Senate Republicans mustered the support necessary to clear a key procedural hurdle Tuesday that will allow the chamber to hold a vote on several pieces of legislation designed to, in some fashion or another, overhaul the U.S. health insurance system.
Vice President Mike Pence broke a 50-50 tie to clear the Senate motion to proceed with the House-passed bill to repeal and replace the 2010 health care law, after weeks of hand-wringing and backroom deal-making by Senate Majority Leader Mitch McConnell.
It is a major victory for the Kentucky Republican, who after seven years of campaigning against the law and vowing to repeal it “root and branch,” was struggling as recently as Monday to come up with the votes needed to clear the initial procedural motion.
After 20 hours of debate, the Senate will then proceed to the so-call vote-a-rama, a process under which nearly unlimited amendments can be offered by both Democrats and Republicans.
It is expected McConnell will hold an initial vote on a bill to repeal large portions of the health care law on a two-year delay that Congress passed in 2015 and was vetoed by then-President Barack Obama.
Votes could then be held on a number of different proposals that Republicans have released in recent weeks, all of which would in some manner repeal the law and implement a number of replacement measures over the next 10 years.
All those proposals would end the law’s Medicaid expansion and impose a stricter growth rate on the entitlement program starting in 2025, which the nonpartisan Congressional Budget Office said would cut $772 billion in federal funding by 2026.
The amount of funding to states varies across the different drafts, with one proposal providing up to $250 billion in federal money over the next several years to help lower premium costs and help shore up the existing individual markets.
One version also includes an amendment from Sen. Ted Cruz of Texas that would allow insurers to offer plans that are non-compliant with the current health care law under certain conditions. That draft would also allocate an additional $70 billion to help states cover high-risk individuals not included in other versions.
The Senate parliamentarian on Friday said a number of provisions in an earlier version of the GOP’s legislation would violate the so-called Byrd Rule, which prohibits extraneous measures from being considered under the fast-track budgetary maneuver known as reconciliation that Republicans are using to advance the health care overhaul.
The GOP, however, is working on revised language incorporating that guidance, Senate Budget Chairman Michael B. Enzi of Wyoming confirmed on Monday.
Despite clearing the procedural motion, it is still unclear whether Republicans have the votes necessary to pass any of the underlying bills. Leadership until today was squarely focused on just getting to debate over the House measure.
McConnell has kept GOP lawmakers completely in the dark over his strategy on the health care bill, to the frustration of several members of his conference. The process has been especially startling for many given the backlash from Senate Republicans over how Democrats advanced their initial health care bill in 2009, which the GOP for years has labeled as too secretive — despite more than a year of open hearings, markups and floor debate.