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Senate Health Care Decision: Pence Breaks Senate Tie | Senate Health Care Decision: Pence Breaks Senate Tie |
(35 minutes later) | |
Right Now: The G.O.P. health effort narrowly advanced after Vice President Mike Pence broke a Senate tie. Here’s the latest. | Right Now: The G.O.P. health effort narrowly advanced after Vice President Mike Pence broke a Senate tie. Here’s the latest. |
• The Senate vote will allow debate to begin on repealing and replacing the Affordable Care Act. | • The Senate vote will allow debate to begin on repealing and replacing the Affordable Care Act. |
• Senator John McCain arrived at the Capitol, despite a diagnosis of brain cancer, to vote to begin debating legislation to repeal the Affordable Care Act. | • Senator John McCain arrived at the Capitol, despite a diagnosis of brain cancer, to vote to begin debating legislation to repeal the Affordable Care Act. |
President Trump, appearing with Prime Minister Saad Hariri of Lebanon at a news conference in the Rose Garden, commended the Senate for advancing the health care debate while scolding the two Republicans — Senators Susan Collins of Maine and Lisa Murkowski of Alaska — who voted against the motion to proceed. | |
“We had two Republicans that went against us, which is very sad, I think. It’s very, very sad for them,” Mr. Trump said. “But I’m very, very happy with the result.” | |
Senators Shelley Moore Capito of West Virginia, Dean Heller of Nevada and Rob Portman of Ohio, three Republicans who have expressed profound doubts about legislation to repeal and replace the Affordable Care Act, announced Tuesday they will vote to begin debate on the future of health care. | Senators Shelley Moore Capito of West Virginia, Dean Heller of Nevada and Rob Portman of Ohio, three Republicans who have expressed profound doubts about legislation to repeal and replace the Affordable Care Act, announced Tuesday they will vote to begin debate on the future of health care. |
“Obamacare isn’t the answer, but doing nothing to try to solve the problems it has created isn’t the answer either. That is why I will vote to move forward and give us a chance to address the unworkable aspects of the law that have left many Nevadans — particularly those living in rural areas — with dwindling or no choices,” Mr. Heller said. | “Obamacare isn’t the answer, but doing nothing to try to solve the problems it has created isn’t the answer either. That is why I will vote to move forward and give us a chance to address the unworkable aspects of the law that have left many Nevadans — particularly those living in rural areas — with dwindling or no choices,” Mr. Heller said. |
Ms. Capito said in a statement, “As this process advances on the Senate floor, I will continue to make decisions that are in the best interest of West Virginians. I remain committed to reforming our health care system while also addressing the concerns I have voiced for months. I will continue to push for policies that result in affordable health care coverage for West Virginians, including those who are in the Medicaid population and those struggling with drug addiction.” | Ms. Capito said in a statement, “As this process advances on the Senate floor, I will continue to make decisions that are in the best interest of West Virginians. I remain committed to reforming our health care system while also addressing the concerns I have voiced for months. I will continue to push for policies that result in affordable health care coverage for West Virginians, including those who are in the Medicaid population and those struggling with drug addiction.” |
Mr. Portman informed his state’s governor, John Kasich, that he too would vote on a procedural motion to take up a repeal bill. | Mr. Portman informed his state’s governor, John Kasich, that he too would vote on a procedural motion to take up a repeal bill. |
The votes — coupled with Senator John McCain’s arrival — put Republican leaders and President Trump close to the 50 they need to move the process forward. | The votes — coupled with Senator John McCain’s arrival — put Republican leaders and President Trump close to the 50 they need to move the process forward. |
But that doesn’t mean a bill will ultimately pass. Mr. Heller warned, “If the final product isn’t improved for the state of Nevada, then I will not vote for it.” | But that doesn’t mean a bill will ultimately pass. Mr. Heller warned, “If the final product isn’t improved for the state of Nevada, then I will not vote for it.” |
