Health care reform

Health Care Bill's Senate Defeat Paves Way For Rand Paul's 'Clean Repeal' Bill; Vote Expected Soon

Paul: "If every Republican that voted for the clean repeal in the past votes for it again, it would pass."

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Tom Williams/CQ Roll Call/Newscom

The Senate voted down a proposal to "repeal and replace" Obamacare on Tuesday night, potentially opening the door for passage of Sen. Rand Paul's so-called "clean repeal" bill today or later this week.

Nine Republicans, including Paul, voted against the comprehensive amendment offered Tuesday night on the floor of the Senate. Parts of the bill may have needed 60 votes to pass, but the Better Care Reconciliation Act won only 43 affirmative votes, falling well short of even a simple majority.

The vote was a microcosm of all the issues that have plagued the Obamacare replacement since it arrived in the Senate after narrowly clearing the House on May 4. The GOP leadership included elements meant to appease moderates (like an extra $100 billion in Medicaid spending added to the bill with an earlier vote Tuesday) and other pieces aimed at enticing more conservative or libertarian members (like Sen. Ted Cruz' amendment to allow insurance companies to offer less expensive, less comprehensive plans). But neither camp was fully satisfied. Paul and Sen. Mike Lee (R-Utah), who have criticized the Republican effort for retaining too much of Obamacare, voted against the bill on Tuesday night, but so did such moderate Republicans as Maine's Susan Collins and Alaska's Lisa Murkowski.

With opposition to the BCRA spanning the breadth of the Senate GOP's ideological spectrum, the way forward for this "Obamacare Lite" proposal seems shut.

Where do we go from here? Today the Senate is expected to take up Paul's proposal to repeal Obamacare without a replacement. The bill would eliminate the Affordable Care Act's individual and employer mandates and would repeal several Obamacare taxes, such as a tax on medical equipment, but it would delay the full repeal for two years to give Congress time to formulate an alternative.

As The New York Times reports today, no version of Paul's repeal bill (plus amendments) is likely to become law, but it could become the basis for a conference committee with the House, if it gets enough votes to clear the Senate first.

This was Paul's plan Tuesday when he voted in favor of a motion to proceed, allowing the Senate to begin debate on the health care bill and its amendments. That vote was a perfect 50-50 split (with Vice President Mike Pence breaking the tie), so any single Republican could have blocked the process before it even started.

Indeed, Paul said in a statement Tuesday that he agreed to support the motion to proceed only after getting assurances from Republican leaders that his repeal bill would be considered after the comprehensive health care bill failed.

"This is the path I've been urging, and what I discussed with President Trump. If this is indeed the plan, I will vote to proceed and I will vote for any all measures that are clean repeal," Paul said in a Facebook post Tuesday.

A vote on Paul's so-called "skinny repeal" bill could happen as early as noon on Wednesday. The Senate has previously supported bills to repeal Obamacare, but it remains unknown whether Paul's effort will have sufficient support this time around.

"We don't know which way it will go," Paul said Tuesday. "If every Republican that voted for the clean repeal in the past votes for it again, it would pass."

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37 responses to “Health Care Bill's Senate Defeat Paves Way For Rand Paul's 'Clean Repeal' Bill; Vote Expected Soon

  1. Lunatic threatens to destroy Senate by asking Senators to do as they promised.

    1. I’m praying for them, I know everyone else on reason prays for them too.

      1. Isiah 3:12
        O My people!
        Their oppressors are children, and women rule over them.
        O My people!
        Those who guide you lead you astray, and confuse the direction of your paths.

  2. But because Collins and Murkowski are not going to vote for it, all you need is one other Republican balking. We shall see which ones have been playing both ends against the middle.

    1. We shall see which ones have been playing both ends against the middle.

      Probably more than enough to sink it. I’d be surprised if Paul’s clean repeal bill gets any more votes for it than the repeal and replace bill did (43).

    2. Susan Collins is basically another Gary Johnson/Bill Weld. A center-left Clinton DLC type who should be in the democratic party, but for whatever weird reason gets her jollies pretending that she’s a republican.

