Voterama in Congress Logo
Find Reps & Senators by
Search Members by State Button
Search Members by Zipcode Button
US Senate

A Closer Look
at Healthcare Issues...

For constituents seeking to dig deeper into their senators' stands on healthcare issues, this page provides additional detail on eight key Senate votes from 2017-2020, including pro-and-con quotes that cut to the heart of partisan and ideological differences in this policy area.
1. Setting Budget Rules For Health Law Repeal
(Votes lookup at Roll Call #26)

Voting 51 for and 48 against, the Senate on Jan. 12, 2017, adopted the budget framework for Republican efforts to repeal or dismantle the Affordable Care Act (ACA). The rules (S Con Res 3) allowed the Senate to repeal the ACA's tax and spending provisions (including its Medicaid expansion) by a simple majority vote, but left other parts of the GOP legislation vulnerable to filibusters.

Floor Debate, Pro & Con:

Cory Gardner, R-Colo., said it is time "to restore reliable and stable health care as well as healthcare markets and insurance markets, and to undo the damage" wrought by the health law.

Richard Durbin, D-Ill., said: "Let's find a way to make the Affordable Care Act even stronger, better, fairer. Sign me up. Make it a bipartisan effort. Don't repeal it. Sit down and rewrite it...."

A yes vote was to advance GOP plans to take down the health law.

2. Starting Debate on Affordable Care Act Repeal
(Votes lookup at Roll Call #167)

By a tally of 51 for and 50 against, with Vice President Mike Pence casting the decisive vote, the Senate on July 25, 2017, agreed to start debate on a House-passed bill (HR 1628) that was the legislative vehicle for later votes to repeal or dismantle the Affordable Care Act.

Floor Debate, Pro & Con:

Orrin Hatch, R-Utah, said: "Anyone who supports the larger effort to repeal and replace Obamacare should be willing to at least debate the various proposals that have been put forward. That is the very definition of a no-brainer."

Brian Schatz, D-Hawaii, said the GOP approach means "people are going to be hurt -- people with preexisting conditions, families with loved ones struggling with opioid abuse, people in nursing homes, people who rely on Planned Parenthood and the tens of millions of people who will lose their insurance almost instantly."

A yes vote was to start debate on GOP legislation to take down the health law.

3. Allowing States to Offer Diluted Health Plans
(Votes lookup at Roll Call #168)

Voting 43 for and 57 against, the Senate on July 25, 2017, failed to reach 60 votes needed to advance changes proposed by Republican Sens. Ted Cruz of Texas and Rob Portman of Ohio to HR 1628. Cruz sought to allow insurers to sell low-cost, bare-bones policies in states where they also offer at least one policy compliant with the Affordable Care Act. Portman sought a $100 billion authorization over 10 years for defraying out-of-pocket costs faced by individuals compelled by the GOP bill to transfer from Medicaid to private insurance.

Floor Debate, Pro & Con:

Cruz said his plan "takes away nothing" because "if you like your Obamacare plans, those are still there. It just adds new options and lets you decide: Do you want the Obamacare option or do you want something else that is affordable?"

Ron Wyden, D-Ore., called the plan "a prescription for misery for millions of Americans dealing with serious illness and bedlam in the private insurance market...This bill is going to send health expenses like deductibles and copayments into the stratosphere."

A yes vote was to adopt the Cruz-Portman measure.

4. Repealing Affordable Care Act
(Votes lookup at Roll Call #169)

Voting 45 for and 55 against, the Senate on July 26, 2017, rejected a proposal by Rand Paul, R-Ky., that would repeal much of the Affordable Care Act (ACA) over two years without providing a replacement. An amendment to HR 1628, the measure sought to end premium subsidies in ACA exchanges and roll back the expansion of Medicaid eligibility then underway in 31 states.

In addition, the amendment would remove the requirement that individuals carry health insurance or pay a tax penalty, the mandate that large employers provide workers with health coverage, and tax provisions that fund the healthcare law.

Floor Debate, Pro & Con:

Rand Paul, R-Ky., said: "The government should not be involved in my healthcare business. I want to be left alone. The right to privacy, the right to be left alone is a fundamental right of Americans. That is what this is about."

Ron Wyden, D-Ore., said: "The pain for our families under this repeal measure is going to start right away....Seventeen million fewer Americans are going to have healthcare one year from now" if the Republican bill becomes law.

A yes vote was to adopt the Paul amendment.

