The Senate on Tuesday voted 51-50 to begin a debate on repealing the Affordable Care Act (ACA). This decision was reached despite Republican leaders not determining which version of the legislation they would be moving forward with at the debate’s onset. Sens. Susan Collins (R-ME), Lisa Murkowski (R-AK), and all Democrats voted against the motion, resulting in a 50-50 tie. Vice President Pence’s “yes” vote broke the tie and facilitated the necessary majority needed to proceed.
After several hours of debate on Tuesday, the Senate voted 43-57 against a modified version of the Better Care Reconciliation Act (BCRA), a bill designed to repeal and replace the ACA. The bill would have led to major provisions to current law, including substantially reducing Medicaid spending and revising ACA requirements for health insurance plans. Since the bill does not comply with major provisions of the Senate’s budget reconciliation rules, it needed 60 votes in order to pass. Nine GOP Senators—Collins, Bob Corker (TN), Tom Cotton (AR.), Lindsey Graham (SC), Dean Heller (NV), Mike Lee (AZ), Jerry Moran (KS), Murkowski, and Rand Paul (KY)—and all Democrats voted against the legislation.
On Wednesday the Senate rejected GOP leaders’ “repeal-and-delay” measure, a strategy that would have involved supporting H.R. 3762, the Restoring Americans’ Healthcare Freedom Reconciliation Act, a bill designed to immediately repeal parts of the Affordable Care Act (Act), and postponing development of new healthcare legislation. Seven GOP Senators—Collins, Heller, John McCain (AZ), Shelley Moore Capito (WV), Murkowski, and Rob Portman (OH)—joined all Democrats in voting against the measure.
On Friday morning the Senate voted 49-51 against the “skinny measure” (formerly called the Health Care Freedom Act). This measure called for substantial changes to existing legislation, including:
Immediately repealing the individual mandate and temporarily repealing the employer mandate
Increasing funding to community health centers by $422 million in 2017
Increasing the contribution limits of health savings accounts between 2018-2020
Revising an ACA provision that allows states to waive certain requirements of the health law
Collins, Murkowski, and all Democrats voted against the measure. The rejection of all three repeal efforts suggests that immediate health care reform is no longer available.