WASHINGTON (CN) – The Senate on Tuesday narrowly voted to begin debate on a bill to repeal the Affordable Care Act, with Vice President Mike Pence casting the tie-breaking vote.
The 51-50 vote was marked by the emotional return of Senator John McCain, who flew from his home in Arizona to Washington to cast a critical vote despite his diagnosis of brain cancer.
The Senate chamber was packed as the vote got underway. Protesters could be heard from outside the Senate gallery shouting “Kill the bill, don’t kill us” and “Shame, shame, shame.” Officers removed protesters from the gallery in an orderly way just before the vote started.
Prior to the vote, McConnell reminded his fellow Republican senators they’d waited for years for the opportunity to dismantle the the signature legislative accomplishment of former President Barack Obama.
“We cannot let this moment slip by,” McConnell said.
Democratic leader Chuck Schumer then took the podium, urging lawmakers to reject it the procedural measure.
“Turn back now before it’s too late,” Schumer said.
It was unclear up until the final hours before the vote whether the measure would have enough support to pass, but wavering Republicans started falling in line just before the vote took place.
Sens. Shelley Moore Capito, Dean Heller and Rob Portman gave their approval of the motion to move to the bill just hours before the vote and just around the time when Republicans held their weekly party lunch to discuss health care.
“Obamacare isn’t the answer, but doing nothing to try to solve the problems it has created isn’t the answer either,” Heller said in a statement. “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. Whether it’s my ideas to protect Nevadans who depend on Medicaid or the Graham-Cassidy proposal that empowers states and repeals the individual and employer mandates, there are commonsense solutions that could improve our health care system and today’s vote gives us the opportunity to fight for them. If the final product isn’t improved for the state of Nevada, then I will not vote for it; if it is improved, I will support it.”
Senate Majority Leader Mitch McConnell’s plan was to convince senators to open debate on the bill, which would require 50 votes, without the full text of the bill being known. That vote would technically be to bring up the House version of the bill, but senators would then be able to make amendments to completely change the bill.
One of those amendments would make the bill a plan to repeal the Affordable Care Act, which the Senate passed in 2015 only to have it vetoed by then-President Obama. The Senate is also expected to vote on the revised version of its health care bill, the Better Care Reconciliation Act if the straight repeal fails.
But it is not clear if Republicans have the vote to pass either measure, as enough senators have come out against each to ensure their defeat. Republicans can only afford four defections while still being able to pass any health care legislation, which they are passing through a special budgetary process known as reconciliation that only requires 50 votes to pass.
Sen. Rand Paul, a Kentucky Republican who was a key holdout on the original version of the Senate health care bill, buoyed Republican chances to move to their repeal legislation when he announced he would support the motion if given the chance to vote on a straight repeal of Obamacare.
Senate Minority Leader Chuck Schumer, D-N.Y., speculated that Paul did so knowing full well that such a vote would fail because he hoped the most likely result of a conference between the House health care bill and whatever the Senate passes would be a clean repeal of Obamacare, an idea Paul has long supported.
The pressure on reluctant Republicans from both McConnell and the White House ramped up in the week before the vote, with leadership in the party reminding lawmakers that many of them have been promising to repeal Obamacare for seven years. In a floor speech before the vote on Tuesday McConnell told his members that the vote to proceed to the bill
“Our constituents are hurting under Obamacare,” McConnell said on the Senate floor. “They are counting on us to do the right thing right now. That means voting to allow the Senate to finally move beyond Obamacare’s failures. That’s what i intend to do. That’s what I urge every colleague to do.”
Trump tweeted on Tuesday morning ahead of the vote, calling the day “a very interesting day for HealthCare.”
“The Dems are obstructionists but the Republicans can have a great victory for the people!” Trump tweeted.
Shortly before the vote, Sen. John Kennedy, a Louisiana Republican, told reporters “it’s time to saddle up and go,” to a vote to repeal Obamacare.
Building the drama in the hours before the vote was the unexpected return of Sen. John McCain, an Arizona Republican who last week announced that he has brain cancer. McCain’s absence would have all but doomed the bill because instead of being able to afford two defections while still being able to pass the bill, McConnell would have needed all but one of his caucus to support the plan.
In the end, all Republicans but Sens. Susan Collins and Lisa Murkowski voted for the motion to move to the bill. McCain and Sen. Ron Johnson cast the final two votes in favor of heading to the bill.