Senate Republicans Likely to Pursue 'Skinny' Repeal of Obamacare

Senate Majority Leader Mitch McConnell (R., Ky.) / Getty Images
July 25, 2017

Republican senators are planning to pursue a "skinny" repeal of Obamacare if Tuesday's Senate votes to open debate on health care and pass the current GOP bill both fail.

The so-called "skinny" repeal would be a series of amendments to dispose of a few key components of the Affordable Care Act that Republicans have identified as being particularly burdensome, NBC News reports.

The first vote on Tuesday will be to open debate on the health care measure. Should that "motion to proceed" pass, the Senate will debate and vote on multiple approaches to the current health care bill. 

Variations include the 2015 measure to repeal Obamacare, which is expected to fail. Multiple GOP lawmakers have indicated they will not vote to support a straight repeal without an immediate replacement bill.

The Senate would then move to vote on the current Senate replacement bill, the Better Care Reconciliation Act. However, the BCRA includes newly added amendments from Sen. Ted Cruz (R, Texas) and Sen. Rob Portman (R, Ohio) that have not been scored by the Congressional Budget Office and would likely need 60 votes, rather than a simple majority of 50, to pass.

The Senate Parliamentarian said last week that some of the most controversial parts of the Senate Republican bill violate chamber rules. If formally challenged, these provisions would require 60 votes. As a result, GOP senators would require support from some Democrats to pass the bill. No Democrats to date have indicated they would vote yes on the bill.

The next step, according to NBC sources, would be for senators to vote on a series of amendments. These amendments would create what leadership has called a "skinny repeal" that address key problematic aspects of Obamacare—its individual mandate penalty, the employer mandate penalty, and the tax on medical devices.

Before the amendments become law, the Senate would have to go to conference with the House of Representatives to work out a final bill. Both chambers would then need to vote on the reconciled bill before it goes to President Donald Trump's desk.

Senate Republican leaders and the Trump administration are optimistic about the outcome. Majority Leader Mitch McConnell (R, Ky.) said Monday that the Senate has a "real opportunity" on health care.

Vice President Mike Pence's top legislative affairs aide, Marc Short, said that Sen. John McCain (R, Ariz.) will push the vote over the finish line.

"But whether he's the 50th or the 51st vote, " Short said on Fox Business, "we're excited to have him back."

McCain returned to Washington D.C. on Tuesday after a a brief absence following his brain cancer diagnosis last week.

Republicans gained the support of a GOP holdout, Sen. Rand Paul (R, Ky.), who announced he will vote "yes" to proceed on Tuesday. 

In a series of tweets, Paul first confirmed that he supports voting on a "clean repeal" and repeated the now commonly held belief that the BCRA "will fail."

The Kentucky lawmaker also indicated that even if a "full, clean 2015 repeal" cannot be passed, he will support a "skinny" repeal—i.e., "whatever version of a clean repeal" that can be passed.

In conclusion, Paul identified the issues with Obamacare that he finds are in most need of repeal, and reaffirmed his commitment to "vote for any and all measures that are clean repeal."