Senate Republicans took a major step on Thursday toward repealing the health law that has extended coverage to more than 20 million Americans.
After a marathon session known as “vote-a-rama” that lasted throughout Wednesday night — and over the loud objections of Democrats, who staged an unusual protest on the floor — the GOP-controlled Senate successfully put into motion a legislative process to roll back Obamacare.
Just before 1:30 a.m., the Senate voted 51–48 largely along party lines to pass a budget resolution that instructs several congressional committees to write legislation dismantling major provisions of health care reform.
The final vote came after hours of roll call votes, and after Senate Democrats launched a last-ditch fight against the repeal effort.
Democratic lawmakers stood one by one to voice their objections, dedicating their “no” votes to the millions of people who stand to lose their insurance coverage if Obamacare is rolled back. Democrats also put forth a series of largely symbolic amendments to protect access to health care, including one provision stipulating that people with preexisting conditions should continue to be protected from discrimination from insurance companies. All of those amendments were ultimately voted down by the Senate.
For the tens of millions of Americans who will lose their healthcare if the ACA is repealed, I vote no. #MakeAmericaSickAgain
— Chuck Schumer (@SenSchumer) January 12, 2017
“I think it’s important for this country to know this was not a usual thing, this is a day which lays the groundwork for 30 million people to be thrown off their health insurance,” Vermont Sen. Bernie Sanders said after the vote. “And if that happens, many of these people will die.”
It was initially unclear whether Republicans would have enough support in the Senate to advance this budget resolution. Several GOP senators expressed concerns this week about rushing to repeal Obamacare before finalizing a replacement plan — an incredibly risky strategy called “repeal and delay” that has sparked widespread criticism for its potential to plunge the insurance industry into chaos. A group of five moderate Republicans led by Tennessee Sen. Bob Corker introduced an amendment to delay the budget resolution to allow for more time to craft a replacement.
But in the end, only Sen. Rand Paul (R-KY) — the loudest critic of repeal and delay in his party — broke from the rest of his colleagues to oppose the measure. Corker withdrew his amendment before the vote.
The group of senators who had previously indicated hesitation said they had been sufficiently assured that Republicans will give congressional committees enough time to write an Obamacare replacement plan — a policy goal that the GOP has failed to deliver on for the past six years.
President-elect Donald Trump — indicating unfamiliarity with the slow pace of Congress — said this week that he expects simultaneous repeal and replacement bills, ideally as quickly as next week. As the New York Times reported, “Trump appeared to be unclear both about the timing of already scheduled votes in Congress and about the difficulty of his demand.”
Republicans have struggled for years to coalesce around a viable Obamacare replacement. One of the main issues is that GOP health proposals typically include a collection of the same Republican ideas about health care, all of which would result in demonstrably less access to insurance than Obamacare.
Trump has said that he wants to replace Obamacare with “something terrific” that is “far less expensive and far better” — but it’s still entirely unclear what that might mean in specific policy terms.
Now that the Senate has advanced the budget resolution, the House is expected to take its own vote as early as Friday. Then Congress will have to dig in for the difficult work of actually writing the legislation, which could take months.