      I wouldn’t be surprised if in a few years from now she’s running for president as a “libertarian” and Welch and Gillespie and the whole wonderful gang here in this place are sitting there telling us all what an awesome friend of liberty and human being she is. If one day she ever starts talking about how much she loves smoking pot, then look out.

      1. Who is your ideal candidate, Mikey?

        1. Rand Paul was far and away my first choice in the last election. It was an easy no-brainer. He’s the smartest and most honest of the bunch, and while he probably wouldn’t pass Weigel’s ridiculous “purity test”, he’s just about the closest thing to a real libertarian we have in the current government. Sadly, he came off as being not quite ready for prime time in the debates. I hope he will be smoother and more polished the next time around.

          Gary Johnson was and is a pathetic joke who I would never vote for in a million years, unless we’re talking about a marathon or a pot smoking contest perhaps. Watching him and his idiot running mate talk about how wonderful Hillary Clinton is during that interview made me want to throw up on the floor and smash my television screen. That moron can’t even spell “libertarian”, much less define what it means to be one.

      2. Gary Johnson campaigned on cutting government spending by 20% and cutting entitlements. That is not center-left or Susan Collins-material by any stretch of the imagination.

  3. Clearly, we need NEW legislation that promises all things to all people!

    1. An omnionmibus bill.

        1. Ominous Omnibus would be a great name for a troll metal band.

  4. What a fucking joke. So we are at the point where everyone can offer their own version of free ice cream forever for my side and a turd sandwich for everyone who disagrees – and it will all be reconciled behind closed doors.

    How is this gonna result in anything but free ice cream for the big crony players and a turd sandwich for everyone else?

    1. The standard federal solution will still apply: try to convince everyone who got a turd sandwich that it’s really ice cream. It worked for Obamacare.

      1. So, kind a like:
        If you like your turd fudge swirl cone, you can keep your turd fudge swirl cone.

  5. “If every Republican that voted for the clean repeal in the past votes for it again, it would pass.”

    Yeah, well, that’s the problem, ain’t it.

    1. “If every Republican who voted for clean repeal in the past–when doing so had absolutely no consequences other than to please the base–would do so now that it could actually become an unpopular law…”–yeah, that’s *real* plausible.

  6. Re: alt-tex.

    Change to something that rhymes with Mitch.

    1. I am confident that Eric had a Ludacris song in mind when typing the Alt-Text.

  7. So what are the odds that all of the proposed amendments fail?

  8. Question. Let’s say Paul manages to pull this off and beat down the cucks too scared to repeal this dubious piece of legislation, what happens to people’s plans? Do they get a chance to revert to what they had before this madness took places? How does it all go back to ‘what it was’ if at all?

    1. Do they get a chance to revert to what they had before this madness took places?

      To what existed in 2007? That sucked for everyone who has ever actually had to make their purchasing decisions re healthcare. An individual insurance system can NEVER work. An employer-based system stops working whenever there is a recession or when benefits stop being offered to workers. And the more ‘insurance’ dominates the system, the less actual access to primary healthcare (all that most people need) there will be.

      Not that the GOP will ever take their heads out of their donors asses for long enough to understand the actual problems that existed then.

      And no – I’m not defending the first fucking thing about Obamaromneycare

      1. If you want to pre-date the madness, you have to go back to at least 1944.

        1. Pre-1939 maybe. 1939 is when the corporate deduction (and individual exemption for employer-provided) for health plan expenses started even though they didn’t take off until WW2.

          But honestly, you probably have to go back to before the Flexner Plan of 1910 which is what distorted medical school training away from general practice and towards specialists. So basically before hospitals took off. Methinks just going backwards and undoing things won’t work to fix the problems.

          1. You mean to say that people might have to learn from history rather than repeating it? I dunno, man. That sounds hard.

            1. I thought the point of learning from history was to figure out how to use dead people to cudgel our current opponents before they use dead people to cudgel us.

  9. “If every Republican that voted for the clean repeal in the past votes for it again, it would pass.”

    I can actually read the sarcasm in his voice here.

