Republicans on Thursday night achieved something of a milestone in their five-year battle against the Affordable Care Act: They finally passed a bill repealing the law through the United States Senate.
The measure cleared by a narrow, party-line margin of 52-47, and it must still return to the House for a final vote next week. But passage in the Senate means that after dozens of failed tries by Republicans in the House, President Obama will get the opportunity to stamp his veto on a bill eviscerating the law that, in the popular parlance if not in text, bears his name.
Chances are, it’ll be a moment that both he and congressional Republicans will relish. Republicans can tell their restive, angry base of conservatives that they have now done everything they could to repeal the hated law, delivering on the promise of the Senate majority they won last fall to put a bill on Obama’s desk. It will frame the choice in 2016 clearer than ever before: Elect a Republican president, and you can be rid of this abomination once and for all.
“For too long, Democrats did everything to prevent Congress from passing the type of legislation necessary to help these Americans who are hurting. Today, that ends,” Majority Leader Mitch McConnell said on the Senate floor before the final vote. “Today, a middle class that’s suffered enough from a partisan law will see the Senate vote to build a bridge past Obamacare and toward better care.”
Yet Democrats see a political winner, too. Obama and his allies in Congress love to mock the GOP’s obsession with repeal, frequently pointing out the 50-plus times that the House had previously passed doomed bills to dismantle the law. And they will undoubtedly use the moment to highlight the fact that Republicans still have not kept their oft-repeated promise to not only repeal but replace the Affordable Care Act.
The repeal votes in the House and Senate were, like so many before them, purely symbolic. In an odd twist of the political dynamic in Washington, the only reason Republicans were able to muster the votes to pass it in the Senate was that it stood no chance of becoming law. Because if Obamacare were repealed without a replacement ready, the health-care system would be thrown into chaos, with millions of Americans poised to lose insurance either on the exchanges or from Medicaid. As it is, Democrats plan to target Republican senators up for reelection next year and accuse them of voting to kick needy constituents off Medicaid.
The measure passed by the Senate on Thursday doesn't actually repeal Obamacare in its entirety. To be able to pass a bill with a simple majority of 51 votes, rather than the filibuster-proof threshold of 60, Republicans needed to use a process known as budget reconciliation, which requires that provisions directly affect the budget. (Democrats used this same process to pass part of the original law in 2010 after Scott Brown’s victory in the Massachusetts Senate race deprived them of their 60th vote.) As such, the bill does not scrap the health law’s provisions allowing parents to keep their children covered under their insurance plans through age 26, or the prohibition on insurers discriminating against people with preexisting conditions, among others. But it does gut the law by eliminating the insurance exchanges and subsidies, and by repealing the Medicaid expansion accepted by 30 states.
The Senate bill is much more robust than a version that passed the House, as Republican leaders tried to prevent defections from conservatives like Senators Ted Cruz and Mike Lee who said it would be meaningless to snip at the law rather than eviscerate it. The measure also defunds Planned Parenthood, but that provision drew protests from centrist Republican Senators Susan Collins, Mark Kirk, and Lisa Murkowski, who failed in their attempt to restore funding by amendment.
McConnell opened the floor to amendments on Thursday afternoon, and following the mass shootings in Colorado and California in the span of a few days, Democrats used the opportunity to force votes on measures to expand gun background checks and prevent people on the terrorist watch list from buying firearms.
Yet it was a political move more than anything. Legislatively, it made little sense, because if Republicans did accept the amendments, then Obama would have been forced to veto a bill that included gun-control provisions he has been demanding for years. Republicans turned them aside anyway. An amendment from Democratic Senator Dianne Feinstein to prevent the sale of guns to suspected terrorists drew just one Republican vote, while a bipartisan measure on background checks from Senator Joe Manchin, a Democrat, and Pat Toomey, a Republican, earned four votes from Republicans. (It was the same measure that failed to pass the Senate in 2013 after the massacre at Sandy Hook Elementary School in Newtown, Connecticut.)
Ultimately, the Senate adopted no extraneous amendments to the health care bill. It passed over the opposition of all Democrats and two centrist Republicans: Collins of Maine and Kirk of Illinois. In a statement, McConnell’s office hailed the vote as a “promise kept.” That’s partially correct. More than a year after voters handed the Senate to Republicans, they have pushed the repeal of Obamacare one key step closer to reality. Next year’s election will determine whether that’s as far as they get.