the House of Representatives, where conferees would work out a final bill. Both chambers would then have to vote on the reconciled bill.
The dramatic return of McCain — who received a standing ovation on the Senate floor — helped give GOP leaders not only a crucial vote but a morale boost for the GOP conference.
While passage of the motion to proceed had been in doubt for weeks, the momentum began to shift Tuesday morning. Sen. Rand Paul, R-Ky., announced in a series of tweets that he supports this plan and would vote "yes" on the motion, saying he was satisfied with the plan going forward because he was promised a vote on a near-full repeal and that the repeal and replace plan will likely fail.