(Bloomberg) — The U.S. Senate voted Thursday to repeal the core of the Affordable Care Act, bringing Congress closer to sending legislation to President Barack Obama for the first time that would dismantle his signature domestic achievement.
Congressional Republicans won’t succeed in undoing the ACA, though, because the president has said he would veto the measure and Democrats in Congress have the votes to block an override. Senators voted 52-47 to pass the legislation. The House has passed a similar bill, and differences between the two must be resolved before the legislation can go to the president.
Both bills also would deny federal funding for Planned Parenthood, the reproductive healthcare organization that has faced criticism by Republicans since undercover videos purported to show its officials discussing reimbursement for providing tissue from aborted fetuses to researchers. Three people were killed in a Nov. 27 shooting at a Planned Parenthood clinic in Colorado Springs, Colorado.
Passing a repeal of most of the 2010 healthcare law means Democrats and Obama can "begin to make amends for the pain and hurt they’ve caused — for all the broken promises, for all the higher costs, for all the failures," Senate Majority Leader Mitch McConnell, a Kentucky Republican, said during Senate floor debate Wednesday.
House Republicans have voted more than 50 times to repeal or delay the law, which Congress enacted with only Democratic votes. This is the first time the Republican-controlled House and Senate have used a procedure aimed at bypassing a filibuster by Senate Democrats’ to get a bill to the president’s desk. No Democrats voted in favor of Thursday’s measure, while Republican Senators Susan Collins of Maine and Mark Kirk of Illinois voted against it.
‘Gesture of futility’
"Everybody knows it’s just a gesture of futility," Senate Democratic leader Harry Reid of Nevada said on the Senate floor Thursday. "We’re wasting our time here today. Everyone knows the result."
The White House said Obama would veto the measure because it would “take away critical benefits and healthcare coverage from hard-working middle-class families.”
During Thursday’s debate, senators rejected two amendments offered by Democrats to increase gun controls, a day after the mass shooting that killed 14 people in San Bernardino, California. One proposal would have expanded background checks of gun purchasers to most sales on the Internet and at gun shows. The other would have barred firearm purchases by people on terrorist watch lists.
The U.S. Supreme Court has twice upheld key provisions of the Affordable Care Act. The court on June 25 preserved subsidies that help millions of Americans pay their health insurance premiums. Obama said at the time that the law has helped tens of millions of Americans and is here to stay.
Financial penalties
The bill passed by the Senate would end financial penalties for individuals and companies that don’t follow the law’s requirement that they buy insurance for themselves and their workers. It also would end an expansion of the federal-state Medicaid health program for the poor, though Senator John Cornyn of Texas, the second-ranking Republican, has said the legislation would provide a two-year transition to enable people to find alternative coverage.
The Senate version of H.R. 3762 also would repeal the health law’s medical device tax and the so-called "Cadillac tax" on high-cost insurance plans.
The U.S. House on Oct. 23 passed a similar measure, which the Senate revised to conform with its rules and to gain enough Republican votes to pass it. The House measure would go further by repealing altogether the ACA’s requirements that individuals acquire health insurance and that large employers provide it to their workers.
The bill uses a process known as reconciliation that prevents Senate Democrats from blocking it by demanding a 60-vote threshold to advance the measure.
Pre-existing conditions
The healthcare law requires insurers to issue policies and set rates without regard to pre-existing health problems. Without the coverage mandate, the government has said those rules would create an industry “death spiral,” in which only patients with costly health conditions would buy insurance. That would drive up premiums, prompting healthy policyholders to drop coverage, causing still more rate increases, the government contends.
In October, three Senate Republicans, Utah’s Mike Lee and 2016 presidential contenders Marco Rubio of Florida and Ted Cruz of Texas, had said they opposed the House bill because it wasn’t a full repeal of the ACA. All three ultimately voted for the measure.
On Planned Parenthood, Senator Mazie Hirono, a Hawaii Democrat, said the defunding effort was "just one part of the Republican anti-women agenda."
"Defunding Planned Parenthood is nothing more than an attempt by some in Congress to pander to a fringe base," Hirono said on the Senate floor Wednesday. "The fact is that the majority of Americans support Planned Parenthood and healthcare services for women. The continuing efforts to defund Planned Parenthood are false proxies for banning abortion — all that will happen is that women’s healthcare will be at risk."
