By a 51–50 vote, Republicans have passed a “motion to proceed” that allows the Senate to begin consideration of the Obamacare repeal-and-replace plan that passed the House of Representatives in May. The deciding vote was cast by Vice President Mike Pence; Maine Sen. Susan Collins and Alaska Sen. Lisa Murkowski were the only Republican members to vote against the motion. Republican Sen. John McCain returned to Washington just days after announcing he’s been diagnosed with brain cancer to cast a “yes” vote.
What happens next is that the Senate will debate health care reform (or, rather, give perfunctory speeches about it) for 20 hours—breaks are allowed—before voting on “amendments” to the House’s bill. These “amendments” can be entirely new bills meant to completely take the place of what the House passed, and any senator can propose them. The meaningful amendments, though, are those endorsed by Republican leaders, and on that front, there is uncertainty: Majority Leader Mitch McConnell has not yet released final text for the Better Care Reconciliation Act repeal-and-replace bill that his caucus has been working on for weeks. Moreover, the BCRA amendment/bill will likely need 60 votes to pass rather than 50 because it is expected to include provisions that haven’t been approved by the Senate parliamentarian for use in the reconciliation process.
So the BCRA is not currently expected to pass. McConnell’s ultimate “amendement” plan, then, is reportedly to try to propose something called “skinny repeal,” which would eliminate the ACA’s mandates that large employers must provide insurance to their employees and that individuals who aren’t covered by employers must buy insurance through state marketplaces. It’s not even clear that this Plan C will pass, and it would possibly be a marketplace-ruining “death spiral” disaster if it became law—but as Slate’s Jordan Weissmann explains, it’s actually only being proposed so that the Senate will have passed a piece of health care legislation that could then be synthesized with the House’s American Health Care Act via a “conference committee.” Both chambers would then have to vote to approve whatever the conference committee came up with.
In other words, we might have a long way to go on this, still.