Double blow convulses Republican bid to reform U.S. health care

Senate Majority Leader Mitch Mc Connell arrives at the U.S. Capitol

The vote on the repeal-only measure showed the changing political dynamics that Republicans have grappled with this year on health care.

Murkowski and Sen. Susan Collins of ME were the only two GOP senators to vote against a procedural vote backed by Senate Majority Leader Mitch McConnell Tuesday afternoon.

Almost 100 people were arrested throughout the day as the Senate opened debate on the Republicans' plans to repeal and maybe replace Obamacare.

So, as lawmakers resume debate on Thursday, they will be staring at basically one possibility: a so-called "skinny repeal" that would surgically remove some key provisions from Obamacare, while leaving the rest intact - at least for now. But it would also have kept in place certain insurance-market reforms, including a requirement for insurers to guarantee coverage for pre-existing conditions.

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The goal for Majority Leader Mitch McConnell at the moment is to find a way to get 50 Republicans to back a final bill - whatever it looks like.

Conservatives generally want a complete repeal of Obamacare's taxes and regulations while moderates worry that ending the law's Medicaid expansion will leave struggling Americans with no way to afford medical coverage. We all knew repealing Obamacare would be hard, but the simple fact remains: The time is now for Republicans to act on health care, even if they have to do it by taking small steps at a time. Rand Paul (R-Ky.) that would have repealed most of Obamacare and given Congress two years to come up with a replacement plan. But now, with President Donald Trump sitting in the Oval Office and itching to sign it, Republican senators demonstrated they didn't have the stomach to go through with passing a measure that would end insurance coverage for more than 30 million Americans over a decade, according to the Congressional Budget Office. This vote to consider a bill that kicks more than 20 million people off of their health care is utterly shameful but we can not throw up our hands when it is time to roll up our sleeves.

The Senate parliamentarian, however, advised last week that the waiting period doesn't comply with the Senate rules for passing the bill with a simple majority. Then they would attempt to hammer out a more comprehensive repeal and replace proposal in the conference with the House. Under the complex rules governing how the legislation is being considered, the debate will culminate at some point Thursday afternoon or evening in a freakish exercise called a "vote-a-rama" during which unlimited amendments can be offered by all sides in rapid succession.

The Blue Cross Blue Shield Association warned Wednesday that repealing, or eliminating the Obamacare mandate that everyone purchase insurance would have dire consequences.

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All but two Republicans in the Senate voted in favor of open debate, with all Democrats opposing the vote.

As with the full repeal without immediate replacement vote, the GOP leadership is getting a sense of where their members are on various proposals, as well as testing out revised language with the parliamentarian on things like the Planned Parenthood defunding provision.

Once the repeal-only bill is on the floor, it could be amended "in various ways", Barrasso said, including changing it to a repeal-and-replace bill. Fifty to 50, two senators, both women, joining the - two Republican senators joining the Democrats voting against opening debate, but, ultimately, Vice President Pence broke the tie, and they are moving forward today. Under today's proposal, the individual and employer mandates would be repealed, the Medicaid expansion and federal subsidies would be ended, and numerous law's taxes would be rolled back.

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