WASHINGTON — With Vice President Mike Pence breaking a 50-50 tie, the Senate voted by a hair Tuesday to start debating Republican legislation to tear down much of the Obama health care law.
The 51-50 vote kept alive hopes of delivering on promises that countless Republican candidates have campaigned on for years — repealing President Barack Obama's 2010 health care overhaul. But the party is divided between fervent conservatives demanding the evisceration of Obama's statute and centrists intent on not pulling coverage away from millions of Americans.
Pence presided over the Senate during the vote, which began after dozens of protesters shouted "Kill the bill" and "Shame" from the chamber's visitors' gallery.
One pivotal "yes" vote was cast by Sen. John McCain, R-Ariz., who flew to the Capitol just days after revealing he'd been diagnosed with brain cancer and was home considering the next steps in his treatment. With Republicans wielding a narrow 52-48 majority, the 80-year-old's appearance let Senate Majority Leader Mitch McConnell, R-Ky., lose two GOP senators and still prevail — wiggle room that would have shrunk to just one in McCain's absence.
McCain entered the chamber 29 minutes into the roll call to a standing ovation from members of both parties and visitors watching from above. Smiling, he exchanged embraces with McConnell, Senate Minority Leader Chuck Schumer, D-N.Y., and others, then cast his "yes" vote with two thumbs up.
Both of Arkansas' senators voted to open debate.
“This vote is the first step toward solving the problems created by Obamacare," Sen. Tom Cotton said in a statement. "It's important we get this right, so that we create a health-care system that works for Arkansans.”
Sen. John Boozman agreed that "much work remains to be done." In a statement, he said: "This vote signals to the American people that we remain committed to repairing our health care system by putting into place a system that ensures access to affordable, quality care for every American.”
Before the vote, McConnell declared, "We can't let this moment slip by," essentially lecturing GOP lawmakers to give their party's high-profile legislation a chance to move forward. "We can't let it slip by. We've been talking about it too long."
Moderate Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska, were the only Republicans to defect from their party's quest. Their complaints about the legislation had included its cuts in Medicaid, the health insurance program for the poor, the disabled and nursing home residents.
Not a single Democrat backed the effort to overthrow Obama's signature domestic legislative achievement. In an unusual move, most of them sat in their states during the climactic roll call.
Technically, Tuesday's vote meant the Senate would consider a measure the House approved in May eliminating much of Obama's statute. Like legislation McConnell crafted mostly privately — and has since revised — it would eliminate Obama's tax penalties on people not buying policies, cut Medicaid, erase many of the law's tax boosts and provide less generous health care subsidies for consumers.
But now, the Senate faces 20 hours of debate and a long parade of amendments. Because the chamber's moderates and conservatives are so riven over how to replace Obama's overhaul, leaders have discussed passing a narrow bill repealing only some unpopular parts of that law — like its penalties on individuals who eschew coverage — with the ultimate goal being to negotiate a final package with the House.
In the moments before the vote, most GOP critics of the legislation fell into line to allow debate to begin. They included conservative Sens. Rand Paul of Kentucky and Mike Lee of Utah, plus moderates Rob Portman of Ohio and Shelley Moore Capito of West Virginia.
Paul said he was voting yes after McConnell told him the Senate would debate his proposal to scuttle much of Obama's law and give Congress two years to enact a replacement — an amendment that seemed certain to lose.
Trump kept up the pressure on GOP lawmakers, tweeting that "After 7 years of talking, we will soon see whether or not Republicans are willing to step up to the plate!" He added: "ObamaCare is torturing the American People. The Democrats have fooled the people long enough. Repeal or Repeal & Replace! I have pen in hand."
McConnell's bill would abolish much of Obama's law, eliminating its tax penalties on people not buying policies, cutting Medicaid, eliminating its tax boosts on medical companies and providing less generous health care subsidies for consumers. But at least a dozen GOP senators have openly said they oppose or criticized the measure, which McConnell has revised as he's hunted Republican support.
Besides allowing an early vote on Paul's repeal plan, moderates were seeking additional money for states that would be hurt by cuts in Medicaid, the health insurance program for the poor, the disabled and nursing home patients. Conservatives wanted a vote on a proposal by Ted Cruz, R-Texas, letting insurers offer bare-bones policies with low premiums, which would be illegal under Obama's law.
Read Wednesday's Arkansas Democrat-Gazette for full details.