Mitch McConnell
Credit: Gage Skidmore/Flickr

The Senate hasn’t posted the roll call yet, but the Republicans managed to clear a major hurdle in their quest to deny tens of millions of Americans access to health care. With Senators Susan Collins of Maine and Lisa Murkowski of Alaska dissenting, the Senate voted 51-50 on a motion to proceed to some nebulous set of amendments that doesn’t currently even resemble a bill. Vice-President Mike Pence cast the tie-breaking vote. This is further than I thought they would get, mainly because losing this vote would have been the most painless way to end their agony. Instead, they must go through an exhausting process that will be humiliating and dishonorable.

After the vote, Sen. John McCain was provided fifteen minutes to talk to his fellow senators, and he made clear that he did not think that a bill will pass using this process and that he had no intention of voting for anything he can see as being on the table. Without his vote or the votes of Collins and Murkowski, the bill will fail. But it will also fail if it includes crippling Medicaid cuts or if it does not include crippling Medicaid cuts. Majority Leader Mitch McConnell has never been able to resolve that conundrum, and it’s not at all clear that he’ll discover a solution now. Finding a solution that can satisfy senators from states that have expanded Medicaid like Sen. Rob Portman of Ohio, Dean Heller of Nevada, and Shelley Moore-Capito of West Virginia might be possible, but not in a way that will be acceptable to hardcore opponents of Obamacare like Rand Paul of Kentucky, Ron Johnson of Wisconsin, and Mike Lee of Utah.

Still, the battle is now on. Even if what emerges from this bill is watered down, it’s likely to be quite damaging to our health care system if anything passes. The Democrats better have had a big bowl of Wheaties this morning, because they’ll need to be ready to use every parliamentary trick and every poison amendment to assure that the end product will not be broadly acceptable to the entire Republican caucus.

The danger could have ended today, but it did not. If calls to your representatives were urgent yesterday, they’re doubly so now.

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Martin Longman is the web editor for the Washington Monthly. See all his writing at