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While America was sleeping, the GOP was hard at work trying to dismantle the signature policy accomplishment of the Obama Administration: the Affordable Care Act. Despite heavy protest from Democrats, the Senate voted 51-48 to clear a procedural hurdle going toward overturning the law.

Democrats said that the vote, while not repealing what has come to be known as Obamacare, sets the stage for weakening its provisions and ultimately collapsing it.

“I think it’s important for this country to know this was not a usual thing, this is a day which lays the groundwork for 30 million people to be thrown off their health insurance,” Sen. Bernie Sanders told CNN. “And if that happens, many of these people will die.”

President-elect Donald Trump ran on a platform of repealing and replacing the ACA, but through today has not spelled out exactly what that replacement would be.



Here’s what you should know:

  • The Senate vote was a budget resolution which has the same process for dismantling the ACA as it did for approving it. The resolution instructs House and Senate committees to start the process of repealing major portions of the law.
  • The vote cleared the path for what is called a “reconciliation bill,” which legislators can use as a tool to undo specific parts of the ACA. If such a bill goes through, only 51 votes would be needed in the Senate rather than the traditional 60 to start to peel away the law’s reforms.
  • Though largely procedural, certain provisions were targeted by Republican senators including an amendment that supports protecting pre-existing conditions for healthcare insurance. Before the ACA passed, many insurance companies considered pregnancy a pre-existing condition. They also attacked protections for veterans and health care coverage for contraceptives.
  • But a reconciliation bill is more complicated than it may look, despite Trump’s vow to get rid of the ACA on “day one” of his administration. The Republicans have to figure out how the bill will be constructed and then work out how to do the actual repealing.
  • This means that they really don’t have anything to replace the ACA with and some Republican legislators have outright objected to taking a vote without a replacement plan. “Putting nearly $10 trillion more in debt on the American people’s backs through a budget that never balances is not the way to get there,” said Rand Paul, the only GOP senator to vote agains the measure. “It is the exact opposite of the change Republicans promised, and I cannot support it, even as a placeholder.”
  • The resolution goes to the House on Friday for a vote, which is expected to pass. That will then set the stage for the reconciliation bill. However House Republicans are demanding more specifics before they vote for a total passage of the budget measure. “We just want more specifics,” said North Carolina Rep. Mark Meadows. “I’m willing to take a vote today if we have the specifics. So it’s not as much slow it down for slowing-it-down purposes as it is, we need to know what we’re going to replace it with.”



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