US Senate in Showdown Over Health Law Overhaul

Republican leaders in the U.S. Senate are now trying to win support for limited changes in the country's health care law after failing both to repeal it outright and to replace it with new policies.

The new effort Thursday is aimed at winning enough votes to approve what Republicans are calling a "skinny" bill that would void part of the seven-year-old Affordable Care Act. The proposal would end the requirement that most Americans buy health insurance or pay a penalty if they don't, and that employers must provide workers medical insurance, in addition to abolishing a tax on medical devices.

But the scaled-down effort would leave intact much of what is commonly called Obamacare, the signature domestic legislative achievement of former President Barack Obama, including a provision requiring insurers to sell policies to people with pre-existing medical conditions that are costly to treat.

So far, however, Republican leaders have yet to secure enough support to approve even the scaled-down bid to make good on their election campaign promises to repeal and replace the law. Conservative lawmakers want to gut as much as possible of Obamacare, while more moderate Republicans are worried that changes could end or limit the government's insurance coverage for millions of poorer Americans.

Senate Republican leaders hope to pass the limited repeal and then negotiate with leaders in the House of Representatives over a final version. The House narrowly passed its version of an Obamacare repeal in May, one initially applauded by President Donald Trump, but then later described as "mean."

Trump, in a new Twitter comment early Thursday, exhorted the Republican majority in the Senate to move ahead in the health care overhaul.

"Come on Republican Senators, you can do it on Healthcare," he said. "After 7 years, this is your chance to shine! Don't let the American people down!"

Republicans hold a 52-48 majority in the Senate. With all 48 Democrats opposed to overturning Obamacare, Republican leaders can only afford to lose two dissenters, with Vice President Mike Pence casting a tie-breaking vote in the event of a 50-50 deadlock, just as he did earlier this week in favor of formally opening the health care debate.

Nine Republican senators joined all the Democrats in rejecting new policies crafted by Majority Leader Mitch McConnell, while seven Republicans joined the Democratic minority bloc against the measure calling for an outright repeal with a two-year delay to development a replacement.

New votes could be taken Thursday and extend into Friday.

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