Senate votes to repeal most of Obamacare

The Senate voted 52-47 to gut Obamacare, strengthening a House-passed bill that many conservatives – including Ted Cruz and Mike Lee – didn't think went far enough.

The House vote on the amended version will come in the next few days and is almost certain to pass.  This means that for the first time, President Obama will be forced to veto an Obamacare repeal bill a prospect that many political experts think will benefit Republicans.

Obamacare is slowly melting down as exchanges are shuttered, insurance companies are pulling out, and fewer healthy people are signing up for coverage.  The writing is on the wall, and Republicans are salivating about running against the unpopular program.

The Hill:

The vote caps weeks of intense and at times acrimonious debate within the Senate GOP conference over how far the repeal should go.

Conservative Sens. Ted Cruz (R-Texas) and Marco Rubio (R-Fla.), who are running for president, and Sen. Mike Lee (R-Utah) threatened to oppose a House-passed repeal bill for not going far enough.

Three moderates, Sens. Susan Collins (R-Maine), Mark Kirk (R-Ill.) and Lisa Murkowski (R-Alaska), balked at it for including language defunding Planned Parenthood.

GOP leaders briefly floated the possibility of dropping the Planned Parenthood language but dropped the idea knowing it could spark a conservative backlash.

Instead, McConnell leaned on Cruz, Rubio and Lee to vote yes and sweetened the prospect by crafting an amendment that dramatically beefed up the Senate package. All three voted yes.

“This bill is a substantial improvement over the original House bill, and I’m grateful to Senate conservatives and Senate leadership for joining me in making it so,” Cruz said in a statement after the vote. 

It repeals the expansion of Medicaid adopted by 30 states as well as many of the law’s tax increases, which the House bill left in place.

It cuts funding for the Prevention and Public Health Fund and eliminates risk adjustment programs from insurance companies that lose money because of the law.

The House bill eliminates the individual and employer mandates, the Cadillac tax on expensive insurance plans and the medical device tax.

The question of how to handle Medicaid was a thorny one for McConnell because it pitted conservatives, who demanded a repeal, against Republican colleagues from states that expanded the safety-net program.

“I am very concerned about the 160,000 people who had Medicaid expansion in my state. I have difficulty with that being included,” Sen. Shelley Moore Capito, a Republican from West Virginia, told The Hill earlier this month.

Vulnerable GOP incumbents face re-election next year in several states that have expanded Medicaid: Illinois, New Hampshire, Ohio and Pennsylvania.

McConnell eased their concerns by phasing-in the repeal over two years to give the federal government and states time to come up with a replacement program.

Why now?  Why not earlier?  For the first time, Republicans used the reconciliation process to avoid the necessity of gathering 60 votes to avoid a filibuster.  Previously, the repeal bills introduced were standalone legislation. 

The additional inducement of defunding Planned Parenthood was another enticement for conservatives, many of whom still think the repeal bill doesn't go far enough.

The rollback of Medicaid expansion will cause some GOP incumbents running for re-election trouble.  Democrats will no doubt accuse senators like Kirk and Portman of waging war on the poor.  But what they won't tell you is that many people who signed up for Medicaid were already eligible under the old rules.  Their coverage will not be dropped.

It hardly matters if the president vetoes the repeal bill.  Obamacare is sinking, and short of a large infusion of taxpayer money billions of dollars it will collapse soon enough.  The lessons of legislative overreach and a failed attempt to change human nature by law will probably be lost on liberals.  But it will be a long time before either party makes such a gargantuan mess of our health care system.