Senate closes in on Obamacare repeal: Here’s how it works

FILE - In this June 25, 2015, file photo, supporters of the Affordable Care Act hold up signs as the opinion for health care is reported outside of the Supreme Court in Washington. (AP Photo/Jacquelyn Martin, File)

WASHINGTON (MEDIA GENERAL) – Five years after Obamacare became federal law, the U.S. Senate is on track to pass a major repeal this week, following dozens of previous attempts in the House.

“It’s time to repeal this law and to start moving to the kind of health care reform Americans are actually looking for,” declared Sen. John Thune.

The South Dakota Republican argued on the Senate floor that Americans are drowning in rising health care deductibles and urgently need “an affordable, accountable, patient-focused system.”

To achieve that, Thune and other conservative leaders will give the Affordable Care Act its biggest gut punch to date – an official repeal vote.

In a twist of legislative fate, GOP Senate leaders will pass their Obamacare repeal package through reconciliation, the same technical procedure Democrats used to pass it in 2010.

Sen. John Thune calls for repeal of Obamacare through reconciliation. (Courtesy: C-SPAN)
Sen. John Thune calls for repeal of Obamacare through reconciliation. (Courtesy: C-SPAN)

Reconciliation is a parliamentary maneuver only allowed on budget-related bills. It’s a useful tool for the majority party when it comes to eking out narrow victories on contentious issues, since reconciliation guidelines eliminate filibusters and require a modest 51-vote majority for approval.

Reconciliation also allows an unlimited number of amendments. But there’s a catch – each amendment must be budget-related as well.

Rather than permitting partisan members to vouch for their amendments’ relevance, Senate rules empower the upper chamber’s parliamentarian to make rulings on the nature of each proposal. In legislative parlance, the add-ons must be “germane” to the budgetary focus of the underlying bill.

The current Senate parliamentarian is Elizabeth MacDonough. She’s an unelected, nonpartisan staffer responsible for knowing and enforcing every jot and tittle of the Senate rulebook.

Elizabeth MacDonough
Elizabeth MacDonough (Courtesy: Wikimedia Commons)

When MacDonough became the Senate’s first-ever female parliamentarian in 2012, Politico described her as a “lace-curtain Irish but with a street-smart whimsy.” It also gushed that MacDonough “earned her stripes but also kept her touch, addressing Capitol janitors by their names while still being able to break down the Senate’s arcane procedures so outsiders can understand.”

This week, MacDonough will be in charge of breaking down which issues fall under the reconciliation process and which are unrelated – unavoidably earning her fans and naysayers.

Based on senators’ floor speeches Tuesday, MacDonough will likely issue rulings on everything from taxes on so-called Cadillac policies to rules mandating employer health care coverage.

While the parliamentarian theoretically functions in a politics-free bubble, it’s difficult to overestimate the partisan pressures accelerating this process.

At its core, the repeal effort is really about campaign promises and bragging rights.

“The Republican-led Senate will keep a promise that we made to the American people … in the last election we told them that we would vote to repeal Obamacare, which is the largest federal overreach in recent history,” said Sen. John Cornyn of Texas, the chamber’s second-ranking GOP member. 

The reconciliation package will also likely address another conservative marquee issue, according to The Washington Post: defunding Planned Parenthood.

This allows members of Congress to return home for December recess with two major talking points. In one fell swoop, WaPo reports that Republicans will have “a chance to force a veto confrontation with Obama over both issues before the end of the year.”

Thune expressed a sunny prospect of Republicans and Democrats joining forces to construct a newer, better Obamacare alternative, saying, “I look forward to debating the bill and working with my colleagues to begin building a bridge to a better health care system for hardworking families across the country.”

Don’t bet on it.

President Obama and fellow Democrats will fight tooth and nail to keep the current system in place.

Before Republicans even got to introduce their bill on Tuesday, Democratic Leader Sen. Harry Reid of Nevada strode to his desk, clipped on his microphone, and announced that the repeal “means nothing” since “it will pass and go to the president and he’ll veto it in about 10 seconds.”

Top Republicans predict the final reconciliation measure will pass on or around Thursday.

If the Senate deviates in any way from the House-passed Obamacare repeal it’s based on, the lower chamber will be required to pass a new version that matches the Senate’s before it can be sent to President Obama’s desk.

Follow Chance Seales on Twitter: @ChanceSeales

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