WASHINGTON -- Senate Republicans took their first major step toward repealing the Patient Protection and Affordable Care Act on Thursday, approving a budget blueprint that would allow them to gut the health care law without the threat of a Democratic filibuster.
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The vote was 51-48. During the roll call, Democrats staged a protest on the Senate floor to express their dismay at the prospect that millions of Americans could lose health insurance coverage.
One by one, Democrats rose to voice their objections. Sen. Maria Cantwell of Washington said Republicans were "stealing health care from Americans." Sen. Ron Wyden of Oregon said he was voting no "because health care should not just be for the healthy and wealthy."
The presiding officer, Sen. Cory Gardner, R-Colo., repeatedly banged his gavel and said the Democrats were out of order because "debate is not allowed during a vote."
The final vote, which ended just before 1:30 a.m. in Washington, followed a marathon session in which senators took back-to-back roll call votes on numerous amendments, an arduous exercise known as a vote-a-rama.
The approval of the budget blueprint, coming before President-elect Donald Trump is inaugurated, shows the speed with which Republican leaders are moving to fulfill their promise to repeal President Barack Obama's signature domestic policy achievement -- a goal they believe can now be accomplished after Trump's election.
The action by the Senate is essentially procedural, setting the stage for a special kind of legislation called a reconciliation bill. Such a bill can be used to repeal significant parts of the health law and is immune from being filibustered. Congress appears to be at least weeks away from voting on legislation repealing the law.
Trump took to Twitter to praise the development: "Congrats to the Senate for taking the first step to #RepealObamacare -- now it's onto the House!"
The Affordable Care Act is often called "Obamacare" by both supporters and opponents of the law.
Republicans say the 2016 elections gave them a mandate to roll back the health care law. "The Obamacare bridge is collapsing, and we're sending in a rescue team," said Sen. Michael Enzi, R-Wyo., and the chairman of the Senate Budget Committee. "Then we'll build new bridges to better health care, and finally, when these new bridges are finished, we'll close the old bridge."
Republican leaders say they will work closely with Trump to develop legislation to repeal and replace the health care law, but it is unclear exactly how his team will participate in that effort.
On Wednesday, Trump said he would offer his own plan to repeal and replace the law "essentially simultaneously." He said he would put forth the plan as soon as his nominee for secretary of health and human services, Rep. Tom Price, R-Ga., is confirmed.
More than 20 million people have gained coverage under the Affordable Care Act, though premiums have risen sharply in many states, and some insurers have fled the law's health exchanges.
The budget blueprint instructs House and Senate committees to come up with repeal legislation by Jan. 27.
Sen. Bob Corker, R-Tenn., and four other Republicans had sought to extend that deadline by five weeks, to March 3. But late Wednesday, Corker withdrew an amendment that would have changed the date.
"We understand that everyone here understands the importance of doing it right," he said. He described the Jan. 27 date in the budget blueprint as a place-holder.
Sen. Rob Portman of Ohio, another Republican who sought to delay the deadline, said, "This date is not a date that is set in stone. In fact, it is the earliest we could do it. But it could take longer, and we believe that it might."
The House was planning to take up the budget blueprint once the Senate approved it, though some House Republicans have expressed discomfort with voting on the blueprint this week because of lingering questions over how and when the health care law would be replaced.
A vote on the measure in the House could come today.
"We have a responsibility to step in and provide relief from this failing law," Speaker Paul Ryan, R-Wis., told reporters Thursday. "And we have to do it all at the same time so that everybody sees what we're trying to do."
In its lengthy series of votes, the Senate rejected amendments proposed by Democrats that were intended to allow imports of prescription drugs from Canada, protect rural hospitals and ensure continued access to coverage for people with pre-existing conditions, among other causes.
In the parlance of Capitol Hill, many of the Democrats' proposals were "messaging amendments," intended to put Republicans on record as opposing popular provisions of the Affordable Care Act. The budget blueprint is for the guidance of Congress; it is not presented to the president for a signature or veto and does not become law.
Republicans do not have an agreement among themselves on the content of legislation to replace the Affordable Care Act, the timetable for votes on such legislation or its effective date.
Sen. Susan Collins, R-Maine, said Wednesday that she agreed with Trump that Congress should repeal the health law and adopt a replacement plan at about the same time.
"But I don't see any possibility of our being able to come up with a comprehensive reform bill that would replace Obamacare by the end of this month," she said. "I just don't see that as being feasible."
Collins also supported pushing back the deadline to come up with repeal legislation.
As Republicans pursue repealing the law, Democrats contend that Republicans are trying to rip insurance away from millions of Americans with no idea of what to do next.
The Senate Democratic leader, Charles Schumer of New York, called the Republicans' repeal plan "irresponsible and rushed" and urged them to halt their push to unravel the law.
"Don't put chaos in place of affordable care," he said.
Separately, Sen. Bernie Sanders, I-Vt., whose Democratic run for White House last year struck a chord with young people and the party's progressive wing, has teamed up with top Democratic leaders to organize about 50 rallies this weekend to trumpet support for the law.
"A good, strong political party needs obviously an inside-the-Beltway strategy, but it also needs an outside-the-Beltway strategy," Sanders said. "There are very few people who will tell you that the Democrats have done a good job in terms of an outside strategy, in terms of standing up with working families and the middle class and lower-income people."
Information for this article was contributed by Thomas Kaplan and Robert Pear of The New York Times and by Andrew Taylor of The Associated Press.
A Section on 01/13/2017