OBAMACARE REMAINS IN PERIL: MCCONNELL WINS A SENATE VOTE.

GOP dives into health-care debate.                                  

Skinny repeal’ could be the Senate’s health-care bill of last resort

The plan would eliminate the Affordable Care Act's individual mandate and two other key elements of the law. Less cost to the government, less coverage for millions of Americans.

Alex Wong / Getty Images For the past few weeks, the Senate health care bill seemed finished. So many senators disliked the bill so much that four said they would not even vote for a motion to proceed with debate on it. [Vox / Dylan Scott]   [But] Senate Majority Leader Mitch McConnell has managed, after prospects looked dim again and again, to open debate on an Obamacare repeal plan. It’s a huge victory for Senate Republicans' hopes of passing some kind of health care bill, and it puts health insurance for millions of Americans at risk. Every plan Republicans are considering is projected to lead to millions fewer Americans having health insurance. Mitch McConnell is like a quarterback who has just converted on fourth and long. The Senate majority leader kept the drive to repeal Obamacare alive, but he’s still trailing by a touchdown, the game clock keeps ticking down and a win is not inevitable. -- He didn’t have a single vote to spare, but the Kentuckian demonstrated impressive legislative prowess by getting 50 Republican senators to vote for the motion to proceed to debate on the health-care bill. It was high political theater: John McCain, recovering from surgery and battling brain cancer, traveled 2,300 miles from Arizona. McCain’s return to Senate injects momentum into GOP health-care battle”:   As police removed protesters yelling “kill the bill” from the gallery, Wisconsin’s Ron Johnson (who has been a holdout in recent weeks) held off on voting until he saw what the outcome was going to be. Vice President Pence then cast a tiebreaking vote. But Republicans haven’t actually settled on what legislation they are trying to pass at the end of this debate. Bills to cleanly repeal much of Obamacare or to more fully repeal and replace the 2010 health care law don’t currently have the votes necessary to pass. In just the past few days, the idea of a much smaller bill, repealing just a few of Obamacare’s most unpopular provisions, surfaced. 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. -- Last night underscored what a tough row to hoe this remains. The rules of the body mean that any senator can now submit amendments that need to be voted on. This leads to what’s called a vote-o-rama, an often chaotic and sometimes unpredictable process. The first item members took up last night was the Better Care Reconciliation Act. That is the carefully negotiated package that McConnell spent weeks crafting, with compromises to get conservatives like Ted Cruz (R-Tex.) and moderates like Rob Portman (R-Ohio) on board. But nine Republicans broke ranks and voted no. The diversity of those who opposed the measure underscored the ideological split within the Republican conference about the best path forward on health care. The group included moderates like Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska), as well as conservative purists like Mike Lee (R-Utah) and Rand Paul (R-Ky.). Also voting no were Bob Corker (R-Tenn.), Tom Cotton (R-Ark.), Lindsey Graham (R-S.C.), Dean Heller (R-Nev.) and Jerry Moran (R-Kan.). Republican Senator Susan Collins It’s hard to overstate the degree to which White House officials and Senate GOP leaders just want to pass something — really, anything — to show the base that they are keeping their promise to roll back Obamacare. They would happily portray even most modest tweaks to the Affordable Care Act as major successes to save face. As far as they’re concerned, whatever gets passed will be the basis for negotiations with the House. So this is not even a final product. That’s where what’s being called “skinny repeal” comes in. “The ‘skinny repeal’ option would repeal the ACA’s mandates that individuals buy plans and that employers with 50 or more employees provide coverage … as well as eliminate the law’s tax on medical device manufacturers,” Sean Sullivan, Juliet Eilperin and Kelsey Snell explain. “This … strategy would keep the overhaul effort alive but amount to a tacit acknowledgment that broader efforts to revise or repeal the law cannot succeed ... The conservative group Freedom Partners (backed by the Koch political network), urged senators to use the votes to partly repeal the law and then keep pushing for full repeal. … But one key way Senate leaders won Tuesday’s procedural vote was by assuring several centrist Republicans that they may end up with a modest bill.” A skinny repeal bill,...[is the modest bill];] an effort to find a slender majority of votes.” Oliver Contreras/For The Washington Post) “John McCain, maverick of the Senate, did not return to Capitol Hill and suddenly stop the progress of the Republican health-care effort. But the Arizona Republican, now battling an aggressive form of brain cancer, did use his moment in the spotlight Tuesday to deliver a sobering message to colleagues,” Elise Viebeck, Paul Kane and Ed O'Keefe report. “The Senate might be known as the world’s greatest deliberative body, McCain said, but it is not clear it deserves that reputation today. The partisanship, the gridlock and the political subterfuge have dragged down the institution, he said. Senators’ work is ‘more partisan, more tribal more of the time than any other time I remember,’ McCain told a rapt audience on the Senate floor. ‘Our deliberations can still be important and useful, but I think we’d all agree they haven’t been overburdened by greatness lately. And right now, they aren’t producing much for the American people.’” (Read Kane’s column about McCain’s emotional return.) Even though he delivered a pivotal vote to move the health-care debate forward, the 2008 GOP presidential nominee publicly criticized his party’s leaders for their lack of transparency and suggested that a bill may not ultimately pass. “We’ve tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them it’s better than nothing, asking us to swallow our doubts and force it past a unified opposition,” McCain said. “I don’t think that’s going to work in the end, and it probably shouldn’t … TWO WHO REVERSED THEIR STANCE TO SUPPORT MCCONNELL: Sen. Dean Heller  -- Las Vegas Sun: “[Sen. Dean Heller] voted in support of a motion to push forward with efforts to roll back Obamacare. … He noted that his vote to proceed was not a vote in favor of the GOP bill. … Rep. Jacky Rosen, D-Nev., who is running against Heller next year, said in a statement after today's vote that Heller folded under pressure from President Donald Trump and GOP leaders.” U.S. Sen. Shelley Moore Capito, R-W.Va. -- Charleston Gazette-Mail: “Following the roll call, [Sen. Shelley Moore] Capito said she expects that the final Senate version will put more money into combating the worsening opioid epidemic and beefing up the Patient and State Stability Fund, which would soften the blow of some of the lost federal funding.”