If you’re confused about what’s happening around healthcare on Capitol Hill this week, believe me, you’re not alone. In simplest terms, the Senate voted on Tuesday afternoon to bring a repeal-and-replace bill – the American Health Care Act (the bill that passed in the House) – to the floor for debate.

The vote count was 50-50, with two GOP senators and all Democrats and Independents voting no, and VP Mike Pence breaking the tie. Voting “yes” on moving to debate did not commit a senator to voting “yes” on any bill.  What it did was initiate 20 hours of debate and voting on “amendments” to the bill – but these “amendments” include entire bills, not just tweaks to the AHCA, the bill that was introduced. First up for a vote was a new version of the Senate’s own Better Care Reconciliation Act, which included the Cruz amendment permitting carriers to offer plans that don’t cover all the essential health benefits and weakening protections for people with pre-existing conditions. This bill was soundly rejected, with nine Republicans and all Democrats voting no.

Insiders say it's looking likely that Senate leaders will now present a repeal-only bill that also looks destined to fail and ultimately offer up a “skinny” repeal bill after exhausting more aggressive measures. As this Washington Post article explains, “The way it's being presented to senators, this scaled-back version of an Obamacare rollback may ditch only a few components of the Affordable Care Act -- its individual and employer mandates, its medical device tax and its public health fund. That would fall far short of Senate Majority Leader Mitch McConnell's (R-Ky.) previous promises to repeal Obamacare 'root and branch.'"

It would be difficult (and probably not very helpful) to report on every step in this mad dash to a vote. Rest assured that you will hear from us as soon as the dust settles enough to provide a glimpse of the way ahead.

Beth Umland
by Beth Umland

Director of Research, Health, Mercer

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