    So, should we start a “don’t actually want to repeal anything” pool? We know Collins and Murkowski are locks. My esteemed congresscritter Portman is a serious risk with his Medicaid boner (even though this isn’t a Medicaid bill). McCain’s always in play when it comes to keeping big government around. Shelley Moore Capito wants to be reelected by Appalachian Democrats, who are certainly of the “get your hands off my damn government benefits” persuasion of voters.


  10. Where do we go from here? Today the Senate is expected to take up Paul’s proposal to repeal Obamacare without a replacement. The bill would eliminate the Affordable Care Act’s individual and employer mandates and would repeal several Obamacare taxes, such as a tax on medical equipment, but it would delay the full repeal for two years to give Congress time to formulate an alternative.

    The world ‘several’ gives me pause, but the straight-up repeal of the mandates is good I guess. The ‘full repeal in two years’ sounds more like ‘gives me two years to get reelected and then pass whatever I want’ to me.

    Full repeal probably won’t happen, but if they put in a provision that in two years the whole thing gets repealed automatically if nothing is done could be ideal since I don’t think they’ll be able to get anything done. That could be the best possible scenario, in that partisan bickering could result in a full repeal by default. I doubt any of them would go along with that plan though, because they want nationalized healthcare.

    That’s actually how it should have been the first time around but Democrats showed three things about their party:

    A) They have no spines.

    B) They have no problem going along with legislation if their district gets it’s pork.

    C) They have no good idea’s on how anything ‘should’ work.

    Notably, I see no differences between them and Republicans in the above points.

  11. The distinction is that this is a real vote whereas all the other votes during the prior administration were fake votes. No comparison of the real and fake votes is appropriate.

  12. Was listening to C-span radio on my morning commute and some clueless young lady called in to say that she is “grateful that the government does such an excellent job with national defense, it should provide healthcare too…”

    Um-sure. When lets have the development of new drugs and medical devices or procedure cost as much and take as long as developing a new fighter jet or submarine.

  13. As a reminder, there were only three alleged problems with healthcare/health insurance when the fascists took over 18% of the economy.
    1. Some people could not afford health care or insurance.
    2. Some people with existing medical issues could not get insurance to cover those issues
    3. Health care costs / health insurance costs were rising faster than ‘everything else’
    A non-problem that was also addressed was that some people did not want to buy health insurance.
    So a clean repeal gives two years to address these very simple ‘problems’. (hint: it can be done is less that three thousand pages)
    1. Provide direct payment to medical providers / insurers based on income, similar to ‘food stamps’. This has got to be cheaper than Obamacare.
    2. Provide a two year window where there will be a partial subsidy to those who have existing conditions and are not covered by insurance who wish to start buying health insurance. After the window, health insurance companies are allowed to restrict benefits during the first years of coverage for someone who had chosen not to have insurance before. This is like guaranteed issue life insurance that only returns premiums in the first few years. This replaces the mandate for everyone to buy health insurance; buying and keeping health insurance becomes a good idea.
    3. Allow individual purchasing of health care and health insurance so that market forces will once again act on the health industry. Character limits are going to get me here.

    1. Health insurance now is actually a mess of pre-paid health service, and actual insurance. Remember, insurance is to cover unexpected events, not predictable and known expenses.
      Individuals do not often shop for health insurance; they take what their employer offers, or maybe select from one or two employer plans. It is highly unlikely that the plans are what they would choose in an open market. Employers do not shop for plans like ‘real’ consumers, they cut a deal for the kind of policy that keeps away the regulators. Thus men get maternity coverage and women are covered for prostate care. Individuals that try to shop o the exchanges are similarly restricted, because the ‘healthy young pup’ policies with low premiums and high deductibles, and limited coverage for things that happen to old folks are now outlawed.
      If all the mandates are removed, and insurance companies can sell whatever policies customers want, then health insurance can once again become insurance. Insurance is, after all, a spreading of risk that is unacceptable for an individual, and spreading it around a group until the risk becomes acceptable to all the group.
      Individuals do not shop for health care because they have to take the providers designated by the insurance companies. If we are allowed to select the coverage we wish, and pay for the routine, predictable costs out of pocket, then insurance only has to cover major, unexpected costs.

    2. How about working on the actual costs (let alone prices) of health care? Granted, mostly a job for state gov’ts, but the feds can achieve some things too.

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