The Senate took a meaningful step toward repealing Obamacare in the early hours of Thursday morning, with Republicans voting nearly unanimously to approve a budget that would kill the health-care law. Going into the session, there was a sense that Democrats might be able to use the vote — and their freedom to offer politically dangerous amendments — to split the GOP over when and how they hoped to enact the repeal. After all, several Republican senators have lately voiced doubts over the party’s apparent strategy of repeal and delay, and the turmoil has only been deepened by Donald Trump’s recent announcements that Obamacare repeal must be accompanied by a full replacement with some yet-to-be-determined-but-definitely-terrific GOP plan. The logistics of doing what the president-elect and the handful of wavering Republican senators want are, to say the least, daunting.
But when it came to cast the key vote last night, party unity held: 51 of 52 Senate Republicans voted for the repeal budget (only Rand Paul bucked party discipline, reflecting his opposition to repealing Obamacare without a replacement plan being in place). No Democrats crossed the line to vote for it, though Dianne Feinstein was absent following surgery.
Over the course of the evening, 17 amendments were brought to the floor. Most were offered by Democrats, seeking to highlight popular aspects of Obamacare that would be lost in repeal. All the amendments were, in turn, defeated. The Republicans senators who were expected to offer an amendment to put off the deadline for passing the actual repeal — in the form of a budget-reconciliation bill — from late January to early March announced they were backing off, based on assurances from leadership that the deadlines could be adjusted later. Which is to say, for the moment, the party managed to paper over substantive disagreements by kicking key questions down the road.
So did Democrats get anything of value from this truncated exercise? Perhaps so. Republican senators are now on record as having rejected opportunities to keep Medicare, Medicaid, and the children’s health program CHIP off the cutting-room floor; to make it possible to import prescription drugs from Canada; to prevent erosion of women’s health services and support for rural hospitals; and perhaps most tellingly, to protect Medicaid funding for the 32 states that accepted the option of expanding that program under the Affordable Care Act.
For the moment, the budget resolution will go to the House, which is expected to approve it on Friday unless the Freedom Caucus (some of whose members share Rand Paul’s heartburn over moving ahead with an Obamacare repeal without a replacement) decides to rebel. And then the real rubber will meet the road as Republicans try to figure out what exactly to put into the repeal legislation to deal with the transition and to satisfy wildly varying Republican views on the post-Obamacare health-care system.
The future for Obamacare remains fuzzy. The big, potentially derailing disagreements over repeal among Republicans — most importantly between the Congressional leadership and Trump — remain very much in place. Nothing about last night’s vote changes that. But the fact that the party could pull together to pass the repeal budget has to be encouraging for conservatives. It’s a relatively easy part of a long process — but there’s no question that America is now a little bit closer to losing Obamacare.