The Obamacare repeal debate has begun in the Senate. That's about all we know for sure.
A slim vote, 51 to 50 with two Republican senators dissenting, to open debate was a huge victory for Republicans' hopes of passing some kind of health care bill, and puts health insurance for millions of Americans at risk.
But Republicans haven't actually settled on what legislation they are trying to pass. Bills to cleanly repeal much of Obamacare or to more fully repeal and replace it don't currently have the votes. In just the past few days, the idea of a much smaller bill, repealing just a few of Obamacare's most unpopular provisions, surfaced.
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That final destination must be sorted out in a mad rush over the next few days, with the Senate's arcane budget rules and a vote-a-rama that will open up Republicans to a flood of Democratic amendments designed to force tough votes promising to make the process even more treacherous.
Senate Republicans scored a victory Tuesday. But the ultimate result is far from clear. Let's break down how the next few days will look.
This is what will actually happen in the Senate over the next day or so
The Senate's process from here is byzantine. The vote on Tuesday was technically to start debate on the House's health care bill, but nobody expects that to be the actual legislation the Senate ultimately votes on.
This is what we expect to happen now, per Senate aides. Remember: Things are fluid. Timing and order could change.
- Two hours of debate on the clean (partial) Obamacare repeal bill, known as the Obamacare Repeal Reconciliation Act. Time is divided evenly between Democrats and Republicans.
- Two hours of debate on the repeal-and-replace plan that Republicans have been drafting since May, the Better Care Reconciliation Act. Time is divided again evenly between Democrats and Republicans. (During debate, each party can decide to give up some of its time if it wants.)
- Vote on the repeal-and-replace bill. Because of some last-minute changes to the legislation, it is expected to require 60 votes. So at some point before the vote, Democrats would likely raise a "point of order," arguing that the Better Care Reconciliation Act runs afoul of the Byrd Rule, which allows some Senate bills dealing with the federal budget to pass without a filibuster. The Senate parliamentarian would have to rule whether their objection is correct. (The parliamentarian, Elizabeth MacDonough, has already found that parts of the current version of the repeal and replace bill violate the Byrd Rule.) Traditionally, senators go along with the parliamentarian's recommendation. Assuming that happens, the Better Care Reconciliation Act would need Democratic support to pass — so it would likely fail, ending Republicans' hopes of repealing and replacing Obamacare at the same time.
- Vote on the clean partial repeal bill, the ORRA. The partial repeal bill would need 51 votes, but it is expected to fail as well because too many Republicans oppose repealing without a replacement.
- 20 hours of debate on the Senate floor. That's 20 hours on the Senate floor, not 20 hours in the rest of the world, so those 20 hours could take a couple of days if senators pause for breaks. Democrats and Republicans will take turns making speeches about health care. Democrats can use certain tactics — like asking for a full bill to be read out loud — to make the process more painful.
- Vote-a-rama. There will then be what's called vote-a-rama — quick up-or-down votes on whatever amendments Republicans and Democrats offer on the bill. Amendments must be considered relevant to health care, and they need 51 votes to be approved. They would technically be amendments to the House bill, if the previous two Senate bills have already failed or not been voted on yet. Democrats plan to use this time to force Republicans to take votes on politically unpopular measures, even if those amendments have little chance of making it into the final bill.
- Final bill. McConnell will eventually offer a final substitute, encompassing the actual plan that Senate Republicans want to pass. This could be the so-called "skinny repeal" billthat surfaced Tuesday morning.
- Vote on passage. That needs 51 votes to pass. Vice President Mike Pence can break a 50-50 tie.