Crunch time as U.S. Senate braces for health care vote

WASHINGTON DC, USA – Senate Republicans vote Tuesday, July 25, on the latest effort to repeal Obamacare, in the face of withering criticism from President Donald Trump – and confusion over whether they even have the votes to move forward.

Trump has spent weeks cajoling, strong-arming and warning Republicans to get on board with his effort to overhaul his successor’s health care reforms, but several are skeptical about how the new plan could affect millions of Americans.

In recent weeks, several measures have been considered – but ultimately collapsed, revealing fissures within the Republican Party on how to proceed with a goal they have had since the Affordable Care Act was passed in 2010.

“Big day for HealthCare. After 7 years of talking, we will soon see whether or not Republicans are willing to step up to the plate!” Trump tweeted early in the day before the all-important vote, expected after 2:00 pm (1800 GMT).

The latest Republican plan would dismantle Obamacare but delay the actual implementation of the repeal to allow time for a viable replacement to be crafted.

That bill is highly unlikely to pass in its current form, but the Senate leadership has stressed the importance of at least voting on it in order for changes to then be introduced.

“This will be a very interesting day for HealthCare,” Trump tweeted. “The Dems are obstructionists but the Republicans can have a great victory for the people!”

On Monday, in a stark warning to fellow Republicans, the president bluntly declared that “Obamacare is death” and that the Senate must act.

‘I don’t have a clue’

Ahead of the vote, the path forward remained murky, irritating some Republicans.

“I don’t have a clue what we’ll be voting on,” Senator Ron Johnson, a Republican who has long criticized the health care reform process, said Monday.

Ideologically conservative Senator Ted Cruz said it remained “unclear exactly which legislative solutions will carry the day.”

But he encouraged a vote to begin debate.

“Now is the time to prove that our rhetoric of the past seven years regarding the repeal and replacement of this disastrous bill will lead to substantive action,” Cruz said in a statement.

Senate Majority Leader Mitch McConnell is expected to lay out the plan Tuesday at a closed-door Republican lunch.

He and other Senate Republican leaders acknowledge they do not know whether there is sufficient support to even open debate on the new plan, a sign of Republican division about the impact such reforms might have on millions of American families.

On the Democratic side, senators urged cooperation – and restraint.

“I can’t believe this process and the hard and calculated rhetoric we see,” Democratic Senator Joe Manchin of West Virginia said Tuesday.

“The Affordable Care Act is not a perfect piece of legislation. It needs repair. We both agree to that. Then we need to fix it.”

McCain returns for vote

On Monday, Trump took to his bully pulpit and demanded his party get in line.

“Any senator that votes against starting debate is telling America that you are fine with the Obamacare nightmare,” Trump said.

Trump has repeatedly grilled fellow Republicans for not following through on their – and his – campaign pledge to repeal and replace Obamacare.

Republicans hold 52 of the Senate’s 100 seats. With all Democrats opposed, Trump can afford just two defectors.

Senator John McCain, who was convalescing in Arizona following a brain cancer diagnosis, returned to Washington Tuesday, in yet another sign of how important the numbers are for this vote.

As of last week, three Republican holdouts said they would vote no on Tuesday’s motion to proceed, which would open debate on the legislation.

Secretive process

Forecasts by the non-partisan Congressional Budget Office on various health reform bills have predicted that millions of Americans would lose health care if the measures become law.

In the case of a bill that repeals Obamacare and provides no replacement, 32 million more people would be uninsured by 2026 as compared to current law, CBO forecast.

Some Republicans have expressed concern with how legislation would impact Medicaid, the health insurance program for the poor and the disabled.

The latest repeal-and-replace bill would roll back an expansion of Medicaid and slash its federal funding.

It would also end the mandate that most individuals have health insurance, and allow states to let insurance companies offer bare-bones plans not allowed under current law.

Democrats have blasted the secretive process, accusing Republican leaders of rushing a mammoth bill to the floor without sufficient discussion or debate.

“No public hearings, no final version, no consultations with health care experts,” Senator Chris Coons said on Twitter. “This is not how we improve our health care system.” – Rappler.com