Trump’s healthcare overhaul just passed its first huge hurdle

Mitch mcconnell
US Senate Majority Leader Mitch McConnell Bill Pugliano/Getty Images

The US Senate voted to open debate on the Republican healthcare overhaul on Tuesday, kicking off a furious voting process after a tumultuous arguments among the GOP.

A procedural vote to begin debate on the House’s healthcare bill passed Tuesday afternoon by narrow by a count of 50-50. Vice President Mike Pence will serve as the tiebreaker to pass the motion.

Every Democrat voted against the motion, with Republican Sens. Susan Collins and Lisa Murkowski defecting from GOP leadership and vote no. There are 52 Republicans in the Senate, so if more than two members voted no the motion would have failed.

Several Republican members that were on the fence regarding the motion decided to vote for the measure after significant pressure from Leader Mitch McConnell and the White House.

The Senate will now begin 20 hours of debate on the healthcare bill, equally divided between Democrats and Republicans.

To get enough Republican senators onboard with the motion to proceed, McConnell likely promised to bring up multiple versions of amendments for a vote, including the repeal-only Obamacare Repeal Reconciliation Act and the repeal-and-replace Better Care Reconciliation Act.

GOP members say McConnell is likely assuming both of those measures will fail and then begin a “skinny repeal” process — a series of amendments that would repeal certain parts of Obamacare.

If those are able to pass in the shell of the House bill, Republicans from both sides of Congress would come together on a conference committee to draft a compromise.

Here’s a rundown of what will happen from here:

  • 20 hours of debate — in legislative time — will begin, split equally between Democrats and Republicans.
  • The first amendment to be voted on is likely to be the ORRA to satisfy conservative hold-out Rand Paul and other conservatives. This plan is likely to be shot down by moderates.
  • The first amendment to be offered procedurally — but the second to be voted on, the news website Axios reported — would be the BCRA, which was last updated on Thursday. Again, Republicans can afford only two defections.
  • According to reports, there is an agreement between Sen. Rob Portman, a more moderate holdout, and Sen. Ted Cruz, a conservative, on an amendment that would keep the structure of the BCRA but allow insurers to sell non-Obamacare-compliant policies and throw in $US100 billion to the state stabilisation fund. But since that would require 60 votes to pass, and it has not been scored by the Congressional Budget Office, it is almost certainly doomed, since there are only 52 Republicans in the Senate.
  • There could then be a series of amendments to the House bill, including those from Democrats. Additionally, other healthcare legislation could be slotted in for a vote.
  • Finally, McConnell will try to push the Senate to pass a bundle of smaller amendments focused on repealing aspects of Obamacare like the individual mandate and medical-device tax. After this, the House and the Senate would flesh out a full replacement bill in a conference committee.