Senate Health Debate Rolls On After First Option Fails Nine Republicans voted against measure; Senate will proceed to vote on repeal-only option By Stephanie Armour, Kristina Peterson and Michelle Hackman

https://www.wsj.com/articles/senate-votes-to-begin-debate-on-health-care-bill-1501009650

WASHINGTON—Senate Republicans overcame a range of internal fissures in narrowly voting on Tuesday to begin debate on their health-care overhaul, but the party suffered a setback hours later when a proposal replacing major portions of the Affordable Care Act failed to attract enough votes to pass.

In a dramatic day at the Capitol, Vice President Mike Pence broke a 50-50 tie, allowing Senate Republicans to clear a procedural hurdle and setting up a days-long stretch of debate and amendment votes on the GOP effort to dismantle and replace much of former President Barack Obama’s 2010 Affordable Care Act.

The two GOP defections came from Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, who joined all Senate Democrats in voting against proceeding to debate the legislation.

The vote, punctuated by an emotional last-minute appearance by Sen. John McCain (R., Ariz.), who was diagnosed recently with brain cancer, delivered a come-from-behind victory for President Donald Trump and Senate Majority Leader Mitch McConnell (R., Ky.), who persuaded Republicans skeptical of the GOP bill to band together long enough to begin debate.

Mr. Trump said after the vote that his party had taken “a big step” that would “move forward to truly great health care.

Even with their surprise win on the procedural motion, which seemed a long shot just last week, Republicans were subdued Tuesday about their prospects of passing a sweeping overhaul of the ACA by week’s end.

“We knew this wasn’t going to be easy, and there’s a lot of work ahead of us,” said Sen. John Thune of South Dakota, a member of the Senate GOP leadership.

On Tuesday night, the first of Senate leaders’ health-care options, a bill toppling and replacing major portions of the ACA, gained only 43 votes to 57 against. That measure included a much-debated proposal from Sen. Ted Cruz (R., Texas) allowing insurers who offer one ACA-compliant health plan to also sell cheaper insurance options that don’t meet ACA rules.

Senate leaders had expected the measure to fail, as Senate rules made it ineligible to pass on a simple majority vote. But the defection of nine GOP Senators—enough to sink the bill even under a simple majority—underscored the lack of support within the party for the ACA replacement that leaders had cobbled together.

On Wednesday, the Senate is expected to take up a separate bill that would largely repeal the ACA with a two-year expiration date, to give lawmakers time to craft a replacement.

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