WASHINGTON -- The Senate will vote as early as Thursday to repeal the Affordable Care Act, a purely symbolic exercise that has played out gazillions of times in Congress. What's different this time, though, is that the bill is expected to make it to President Barack Obama's desk.
Republicans will use a special budgetary tool, known as reconciliation, to take up a bill that would gut most of Obamacare. By using reconciliation, they only need 51 votes to pass it, and Republican leadership is confident they have the votes. The House already passed their version of the bill in late October.
“Obviously, we’re not anticipating a presidential signature," Senate Majority Leader Mitch McConnell (R-Ky.) said Tuesday. "But I think the president should have to take credit for this for the debacle that this legislation has created."
Senate Republicans have already voted a handful of times to repeal Obama's signature health care law. They've voted dozens more times to repeal or defund part of it. But past repeal efforts haven't made it out of the chamber because they didn't have the 60 votes needed to clear a procedural hurdle to move forward on a bill. Now that Republicans control the Senate, they can use obscure maneuvers like reconciliation to advance certain bills with just 51 votes.
Finalized details of the provisions have yet to be released, but according to lawmakers, leadership presented a plan that would repeal Medicaid expansion in a gradual phase-out, setting the stage for the next president to pass a new health care reform law.
“Some people would like to have a transition to more affordable, better care and that gives time for that to take place under a new administration,” Senate Majority Whip John Cornyn (R-Texas) told reporters after a Republican meeting to discuss the bill.
Unlike the House plan, the Senate bill would also scrap subsidies for people who buy insurance through federal health exchanges, and cut nearly all of the law’s tax increases, according to Senate aides.
To appease conservatives in both chambers, a measure defunding the family planning provider Planned Parenthood will also be included. But it could cost McConnell votes with moderates in his caucus.
Sen. Susan Collins (R-Maine), one of few moderates, told The Huffington Post her concerns with the package “center” on the Planned Parenthood provisions.
“They are extremely broad and would result in the closure of virtually every Planned Parenthood clinic in the United States, thus depriving millions of Americans some basic health care -- cancer screenings, family planning services,” Collins said.
“And there already is a federal program, which I support, against the use of federal funds for abortions except rape, incest and life of the mother. This is far broader than that and would deny Medicaid coverage for cancer screenings for a low-income woman who chooses to go to Planned Parenthood,” Collins continued. “That’s my number one concern.”
Democrats are expected to offer an amendment that would void the measure stripping Planned Parenthood of its federal funds, something Collins said she would support. If that gets taken out, Collins wouldn’t say if she would vote for the underlying bill to repeal Obamacare.
Still, she defended the effort: “This vote is different because this would be the first time that a bill that guts large parts of Obamacare would actually make it to the president’s desk."
For their part, Democrats said the entire exercise is pointless. Senate Minority Leader Harry Reid (D-Nev.) said Republicans are "obsessed" with Obamacare and should be focused on everything they have to get done in the next few weeks: a government funding bill, a highway bill, an education bill, tax extenders and clearing a backlog of nominations.
"Republicans are forcing another show vote on repeal," Reid told reporters. "This will be the 16th in the Senate, and honestly, I have lost track of how many in the House. Everyone knows this bill can't become law."
Sen. Richard Shelby (R-Ala.) said it's important for Republicans to keep voting to repeal Obamacare over and over again, even if nothing actually changes as a result.
"Every chance we have an opportunity, we want to do those kind of things," Shelby said. "The value is to let him know, the president, and others, that there's a big division in this country. And a lot of us don't like it. And the American people don't like it."
At least 17 million people do like it. That's how many have gotten health insurance since the core of Obamacare took effect in 2013, according to a February RAND Corp. study.
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