Senate fails to pass “skinny repeal” in early morning vote

Nearly two weeks ago, several Republican Senators announced their opposition to the Better Care Reconciliation Act, the Senate’s Affordable Care Act (ACA) repeal and replace bill. Their opposition meant that the Senate would not have the simple majority vote required to pass the bill, and the Republicans’ long promised effort to repeal and replace the ACA seemed to end.

 But then the President breathed new life into the effort by imploring Republicans to push forward. Republicans answered the President’s call and this week held a series of votes on healthcare reform. The first, and one of the most critical, was a procedural vote to move the repeal and replace bill to the Senate floor for the debate and amendment process.  This vote narrowly passed with Vice President Mike Pence casting the tie-breaking vote. And so began the Senate vote-a-rama where amendments failed to pass left and right.

The “skinny repeal”

From all of this chaos the “skinny repeal” bill emerged. This smaller bill would repeal the individual mandate, employer mandate and a few taxes of the ACA but would leave Medicaid untouched. Many Senators believed that this bill would garner enough support to pass the Senate and move to a conference committee in the House. There, House and Senate Republicans would come together to create a “better plan” that would ultimately become law.

The “skinny repeal” was never intended to become law in the form it was introduced to the floor. Several Senators, including Lindsey Graham (SC), John McCain (AZ), Ron Johnson (WI), and William Cassidy (LA) held a press conference stating the “skinny repeal” bill was not a good law and, in no scenario, did they intend for the bill to become the law of the land. They would only use the “skinny repeal” as a vehicle to move a health care bill to a conference committee so that a better plan could be created. 

The vote

The Senate began voting on the “skinny repeal” with this in mind and, in the early hours of the morning, Vice President Mike Pence made his way to the Senate in case he needed to cast a tie-breaking vote. It was an incredibly tight vote, but in the end the vote failed 49 to 51, with three Republican Senators voting against the bill.  Senator McCain cast the final no vote that sank the bill. 

The aftermath

After the failed vote, Senate Majority Leader Mitch McConnell addressed the Senate, and while he expressed his disappointment in their failure to repeal Obamacare, he suggested that it was time for Republicans to move on and address other agenda items.

President Trump tweeted that he would just let “ObamaCare implode.” 

Senate Minority Leader Chuck Schumer also addressed the Senate and suggested that they start tackling health care reform in a bipartisan manner. 

What's next?

It’s been less than 24 hours since the vote. The Republican’s failure to repeal and replace the ACA is still setting in for many.

But this is not the end of the health care debate in America. 

Both sides of the aisle agree that there are significant issues with American health care. If insurers continue to leave markets and increase premium rates, Republicans and Democrats might begin working together on legislation to stabilize health care.  Neither side wants to see the fallout of a destabilized market and the effects it would have on Americans. 

In the meantime, Republicans will likely move on to other agenda items such as tax reform and immigration policy. While some Republicans are urging for continued action on the repeal and replace effort, it’s unlikely that repeal and replace will happen this year.

The ACA remains the law of the land and individuals and employers need to acknowledge their compliance requirements under the ACA and take proactive steps to achieve compliance and reduce their risk of penalties. The health care conversations continue, but the ACA persists.