Health Care Alert: “Skinny Repeal” Rejected in Senate

Health Care Alert:  “Skinny Repeal” Rejected in Senate 

During the early hours of July 28, Senators Susan Collins (R-Maine), John McCain (R-Ariz.) and Lisa Murkowski (Alaska) voted “no” on the Senate Republican’s “skinny repeal” proposal, a scaled-back version of previously supported Senate Republican Affordable Care Act (ACA) repeal bills, which failed by a vote of 49 to 51. If the vote on final passage had been successful, it would likely have triggered a conference committee with the House of Representatives whereby the chambers would have tried to resolve their legislative differences. Senate Majority Leader Mitch McConnell’s (R-Ky.Y) statement on the failed vote can be read here.  

At this time, it is unclear what further action Congress will take on health care reform.  Most likely, their attention will now turn to tax reform.  

Below is an overview of the actions that led up to the July 28 vote:

On July 25, the U.S. Senate voted to begin debate on the repeal of the Affordable Care Act (ACA). The Senate voted 50-50, with Vice President Mike Pence breaking the tie, in support of moving forward with debate on H.R. 1628, the American Health Care Act. In advance of the vote, ABC sent a key vote letter urging senators to vote “yes” on the motion to proceed. 

On Tuesday evening, the Senate voted on the Senate Republicans’ Better Care Reconciliation Act, which included the Cruz and Portman proposals.  The amendment failed by a vote of 43 to 47, with nine Republican senators voting no.  Sixty votes were needed for it to advance. 

On July 26, the Senate voted on Sen. Rand Paul's (R-Ky.) amendment to repeal the ACA with a two-year delay, which failed by a vote of 45-55.  Seven Republican senators voted no.  

The Senate moved forward with 20 hours of debate and voted on dozens of amendments. 


On May 4, the U.S. House of Representatives took steps to repeal and replace the ACA by passing H.R. 1628, the American Health Care Act (AHCA). H.R. 1628 would repeal several of the most harmful and burdensome provisions of the ACA, including the employer mandate penalty, costly tax increases and limitations on contributions to and restrictions on the use of flexible spending accounts and health savings accounts. ABC sent a letter in support of H.R. 1628 to the U.S. House of Representatives, which passed the House by a vote of 217-213

For the past several weeks, the U.S. Senate had worked on crafting “repeal and replace” legislation, and at the end of June, H.R. 1628, the Better Care Reconciliation Act (BCRA) was unveiled as well as scored by the Congressional Budget Office (CBO). On July 13, an updated version of BCRA was released following further discussions with the Senate Republican Conference, which included the much-publicized Cruz amendment.  No vote was taken on the bill, as various reports indicated Republicans did not have enough support to move the bill forward.   

On July 20, a third draft of the BCRA was released (see a section-by-section summary for details). CBO estimated that over the next ten years, the bill (which did not include the Cruz amendment) would reduce federal deficits by $420 billion and increase the number of uninsured individuals by 22 million in 2026.  

ABC staff will continue to provide updates on any health care developments in Newsline.