On Tuesday the Senate voted on the Motion to Proceed to H.R. 1628. Essentially they were voting to allow the Senate to debate and vote on the House’s American Health Care Act of 2017. The initial vote to proceed passed with a tie.
Vote Count on Motion to Proceed
Due to the tie, Vice President Mike Pence cast a tie breaking vote and the motion was passed 51 to 50. What this vote did was give the Senate the ability to debate for 20 hours (10 hours for Democrats and 10 hours for Republicans) and offer up amendments for budget reconciliation.
Now let’s take a quick walk into the forest of reconciliation and something called the Byrd Rule. Most bills require a 60 vote majority in the Senate to pass without a filibuster. In the case of budget changes there is a way for Congress to expedite the passage of bills with only have a 51 vote majority. However, the Byrd Rule sets rules that basically states no legislative changes are allowed into reconciliation bills if they do not affect the federal budget. What has happened is that after the Better Care Reconciliation Act that was released on June 26th the Senate Budget Committee asked the current Parliamentarian of the United States Senate to see if there were any items in the BCRA that would not qualify for being in the reconciliation bill. Her response was that at least 11 items needed to have a 60 vote majority to pass.
The 11 items from the first check of the bill were:
- Defunding Planned Parenthood
- Abortion Restrictions for Tax Credits
- Sunset of Essential Health Benefits Requirement for Medicaid
- Funding for Cost-Sharing Subsidies
- Stabilizing the Individual Insurance Markets (“Six Month Lock Out”)
- Medical Loss Ratio
- Availability of Rollover Funds
- Decrease in Target Expenditures for Required Expenditures by Certain Political Subdivisions (“Buffalo Bailout”)
- Grandfathering Certain Medicaid Waivers; Prioritization of HCBS Waivers
- Reporting of CMS-64 Data (T-MSIS)
- Coordination with States
That leads to the first vote that the Republicans attempted to pass about seven hours after the first vote. Basically, the only way for them to pass the BCRA using reconciliation would be to vote to ignore the fact that the Parliamentarian said it shouldn’t be passed with only 51 votes and do it anyhow. The first vote was A Motion to Waive All Applicable Budgetary Discipline which included the text from a revised Better Care Reconciliation Act (Which we’ve talked about here) and Ted Cruz’s Consumer Freedom Plan amendment.
Vote Count on Whether to Ignore that 60 votes are needed to actually repeal and replace
The vote needed 60 votes and ended up only getting 43 so it failed.
On Wednesday the Republicans were ready to try again. This time with a vote on an amendment by Rand Paul named the Obamacare Repeal Reconciliation Act of 2017. This bill would have repealed the ACA but not until 2020. The reasoning behind waiting until 2020 is so Republicans would have time between now and then to come up with a plan to replace it. The CBO also came up with a summary that can be read here.
Vote Count ON PAUL Amendment 271 (“Kicking the can” for a 2020 repeal)
Paul amendment 271 failed which brings us to the last item which is the Vote-a-Rama.
The Vote-a-Rama is when all of the amendments are voted on without debate. We will see what amendments get voted on but the main one that keeps getting talked about is the Skinny Repeal. At this point we do not know exactly what the Skinny Repeal will entail but from the information released so far it appears that it will likely be keeping the current Affordable Care Act but just removing the individual and employer mandates. Essentially making an Obamacare Lite that can not pay for itself.
The main draw of the Skinny Repeal appears to be that it will garner enough votes from both moderate and conservative Republicans to allow the bill to go to a conference committee where then the House and the Senate will make changes until both agree on the same bill and the final draft is sent to President Trump to be signed.
Thursday and Friday will see a whirlwind of action most likely while everyone waits to see if the Senate can get something passed to start the final process.