The Senate voted on Tuesday to open debate on their plan to overhaul the US healthcare system.
After a 51-50 vote on the motion to proceed (with the tie broken by Vice President Mike Pence), the bill is up for 20 hours of debate. And by the end of the week, there’s expected to be a vote on a health bill. Exactly what that will look like remains to be seen. And it’s still far from working shape.
“I will not vote for the bill as it is today. It’s a shell of a bill right now,” Sen. John McCain of Arizona said in a speech Tuesday after voting for the motion to proceed. “We all know that. I have changes urged by my state’s governor that will have to be included to earn my support for final passage of any bill. I know many of you will have to see the bill changed substantially for you to support it.”
Chris Krueger, an analyst at the Washington-based Cowen and Company, compared getting every GOP senator to sign to squeezing a balloon, because it’s so hard to get both moderates and conservatives on board. That’ll result in another 50-50 vote.
“With everyone promised their policy pony, debate on the underlying bill will proceed on a 50-50 vote and VP Pence breaking the tie,” Krueger wrote in a note to clients following the motion-to-proceed vote. “Twenty hours of debate and then a Vote-a-Rama with literally hundreds of messaging amendments from everything from Russia to drug pricing. And at the end of this beleaguered process, we will be back to the dozen bellwether Republican Senators who cannot find common ground.”
Those include conservative members, members of the Senate running for reelection, among others who have fundamental concerns about the healthcare bill.
Dragging out this process has implications on other bills as well, along with a possible government shutdown at the end of September.
“By dragging out a deeply unpopular and partisan process, the odds of a government shutdown continue to go up,” Krueger wrote.
There are a number of healthcare bills that the Senate will be considering, including the Better Care Reconciliation Act (the repeal and replace plan) and the Obamacare Repeal Reconciliation Act (the repeal only plan). Should both of these fail to get support, Senate Majority Leader Mitch McConnell would move on to a so-called “skinny repeal” plan, in which a series of amendments would be made to the House bill that would repeal certain parts of the Affordable Care act.
In the end, the House and Senate would have to work together to form a compromise bill that they would have to vote on. That, too, wouldn’t be an easy or quick process, Krueger wrote.