5. Prohibiting Scale-Back of Medicaid
(Votes lookup at Roll Call #170)

Voting 48 for and 52 against, the Senate on July 26, 2017, defeated an amendment that sought to remove language from the GOP repeal bill that would convert Medicaid to a state-run program with only minimal federal oversight and prevent states from expanding Medicaid eligibility under the Affordable Care Act.

Floor Debate, Pro & Con:

Joe Donnelly, D-Ind., said the GOP changes "would harm millions of working Americans who count on Medicaid for basic healthcare. It would affect more families than that, including those families who have insurance through their jobs but also use Medicaid to access care for chronic or complex conditions."

John Cornyn, R-Texas, said Republicans "want to put Medicaid,the safety net for low-income Americans,on a sustainable path....In my state, only about one third of doctors will accept a new Medicaid patient because it pays at such a low rate."

A yes vote was to adopt the amendment.

6. Repealing Affordable Care Act
(Votes lookup at Roll Call #179)

Voting 49 for and 51 against, with Sen. John McCain, R-Ariz., casting the deciding vote, the Senate defeated on July 28, 2017, defeated a GOP-sponsored measure to repeal much of the Affordable Care Act (ACA) without providing a comprehensive replacement.

An amendment to HR 1628, the measure sought to eliminate individual and employer mandates; undercut the ACA's "essential health benefits;" scale back Medicaid and put most of the program under state control; expand Health Savings Accounts and put a one-year hold on patients using Medicaid to obtain care at Planned Parenthood clinics, among other provisions. The Congressional Budget Office said the measure would increase the number of uninsured Americans by 15 million in the next year while sharply raising premiums in the individual insurance market.

Floor Debate, Pro & Con:

Rob Portman, R-Ohio, said: "Today, after seven years of consistently calling for repeal and replace, I am supporting a sensible plan to do just that. Is it perfect? No. I don’t think any substitute is. Replacement is hard. But it is an improvement on the unsustainable status quo" of Obamacare.

McCain said: "I will not vote for this bill as it is today. It is a shell of a bill right now." He added that "Democrats shouldn't have forced through Congress -- without any opposition support -- a social and economic change as massive as Obamacare, and we shouldn’t do the same with ours."

A yes vote was to repeal core provisions of the 2010 health law.

7. Blocking Trump Rule to Weaken Health Law
(Votes lookup at Roll Call #226)

Voting 50-50, the Senate on Oct. 10, 2018, defeated a bid to overturn a Trump administration rule under which states could authorize the sale of short term health insurance in the individual market as an alternative to Affordable Care Act (ACA) coverage. Such policies cost less because they omit the ACA's "essential health benefits," including coverage of consumers with pre-existing conditions and a prohibition on annual or lifetime coverage limits.

Critics called such plans "junk insurance" that would weaken the health law by siphoning off younger and healthier individuals, while supporters said they offer an affordable alternative to persons seeking relief from the ACA's many regulations. The vote occurred during debate on SJ Res 63.

Floor Debate, Pro & Con:

Tammy Baldwin, D-Wis., said: "The Trump administration has expanded junk insurance plans. These plans are cheap for a reason; they do not have to provide essential health benefits like hospitalization, prescription drugs and maternity care."

Lamar Alexander, R-Tenn., said the rule "doesn't change one single word in the Affordable Care Act, which guarantees that if you have a pre-existing condition, you have a right to buy Obamacare, and you can't be charged more because of it."

A yes vote was to use the Congressional Review Act to nullify the Trump administration rule.

8. Blocking Administration Order on Diluted Plans
(Votes lookup at Roll Call #337)

Voting 43 for and 52 against, the Senate on Oct. 30, 2019, turned back a Democratic measure (SJ Res 52) that would prohibit Trump administration waivers under which state-run insurance exchanges could offer diluted versions of coverage required by the Affordable Care Act (ACA).

The ACA standards are intended to ensure individuals with pre-existing conditions to receive coverage. In addition, they require policies to cover "essential health benefits" such as pediatric care, mental health and substance-abuse treatments, emergency care, outpatient services and maternity care.

Backers of the waiver policy said it gives states flexibility to offer lower-priced yet satisfactory alternatives. But critics said such policies would hollow out the health law by siphoning healthy and younger individuals out of risk pools.

Floor Debate, Pro & Con:

Jeanne Shaheen, D-N.H., said: "I think it is important to understand the shortcomings of these junk plans that the administration is promoting. These plans are allowed to deny coverage to someone who has a pre-existing condition."

John Barasso, R-Wyo., said: "Republicans remain 100 percent committed to protecting people with preexisting conditions. We will protect them today, tomorrow and always."

A yes vote was to adopt the Democratic resolution.

Copyright 2020, Thomas Voting Reports, Inc.