Wednesday, July 26, 2017

Senate passes motion to open debate on - what? Here's what's next in store for health care in the Senate.

Here is an outline of what to expect during the rest of this week - and maybe longer - from Sarah Kliff’s VoxCare email.

The Obamacare repeal debate has begun in the Senate. That’s about all we know for sure.

Senate Majority Leader Mitch McConnell has managed, after prospects looked dim again and again, to open debate on an Obamacare repeal plan. It’s a huge victory for Senate Republicans’ hopes of passing some kind of health care bill, and it puts health insurance for millions of Americans at risk. Every plan Republicans are considering is projected to lead to millions fewer Americans having health insurance.

But Republicans haven’t actually settled on what legislation they are trying to pass at the end of this debate. Bills to cleanly repeal much of Obamacare or to more fully repeal and replace the 2010 health care law don’t currently have the votes necessary to pass. In just the past few days, the idea of a much smaller bill, repealing just a few of Obamacare’s most unpopular provisions, surfaced.

That final destination must be sorted out in a mad rush over the next few days, with the Senate’s arcane budget rules and a vote-a-rama, which will open up Republicans to a flood of Democratic amendments designed to force tough votes that could make the process even more treacherous.

Senate Republicans scored a victory Tuesday. But the ultimate result is far from clear. Let’s break down how the next few days will look.

This is what will actually happen in the Senate over the next day or so

The Senate’s process from here is byzantine. The vote on Tuesday was technically to start debate on the House’s health care bill, but nobody expects that to be the actual legislation the Senate ultimately votes on.

This is what we expect to happen now, per Senate aides. Remember, timing and order are fluid. But this is a rough outline.

  • Two hours of debate on the clean (partial) Obamacare repeal bill.
  • Two hours of debate on the repeal-and-replace plan that Republicans have been working on since May.
  • Vote on the repeal-and-replace bill. Because of some last-minute changes to the legislation, it is expected to require 60 votes. That would demand Democratic support, which will never happen, so it looks likely fail.
  • Vote on clean (partial) repeal bill. It would need 51 votes, but it is expected to fail as well because too many Republicans are opposed to repealing without a replacement.
  • 20 hours of debate on the Senate floor. That is floor time, not real time, so those 20 hours could take a couple of days. Democrats and Republicans will take turns making speeches about health care. Democrats can use certain tactics — like asking for a full bill to be read out loud — to make the process more painful.
  • Vote-a-rama. This is a lengthy series of amendments offered by Republicans and Democrats to amend the bill. Amendments must be considered relevant to health care, and they need 51 votes to be approved. They would technically be amendments to the House bill, if the previous two Senate bills have already failed or not been voted on yet.
  • Final bill. McConnell will eventually offer a final substitute, encompassing the actual plan that Senate Republicans want to pass. This could be the “skinny repeal” plan that surfaced Tuesday morning.
  • Vote on passage. That needs 51 votes to pass. Vice President Mike Pence can break a 50–50 tie.

More to come. Stay tuned.

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