Senator McCain, Republican of Arizona, arrived at the Capitol, despite a diagnosis of brain cancer, to cast his vote on whether to begin debating legislation to repeal the Affordable Care Act. | Senator McCain, Republican of Arizona, arrived at the Capitol, despite a diagnosis of brain cancer, to cast his vote on whether to begin debating legislation to repeal the Affordable Care Act. |
After seven months of strategizing, debate and closed-door meetings, the Senate finally is voting. Senate Republican leaders can afford to lose only two Republicans. One is almost certainly gone, Senator Susan Collins of Maine. Senator Lisa Murkowski of Alaska is still on the fence, but leaders think they can win her over. Senator Rand Paul of Kentucky, one of the most vocal opponents of the Republican bill to replace the health care law, now appears ready to at least debate it. | After seven months of strategizing, debate and closed-door meetings, the Senate finally is voting. Senate Republican leaders can afford to lose only two Republicans. One is almost certainly gone, Senator Susan Collins of Maine. Senator Lisa Murkowski of Alaska is still on the fence, but leaders think they can win her over. Senator Rand Paul of Kentucky, one of the most vocal opponents of the Republican bill to replace the health care law, now appears ready to at least debate it. |
If the motion to begin debate passes, the first vote will be on legislation to repeal the Affordable Care Act without a replacement. That is likely to fail, and would be followed by a vote on the Senate Republican bill to replace the health law. | If the motion to begin debate passes, the first vote will be on legislation to repeal the Affordable Care Act without a replacement. That is likely to fail, and would be followed by a vote on the Senate Republican bill to replace the health law. |
If that also fails, Senate leaders may fall back on a narrow bill that repeals the Affordable Care Act’s mandate that nearly everyone have health insurance, a separate mandate that most employers offer their employees health insurance and a repeal of the medical device tax. | If that also fails, Senate leaders may fall back on a narrow bill that repeals the Affordable Care Act’s mandate that nearly everyone have health insurance, a separate mandate that most employers offer their employees health insurance and a repeal of the medical device tax. |
The goal of that would be to simply get senators to negotiations with the House on a final repeal measure. | The goal of that would be to simply get senators to negotiations with the House on a final repeal measure. |
The Senate moved toward a showdown Tuesday afternoon on whether to begin debate on legislation to repeal the Affordable Care Act — and President Trump kept up a drumbeat on Twitter to force a yes vote. | The Senate moved toward a showdown Tuesday afternoon on whether to begin debate on legislation to repeal the Affordable Care Act — and President Trump kept up a drumbeat on Twitter to force a yes vote. |
That missive came after a stream of other Twitter posts intended to cajole, pressure and badger Senate Republicans, 50 of whom he needs just to start the debate on his promise to repeal former President Barack Obama’s signature domestic policy achievement. | That missive came after a stream of other Twitter posts intended to cajole, pressure and badger Senate Republicans, 50 of whom he needs just to start the debate on his promise to repeal former President Barack Obama’s signature domestic policy achievement. |
And a man who has never apologized for questioning Senator McCain’s heroism in Vietnam was suddenly very appreciative of his decision to fly in from Arizona after his brain cancer diagnosis to cast a vote. | And a man who has never apologized for questioning Senator McCain’s heroism in Vietnam was suddenly very appreciative of his decision to fly in from Arizona after his brain cancer diagnosis to cast a vote. |
Centene, one of the largest health insurers offering coverage under the Affordable Care Act, continues to defy the Republican talking point that the individual market is collapsing. One of the rare insurers that increased its bet on the marketplaces as many of its competitors exited, the company reported higher quarterly profits on Tuesday. | Centene, one of the largest health insurers offering coverage under the Affordable Care Act, continues to defy the Republican talking point that the individual market is collapsing. One of the rare insurers that increased its bet on the marketplaces as many of its competitors exited, the company reported higher quarterly profits on Tuesday. |
