Republicans have found it difficult to fulfill their campaign promises to repeal Obamacare, which enabled 20 million more Americans to get health insurance.
Polls show Obamacare is now far more popular than the Republican alternatives. The nonpartisan Congressional Budget Office has estimated the Senate’s replacement bill could lead to as many as 22 million fewer Americans being insured.
The health industry has watched the debate nervously, and after the vote some groups urged the Senate to reconsider its approach.
America’s Essential Hospitals, a group representing safety-net hospitals, said in a statement it strongly opposed all the Republican plans and feared the big cuts in Medicaid in the bills “would jeopardize the health and financial security of millions of working people and families.”
Shares in health insurer Centene Corp turned sharply lower after the Senate vote. Earlier on Tuesday, the company had reported a better than expected profit as it benefits from a strong Obamacare business.
‘KILL THE BILL’
As the debate vote opened, more than two dozen protesters in the Senate chamber chanted “kill the bill” before they were removed.
Senators said several approaches have been discussed, including a straight repeal of Obamacare with no replacement plan, or repealing and replacing the law while also overhauling Medicaid.
Senate Republicans also could consider a shortened version of repeal, called a “skinny repeal,” which would end the mandates in Obamacare on individuals and employers to obtain or provide health insurance, and a medical device tax, a Senate aide and a lobbyist said.
“Some of us want clean repeal, some of us want the Senate leadership bill, they’re both going to get a vote early on and I think that’s a fair way to do it,” Republican Senator Rand Paul said. “If either one of them fails and another one succeeds, maybe we can find something in between that actually succeeds.”
Republican Senator Bob Corker said the goal was to gain enough votes to get a bill through the Senate and send it to the House of Representatives, which passed its own bill to replace Obamacare in May, for negotiations.
“Everybody understands this is just a first step,” he said.
Several of the Democrats opposing the motion for debate were from conservative states that backed Trump in 2016 and face tough re-election bids next year, including Senators Joe Manchin of West Virginia, Heidi Heitkamp of North Dakota and Jon Tester of Montana.
“We have a good chance to beat this,” Senate Democratic Leader Chuck Schumer told reporters after the vote.
Dick Durbin, the No. 2 Senate Democrat, praised Collins and Murkowski for taking a principled stand against the Republican move to open debate.
“That wasn’t easy,” Durbin said. “That was an act of political courage on their part; I’m sure they were under tremendous pressure.”
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