Despite opposition from Democrats, healthcare leaders and the public, the Senate voted 51-50 to begin debate on a replacement for the Affordable Care Act.
Senators Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska, voted against it, as did all Democratic senators. The motion required a simple majority to pass. Because it was tied 50-50, Vice President Mike Pence cast the deciding vote.
The vote was a crucial procedural step known as the motion to proceed. And it’s just the first step in what will likely be a complicated process through budget reconciliation.
Because a majority voted in favor of the motion to proceed, the Senate will now begin debating some form of healthcare reform. It’s still unclear what bill they will debate, as several measures have been discussed.
Technically, the process will begin with the American Health Care Act, passed by the House in May. But that measure had little Senate support, so the motion to proceed will allow the bill to come to the floor and later be amended. More likely, the Senate will vote on a measure to fully repeal the ACA, a move opposed by Democrats but supported by President Donald Trump.
Up until now, neither the Senate GOP bill, the Better Care Reconciliation Act, nor a repeal-and-delay measure known as the Obamacare Repeal Reconciliation Act, had enough support from Republican senators to reach the 50-vote threshold needed to pass.
The vote to pass the motion hinged on the return of Sen. John McCain, R-Ariz., who was recently diagnosed with brain cancer. He returned Tuesday to thunderous applause and voted yes in favor of the motion to proceed.
President Donald Trump said at a press conference that he's "extremely happy" the procedural motion passed, adding that "they say, if you look historically, this is the tough vote to get.”
In the next week or two, "we’re all going to sit together and we’re going to try to come up with something that’s really spectacular. We have a lot of options,” he said.