“The marketplace business continues to be particularly strong, confirming our business-as-usual approach,” said Centene’s chief executive, Michael F. Neidorff, in a statement. The company said it expected the business to remain strong for the rest of 2017. | “The marketplace business continues to be particularly strong, confirming our business-as-usual approach,” said Centene’s chief executive, Michael F. Neidorff, in a statement. The company said it expected the business to remain strong for the rest of 2017. |
The company reported significantly higher net earnings of $254 million for the three months ended June 30, compared to $170 million for the same quarter of 2016. Revenue climbed to $12 billion for the quarter, an increase from $11 billion. | The company reported significantly higher net earnings of $254 million for the three months ended June 30, compared to $170 million for the same quarter of 2016. Revenue climbed to $12 billion for the quarter, an increase from $11 billion. |
The insurer, which has traditionally served low-income individuals who are eligible for Medicaid, covers 1.1 million people in the marketplaces. Centene, based in St. Louis, has also benefited from the Medicaid expansion, adding an additional 1.1 million members. | The insurer, which has traditionally served low-income individuals who are eligible for Medicaid, covers 1.1 million people in the marketplaces. Centene, based in St. Louis, has also benefited from the Medicaid expansion, adding an additional 1.1 million members. |
In a call with investors, Mr. Neidorff acknowledged “the headline noise” surrounding the various Republican proposals to replace the Affordable Care Act. He said the company was working closely with state and federal officials to try to stabilize the individual market. “It is a moving target with a long way to play out,” he said. | In a call with investors, Mr. Neidorff acknowledged “the headline noise” surrounding the various Republican proposals to replace the Affordable Care Act. He said the company was working closely with state and federal officials to try to stabilize the individual market. “It is a moving target with a long way to play out,” he said. |
Mr. Neidorff also emphasized the importance of government funding for subsidies to low-income people, saying the failure to provide them will only hurt the people who need them. President Trump has repeatedly threatened to end those subsidies. “The leaders in Washington bear a responsibility to ensure that doesn’t happen,” he said. | Mr. Neidorff also emphasized the importance of government funding for subsidies to low-income people, saying the failure to provide them will only hurt the people who need them. President Trump has repeatedly threatened to end those subsidies. “The leaders in Washington bear a responsibility to ensure that doesn’t happen,” he said. |
For years, Republicans have promised to repeal and replace the Affordable Care Act, which was President Barack Obama’s signature domestic achievement. But they have struggled to find a consensus on how, exactly, to go about dismantling the law and installing a replacement. | For years, Republicans have promised to repeal and replace the Affordable Care Act, which was President Barack Obama’s signature domestic achievement. But they have struggled to find a consensus on how, exactly, to go about dismantling the law and installing a replacement. |
The Senate majority leader, Mitch McConnell of Kentucky, says it is time for a vote. | The Senate majority leader, Mitch McConnell of Kentucky, says it is time for a vote. |
On Tuesday, he will have the Senate vote on a motion to proceed — in this case, on whether to take up a health care repeal bill that narrowly passed the House in May. | On Tuesday, he will have the Senate vote on a motion to proceed — in this case, on whether to take up a health care repeal bill that narrowly passed the House in May. |
Nobody expects that bill to become law. Instead, it would essentially serve as the vehicle for the Senate’s legislation. The House bill’s text would be swapped out for the Senate’s preferred language, whatever that ultimately is. | Nobody expects that bill to become law. Instead, it would essentially serve as the vehicle for the Senate’s legislation. The House bill’s text would be swapped out for the Senate’s preferred language, whatever that ultimately is. |
Republicans hold 52 seats in the Senate, and to be successful, they need a majority for the motion to proceed. In a deadlock, Vice President Mike Pence would break the tie in favor of proceeding. | Republicans hold 52 seats in the Senate, and to be successful, they need a majority for the motion to proceed. In a deadlock, Vice President Mike Pence would break the tie in favor of proceeding. |
