Senate Votes to Begin Debate on Health-Care Bill With Pence Breaking Tie

Series of amendments will now be offered with final vote possible this week
The Wall Street Journal By Stephanie Armour
Updated July 25, 2017

Senate Republicans on Tuesday backed a motion that allows lawmakers to launch into debate over a health-overhaul bill, a significant victory for Senate Majority Leader Mitch McConnell and for President Donald Trump, who stepped in to pressure Republicans after it appeared they were failing in their bid to repeal the Affordable Care Act.

The 51-50 vote sets the stage for hours of politically tricky debate, and numerous complex amendments, on Republicans’ seven-year quest to topple most of the current health law and possibly replace it with a GOP plan. After Republican Sens. Susan Collins of Maine and Lisa Murkowski of Alaska voted against the motion, Vice President Mike Pence broke the tie.

A final vote on the Senate health bill could come later this week.

Tuesday’s vote was a procedural step that allows debate to begin, rather than a win for any particular measure. But it is a coup for Mr. McConnell (R., Ky.), who three times delayed a vote as Republicans dissented from various provisions in the proposed legislation.

Republican senators now will likely have to vote on amendments from Democrats as well as fellow Republicans, some of which could put them in politically tricky situations. Democrats, too, could face politically challenging votes.

That’s because the process Mr. McConnell is using to pass the health bill with a simple 50-vote majority, rather than the 60 votes required for most legislation, means both parties can add a host of amendments during the debate.

In a scenario with few recent precedents, Senate Republicans ahead of the procedural vote weren’t aware of which measures they would vote on later this week, potentially even later Tuesday. Rarely have lawmakers faced such a high-profile vote with so little definition about the legislative path ahead.

Conservative lawmakers such as Rand Paul of Kentucky want a broad repeal of the ACA, ending its Medicaid expansion and its requirement that most people have insurance or pay a penalty. They say the ACA, also called Obamacare, has led to rising premiums and limited choice.

Some Republican senators have been concerned about the GOP bill’s proposed cuts to Medicaid and about potentially doing away with what they call important consumer protections.