With the release of their latest draft on Thursday, Senate Republican leaders have spent more than two-and-a-half months writing an overhaul of the nation’s health-care system behind closed doors.
It now may die before ever seeing an up-or-down vote.
Majority Leader Mitch McConnell’s revised bill to partially repeal and replace the Affordable Care Act drew swift opposition from two Republican senators on either side of the party’s ideological spectrum, Senator Susan Collins of Maine and Senator Rand Paul of Kentucky. But what was particularly notable about their positions is that Collins and Paul are not merely vowing to vote against the final legislation—they would block it from even coming up for debate next week. If just one more of the 50 remaining Republican senators joins them, McConnell’s bill—and the party’s broader promise to dismantle Obamacare—would be finished.
Procedure is everything in the Senate, home to the filibuster and dozens of other examples of parliamentary arcana. The first step in calling up McConnell’s bill is a motion to proceed to debate, which under the rules Republicans are following is subject to the same 51-vote threshold as a vote on final passage. (The GOP is already structuring the legislation to skirt the 60-vote threshold that would face a Democratic filibuster.) Democrats won’t lift a finger to help McConnell after he shut them out of negotiations, so he’ll need at least 50 of the 52 Republicans. If he holds everyone but Collins and Paul, Vice President Mike Pence could break a tie to get the bill on the floor.