Senate votes to open debate on health care repeal



WASHINGTON (Reuters) - U.S. Senate Republicans narrowly agreed on Tuesday to open debate on a bill to repeal Obamacare, but the party's seven-year effort to roll back Democratic President Barack Obama's signature health care law still faces significant hurdles.

The Senate deadlocked 50-50 on whether to move forward with the health care debate, forcing Vice President Mike Pence to cast the tie-breaking vote and send the bill to the Senate floor.

SEE ALSO: Trump jokes Price better get health care votes otherwise he's 'fired'

The outcome was a huge relief for President Donald Trump, who had pushed his fellow Republicans hard in recent days to live up to the party's campaign promises to repeal the 2010 Affordable Care Act, commonly known as Obamacare.

But the narrow victory on a simple procedural matter raised questions about whether Republicans can muster the votes necessary to pass any of the repeal approaches the Senate will consider.

Senator John McCain, who has been battling brain cancer at home in Arizona, made a dramatic return to the Capitol to cast a vote to open the health care debate. He received an ovation from his fellow senators when he entered the chamber.

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Protests against the Republican health care bill
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Protests against the Republican health care bill
THE PARK IMPERIAL AT 230 WEST 56TH ST , NEW YORK, UNITED STATES - 2017/07/10: New Yorkers and healthcare advocacy groups organized a protest on July 10, 2017; outside Rep. John Faso's fundraiser as donors arrive at the Park Imperial at 230 West 56th St. in Midtown Manhattan. Faso voted for the House Trumpcare bill in May, he also coauthored the notorious Collins-Faso amendment to both the House and Senate bills that would shift New York Medicaid funding from counties budgets to the state budget. (Photo by Erik McGregor/Pacific Press/LightRocket via Getty Images)
A healthcare activist protests to stop the Republican health care bill at Russell Senate Office Building on Capitol Hill in Washington, U.S., July 17, 2017. REUTERS/Yuri Gripas
Healthcare activists protest to stop the Republican health care bill at Russell Senate Office Building on Capitol Hill in Washington, U.S., July 17, 2017. REUTERS/Yuri Gripas
Healthcare activists get a police warning during a protest to stop the Republican health care bill at Hart Senate Office Building on Capitol Hill in Washington, U.S., July 17, 2017. REUTERS/Yuri Gripas
Healthcare activists protest to stop the Republican health care bill at Hart Senate Office Building on Capitol Hill in Washington, U.S., July 17, 2017. REUTERS/Yuri Gripas
WASHINGTON, DC - JULY 10: A demonstrater from Arizona chants, 'Kill the bill or lose your job' while sitting on the floor outside the offices of Sen. Jeff Flake (R-AZ) during a protest against health care reform legislation in the Russell Senate Office Building on Capitol Hill July 10, 2017 in Washington, DC. More than 100 people from across the country were arrested during the protest that was organized by Housing Works and Center for Popular Democracy. (Photo by Chip Somodevilla/Getty Images)
NEW YORK COUNTY REPUBLICAN OFFICE, NEW YORK, UNITED STATES - 2017/07/05: The Socialist Feminists of Democratic Socialists of America (DSA) organized a protest outside of the New York County Republican Office in New York City on July 5, 2017; to tell Republicans that is it despicable and undemocratic that they are trying to ram Trumpcare through the Senate without debate or public hearings. (Photo by Erik McGregor/Pacific Press/LightRocket via Getty Images)
UNITED STATES - JULY 10: Health care protesters from Arkansas chant outside of the office of Sen. John Boozman, R-Ark., in the Hart Senate Office Building on Monday, July 10, 2017. About a dozen people loudly voiced opposition to the GOP health care bill. (Photo By Bill Clark/CQ Roll Call)
THE PARK IMPERIAL AT 230 WEST 56TH ST , NEW YORK, UNITED STATES - 2017/07/10: New Yorkers and healthcare advocacy groups organized a protest on July 10, 2017; outside Rep. John Faso's fundraiser as donors arrive at the Park Imperial at 230 West 56th St. in Midtown Manhattan. Faso voted for the House Trumpcare bill in May, he also coauthored the notorious Collins-Faso amendment to both the House and Senate bills that would shift New York Medicaid funding from counties budgets to the state budget. (Photo by Erik McGregor/Pacific Press/LightRocket via Getty Images)
NEW YORK, NY - JULY 5: A small group of activists rally against the GOP health care plan outside of the Metropolitan Republican Club, July 5, 2017 in New York City. Republicans in the Senate will resume work on the bill next week when Congress returns to Washington after a holiday recess. (Photo by Drew Angerer/Getty Images)
A small group of activists rally against the GOP health care plan outside of the Metropolitan Republican Club, July 5, 2017 in New York City. Republicans in the Senate will resume work on the bill next week when Congress returns to Washington after a holiday recess. (Photo by Zach D Roberts/NurPhoto via Getty Images)
Healthcare activists protest to stop the Republican health care bill at Russell Senate Office Building on Capitol Hill in Washington, U.S., July 10, 2017. REUTERS/Yuri Gripas
Healthcare activists are detained after a protest to stop the Republican health care bill at Hart Senate Office Building on Capitol Hill in Washington, U.S., July 17, 2017. REUTERS/Yuri Gripas
A staff members asks the media to leave the room as Healthcare activists protest in the office of Senator Jeff Flake (R-AZ) to stop the Republican health care bill at Russell Senate Office building on Capitol Hill in Washington, U.S., July 10, 2017. REUTERS/Yuri Gripas
U.S. Capitol police arrest demonstrators in wheelchairs protesting against the AHCA health care bill put forward by President Trump and Congressional Republicans as several dozen protestors are taken into custody after refusing to leave the rotunda of the U.S. Capitol in Washington, U.S., March 22, 2017. REUTERS/Jim Bourg
Demonstrators hold signs during a protest against the repeal of the Affordable Care Act outside the Capitol Building in Washington, U.S., March 22, 2017. REUTERS/Aaron P. Bernstein
Healthcare activists are detained after a protest to stop the Republican health care bill at Russell Senate Office Building on Capitol Hill in Washington, U.S., July 17, 2017. REUTERS/Yuri Gripas
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Senators Susan Collins and Lisa Murkowski were the only Republicans to oppose the measure. Democrats were united in opposition to the motion to proceed.

A loss on Tuesday could have been a death blow for Republican efforts to repeal Obamacare, and also cast doubt on Trump's prospects to achieve any of his other top legislative agenda items, including tax reform.

"We have a duty to act," Senate Majority Leader Mitch McConnell told senators before the vote, reminding Republicans they had promised to repeal Obamacare in four straight elections. "We can't let this moment slip by."

As the vote opened, more than two dozen protesters in the Senate chamber chanted "kill the bill" before they were removed.

The Senate will now launch what McConnell has promised will be a robust debate on health care that could include a variety of amendments.

Senators said a variety of approaches have been discussed, including a straight repeal of Obamacare with no replacement plan, or repealing and replacing the law while also overhauling Medicaid, the federal health insurance program for the poor and disabled.

Senate Republicans also could consider a shortened version of repeal, called a "skinny repeal," that would end Obamacare's individual and employer mandates and the medical device tax, a Senate aide and a lobbyist said.

"Some of us want clean repeal, some of us want the Senate leadership bill, they're both going to get a vote early on and I think that's a fair way to do it," Republican Senator Rand Paul said. "If either one of them fails and another one succeeds, maybe we can find something in between that actually succeeds."

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