
[W]ASHINGTON — In a dramatic vote Tuesday afternoon punctuated by the shouts of protesters from Vermont and elsewhere, the Senate took a step toward repealing the signature health care law of the Obama era.
With a vote of 51 in favor and 50 against, the Senate opened debate on a House bill that would repeal and replace the Affordable Care Act.
Two Republicans broke ranks and voted with the Democrats and independents — including both Vermont senators — against the motion. Vice President Mike Pence broke the tie.
Whether there would be sufficient support in the Republican caucus to pass the motion to proceed was in question even as the vote began. The passage of the motion began 20 hours of debate, which can be spread across several days, on the bill.
Senate Majority Leader Mitch McConnell, R-Ky., previously postponed action on Obamacare repeal several times as Republicans splintered in their support for various proposals.
The vote count was made more uncertain with the announcement last week that Sen. John McCain, R-Ariz., has a serious form of brain cancer. Despite the recent diagnosis, McCain returned to Washington this week for the vote on Obamacare repeal.
Still, the fate of the health care bill remains uncertain. Though Republicans secured enough votes to open debate, every legislative proposal that has been floated so far has lost key levels of support within the caucus.
The bill that passed the House earlier this year likely does not have the votes to pass the Senate, but senators are in the process of offering various proposals to amend the legislation. There are also reports that McConnell is considering a new pared-down “skinny repeal” proposal designed to get enough Republicans on board to pass the bill.
Vermont’s senior senator, Democrat Patrick Leahy, said that even now, as debate begins, the Republican leadership’s vision for legislation isn’t clear.

“Nobody knows what a final bill is going to look like, or anything close to it,” Leahy said. “I wish I could tell you what it would be, but (Republicans) don’t know.”
The vote Tuesday began midafternoon, after weekly caucus luncheons.
McConnell walked determinedly past throngs of reporters, forgoing a customary press briefing, to go straight to the Senate floor.
“The American people elected a House with a vision, with a better way on health care, and then they elected a Senate and then they elected a president,” McConnell said on the floor. “Now, having been given the responsibility to govern, we have a duty to act.”
As the motion was made, protesters began to chant: “Kill the bill, kill the bill.” They continued to yell out as security removed them from the gallery.
Half a dozen Vermonters were among the demonstrators, including state Rep. Kiah Morris, D-Bennington.
Even after the demonstrators were outside the chamber, their chanting echoed through the Senate as the clerk called the names of each member to cast their votes.
The only two Republicans to vote against taking up the bill were Sens. Susan Collins, of Maine, and Lisa Murkowski, of Alaska. One more Republican dissenter would have defeated the motion.
As the clerk read out names, Democrats and independents initially sat silently. After all the Republican votes were tallied, the opponents cast their “no” votes one by one. Leahy said they did so because they wanted to make the contrast in votes “very clear.”
“We wanted the American public to see who was on their side,” Leahy said later in the day.
Several tense minutes passed as McCain and one other remaining Republican had not yet voted. About 100 reporters crowded into the press gallery to wait. Senate aides lined the chamber walls, looking on, as senators chatted with each other and checked their phones.
McCain, a wound above his left eye, entered the chamber to a standing ovation from both sides of the aisle. He and Sen. Ron Johnson, R-Wis., cast their votes in favor — paving the way for the motion’s success.
After the voting, McCain took the podium and delivered a passionate speech that raised applause from both Republicans and Democrats.
“Stop listening to the bombastic loudmouths on the radio, television and internet. To hell with them. They don’t want anything done for the public good. Our incapacity is their livelihood,” he said. “Let’s trust each other. Let’s return to regular order.”
While Republican leaders held a press briefing after the vote inside, a gaggle of lawmakers who opposed the motion, including Sen. Bernie Sanders, I-Vt., went outside to meet protesters on the lawn.

Vermont’s delegation voiced strong opposition to the motion to proceed on the Obamacare repeal bill.
Late Tuesday afternoon, Leahy said he felt the vote was “unfortunate for the country” and “unfortunate for what it means about the Senate.”
He charged that “Trumpcare is a tax plan, disguised as a health plan.”
In a statement, Sanders said the motion to proceed is a step toward “passing the most dangerous and destructive piece of legislation in the modern history of our country.”
“If this bill ends up resembling the House bill, 22 million people will lose health insurance, Medicaid will be cut by nearly $800 billion over the next decade, premiums for older Americans will increase, and 2.5 million women will lose health care as a result of defunding Planned Parenthood. Make no mistake about it, thousands of Americans every year will die unnecessarily if this legislation is passed,” Sanders said.
The proposals to repeal the Affordable Care Act have drawn criticism from top Vermont GOP officials as well. Gov. Phil Scott, who has been openly critical of the Senate’s Obamacare repeal bill, said in a statement Tuesday evening that he will work with other governors and Vermont’s congressional delegation on health care.
“I hope that during the ongoing discussion the Senate will consider the feedback numerous states, including Vermont, have given about the need to maintain federal-state partnerships that build on the approaches states have taken to ensure people have access to health care,” Scott said.
The protesters from Vermont, organized by the group Rights and Democracy, drove to Washington, D.C., on Monday and spent the night sleeping on the floor of a church. Members of the group said they wanted to join the protests for many reasons, including the belief that everyone has a right to health care. One participant said she came because this is a “huge moment for the country.”
Three Vermonters were arrested as part of the protest, according to Morris, who was not arrested. Capitol Police said 95 protesters in all were arrested Tuesday afternoon.
Sitting in the sunshine a few blocks from the capitol Tuesday morning before the vote, Morris said the proposed health care policy changes would have a major impact in Vermont, where federal funding is a key factor in programs that serve vulnerable populations.
Morris also criticized the way the proposals were being brought forward.
“It’s being played like an insidious chess game with people’s lives as the pawns, and that just disgusts me,” she said.
