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Senate votes to open floor on ACA repeal


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On a strict party line vote, Senate Republicans this afternoon narrowly approved a procedural vote that would allow floor debate to begin, with the ultimate aim of repealing the Affordable Care Act.

The procedural vote narrowly pushed through, 51-50, with the help of Vice President Mike Pence, even though Republican leaders leading up to the vote couldn’t say exactly which version of the Better Care Reconciliation Act they were putting forward. And because no particular version of the bill has been specified by Senate Republican leaders, the Congressional Budget Office can’t score the effect of the proposal.

However, all previous attempts to repeal the ACA in both the House and Senate in the past three months have called for massive funding cuts that the CBO said would likely result in millions of people kicked off the Medicaid rolls, or priced out of individual markets for health insurance.

With majority Republicans voting “yes” on the motion to proceed, they now begin a period of debate, lasting up to 20 hours, on various amendments to the House version of the bill, which passed in May. After debate, they will begin a “vote-a-rama” — a period of successive votes on the offered amendments. Mitch McConnell, the majority leader, could introduce a substitute amendment that would replace all of the others. Finally, the legislation would move to a final vote. If it passes, the same version will have to be approved by the House before being sent to the president to sign.

Senate Republicans are considering passing a dramatically scaled-down version of their ObamaCare repeal bill as a way to pass something and set up negotiations with the House, according to GOP aides. The measure, known as a “skinny bill,” is intended to be something all Republicans can agree on, allowing something to pass and setting up a conference committee with the House.

A vote on final passage of a bill could then come as soon as Thursday, with the final legislative text made available only shortly before the vote — and without a full CBO analysis of the impact on coverage and on premiums and deductibles. Once again, congressional leaders may promise that the bill has been “fixed” — with the information needed to assess that claim not available until after the vote.
   
An amendment to the GOP’s health bill could lead to higher premiums for sick people and lower premiums for healthy people, a new analysis released Tuesday shows. Sen. Ted Cruz‘s (R-Texas) “Consumer Freedom Amendment” would allow insurers to sell plans that don’t comply with ObamaCare regulations, as long as they also sell plans that do meet those requirements.

On July 21, the Senate Parliamentarian ruled that several provisions of the BCRA, as currently written, were in violation of the Byrd Rule and could be stricken from the bill if requested by a point of order from a member of the Senate.