Only days after announcing he has brain cancer, Senator John McCain, Republican of Arizona, plans to return to the Senate on Tuesday. His presence means Mr. McConnell can afford for two Republicans to vote against the motion. If Mr. McCain had been absent, Mr. McConnell would have been able to lose only a single Republican. | Only days after announcing he has brain cancer, Senator John McCain, Republican of Arizona, plans to return to the Senate on Tuesday. His presence means Mr. McConnell can afford for two Republicans to vote against the motion. If Mr. McCain had been absent, Mr. McConnell would have been able to lose only a single Republican. |
At least one defection is all but certain: Senator Susan Collins of Maine indicated on Monday that she would vote against proceeding in just about every imaginable circumstance. | At least one defection is all but certain: Senator Susan Collins of Maine indicated on Monday that she would vote against proceeding in just about every imaginable circumstance. |
One big factor is what Mr. McConnell plans to do after the procedural vote. | One big factor is what Mr. McConnell plans to do after the procedural vote. |
For example, Senator Rand Paul of Kentucky is an expected “no” vote if after clearing the procedural hurdle, the Senate turns to a bill by Mr. McConnell to repeal and replace the health law. Mr. Paul detests that bill. | For example, Senator Rand Paul of Kentucky is an expected “no” vote if after clearing the procedural hurdle, the Senate turns to a bill by Mr. McConnell to repeal and replace the health law. Mr. Paul detests that bill. |
On the other hand, Senators Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska indicated last week that they would not vote to proceed if Mr. McConnell afterward scheduled a vote on a bill to repeal the health law without providing a replacement. | On the other hand, Senators Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska indicated last week that they would not vote to proceed if Mr. McConnell afterward scheduled a vote on a bill to repeal the health law without providing a replacement. |
In addition, a number of other Republican senators have expressed varying qualms, with varying degrees of certitude. They include Mike Lee of Utah, Jerry Moran of Kansas, Rob Portman of Ohio and Dean Heller of Nevada. | In addition, a number of other Republican senators have expressed varying qualms, with varying degrees of certitude. They include Mike Lee of Utah, Jerry Moran of Kansas, Rob Portman of Ohio and Dean Heller of Nevada. |
Such a vote would start the debate in the Senate on health care. At some point, Mr. McConnell is expected to offer an amendment that would substitute a new measure for the text of the bill that passed the House. But it remains to be seen what that new measure would be. Republicans are trying to pass the bill using special budget rules that limit debate to 20 hours and prevent a Democratic filibuster. | Such a vote would start the debate in the Senate on health care. At some point, Mr. McConnell is expected to offer an amendment that would substitute a new measure for the text of the bill that passed the House. But it remains to be seen what that new measure would be. Republicans are trying to pass the bill using special budget rules that limit debate to 20 hours and prevent a Democratic filibuster. |
Republicans are not expected to abandon their repeal effort, but its future would appear bleak, at least in the short term. | Republicans are not expected to abandon their repeal effort, but its future would appear bleak, at least in the short term. |
“We’ll go back to the drawing board,” Senator John Thune of South Dakota, a member of the Republican leadership, said on “Fox News Sunday.” Of voting to repeal and replace the health law, he said, “It’s not a question of if, it’s a question of when.” | “We’ll go back to the drawing board,” Senator John Thune of South Dakota, a member of the Republican leadership, said on “Fox News Sunday.” Of voting to repeal and replace the health law, he said, “It’s not a question of if, it’s a question of when.” |
Recent history provides some support for Mr. Thune’s optimism. The repeal bill in the House was declared dead before coming back to life — and Republicans there ultimately succeeded in passing a bill. | Recent history provides some support for Mr. Thune’s optimism. The repeal bill in the House was declared dead before coming back to life — and Republicans there ultimately succeeded in passing a bill. |