Skip to main content

The context you need, when you need it

When news breaks, you need to understand what actually matters — and what to do about it. At Vox, our mission to help you make sense of the world has never been more vital. But we can’t do it on our own.

We rely on readers like you to fund our journalism. Will you support our work and become a Vox Member today?

Join now

The latest vote to repeal Obamacare fails in the Senate

But the debate lives on.

Dylan Scott
Dylan Scott covers health for Vox, guiding readers through the emerging opportunities and challenges in improving our health. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo, and STAT before joining Vox in 2017.

The Senate failed Wednesday to advance a bill that would have partially repealed Obamacare without replacing it, another step in the Senate health care debate that is likely heading toward a much more scaled-down bill.

It was the second defeat for the biggest Republican promises to uproot the 2010 health care law. On Tuesday night, the Senate’s repeal-and-replacement bill, the Better Care Reconciliation Act, failed on a procedural vote, with nine Republicans opposing it.

On Wednesday afternoon, a cleaner repeal bill, the Obamacare Repeal Reconciliation Act, also failed, 45 to 55, with seven Republicans and all Democrats voting to block it.

The legislation would have repealed Obamacare’s spending on insurance coverage and its taxes on the wealthy and health care industries; it would not have included any new provisions to replace the law. The projected outcome, according to the Congressional Budget Office, would have been 32 million fewer Americans with health insurance 10 years from now without such a replacement.

Conservatives, led by Sen. Rand Paul (R-KY), had pushed for a vote on a clean repeal bill, and now they’ve gotten it. It is clear that repealing Obamacare without replacing it is not a viable option, even as Republicans now control all the levers of government. A repeal-and-replace plan also looks significantly short on support, after Tuesday’s votes.

Neither result would be a surprise. Health care lobbyists and Senate aides believe the most likely destination is a skinny Obamacare repeal bill that undoes the individual mandate, the employer mandate, and a few of the law’s taxes. The text of that legislation has not yet been released or scored by the Congressional Budget Office.

The Senate health care debate is still ongoing, though

Debate will continue through Wednesday and into Thursday on the House health care bill, which is technically the bill that Republican senators voted to take up Tuesday.

Here’s what is still to come.

  • Vote Wednesday afternoon on a Democratic motion to send health care to the committees.
  • The rest of the 20 hours of debate on the Senate floor. That’s 20 hours on the Senate floor, not 20 hours in the rest of the world, so those 20 hours could take a couple of days if senators pause for breaks. 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. Some of that time has been consumed by the debates on the ORRA and BCRA.
  • Vote-a-rama. There will then be what’s called vote-a-rama — quick up-or-down votes on whatever amendments Republicans and Democrats offer on 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. Democrats plan to use this time to force Republicans to take votes on politically unpopular measures, even if those amendments have little chance of making it into the final bill.
  • Final bill. McConnell will eventually offer a final substitute, encompassing the actual plan that Senate Republicans want to pass. This could be the so-called “skinny repeal” bill that surfaced Tuesday morning.
  • Vote on passage. That needs 51 votes to pass. Vice President Mike Pence can break a 50-50 tie.

More in Politics

Podcasts
The Supreme Court abortion pills case, explainedThe Supreme Court abortion pills case, explained
Podcast
Podcasts

How Louisiana brought mifepristone back to SCOTUS.

By Peter Balonon-Rosen and Sean Rameswaram
Politics
Trump’s China policy is nearly the exact opposite of what everyone expectedTrump’s China policy is nearly the exact opposite of what everyone expected
Politics

As Trump heads to China, attention and resources are being shifted from Asia to yet another war in the Middle East.

By Joshua Keating
Politics
Are far-right politics just the new normal?Are far-right politics just the new normal?
Politics

Liberals are preparing for a longer war with right-wing populists than they once expected.

By Zack Beauchamp
The Logoff
Flavored vapes doomed Trump’s FDA headFlavored vapes doomed Trump’s FDA head
The Logoff

Why Marty Makary is out at the FDA, briefly explained.

By Cameron Peters
Politics
Virginia Democrats’ irresponsible new plan to save their gerrymanderVirginia Democrats’ irresponsible new plan to save their gerrymander
Politics

Democrats just handed the Supreme Court’s Republicans a loaded weapon.

By Ian Millhiser
The Logoff
Can Trump lower gas prices?Can Trump lower gas prices?
The Logoff

What suspending the gas tax would mean for you, briefly explained.

By Cameron Peters