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Senate approves bill repealing much of ObamaCare

The Senate on Thursday passed legislation repealing the core pillars of ObamaCare, taking a major step toward sending such a bill to the president’s desk for the first time.

Republicans hailed it as a political messaging victory and a fulfillment of their promise from the 2014 midterm election to force President Obama to veto the landmark healthcare reform law named after him.

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The measure passed 52-47 after the Senate voted to significantly strengthen the bill originally passed by the House and brought straight to the floor by Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellGraham: I hope Dems 'get their ass kicked' for conduct around Kavanaugh Saudi mystery drives wedge between Trump, GOP Overnight Defense: Trump worries Saudi Arabia treated as 'guilty until proven innocent' | McConnell opens door to sanctions | Joint Chiefs chair to meet Saudi counterpart | Mattis says Trump backs him '100 percent' MORE (R-Ky.).

The House will need to approve the amended legislation before it can be sent to the White House.

Thursday’s vote was a major event in the Senate, as Democrats never allowed a stand-alone vote on an ObamaCare repeal bill when they controlled the chamber.

Democrats were also unable to block the GOP measure, which was brought to the floor under budget reconciliation rules that prevented a filibuster.

“For too long, Democrats did everything to prevent Congress from passing the type of legislation necessary to help these Americans who are hurting,” McConnell said on the floor. “Today, that ends.”

The measure guts the law by repealing authority for the federal government to run healthcare exchanges, and scrapping subsidies to help people afford plans bought through those exchanges. It zeros out the penalties on individuals who do not buy insurance and employers who do not offer health insurance.

Sen. Bernie Sanders (I-Vt.), who is running for the Democratic presidential nomination, missed the final vote. 

The vote caps weeks of intense and at times acrimonious debate within the Senate GOP conference over how far the repeal should go.

Conservative Sens. Ted CruzRafael (Ted) Edward CruzFive takeaways from Cruz, O'Rourke's debate showdown O'Rourke's mom discusses past Dem votes after labeled 'lifelong Republican' by son Live coverage: Cruz faces O'Rourke in Texas debate showdown MORE (R-Texas) and Marco Rubio (R-Fla.), who are running for president, and Sen. Mike LeeMichael (Mike) Shumway LeeSenators pledge action on Saudi journalist’s disappearance Bernie Sanders: US should pull out of war in Yemen if Saudis killed journalist Senators warn Trump that Saudi relationship is on the line MORE (R-Utah) threatened to oppose a House-passed repeal bill for not going far enough.

Three moderates, Sens. Susan CollinsSusan Margaret CollinsGraham: I hope Dems 'get their ass kicked' for conduct around Kavanaugh St. Lawrence alumni, faculty want honorary degree for Collins revoked 'Suspicious letter' mailed to Maine home of Susan Collins MORE (R-Maine), Mark Kirk (R-Ill.) and Lisa MurkowskiLisa Ann MurkowskiEx-Florida lawmaker leaves Republican Party Murkowski not worried about a Palin challenge Flake on Kavanaugh confirmation: To see GOP 'spiking the ball in the end zone' doesn't seem right MORE (R-Alaska), balked at it for including language defunding Planned Parenthood.

GOP leaders briefly floated the possibility of dropping the Planned Parenthood language but dropped the idea knowing it could spark a conservative backlash.

Instead, McConnell leaned on Cruz, Rubio and Lee to vote yes and sweetened the prospect by crafting an amendment that dramatically beefed up the Senate package. All three voted yes.

“This bill is a substantial improvement over the original House bill, and I’m grateful to Senate conservatives and Senate leadership for joining me in making it so,” Cruz said in a statement after the vote. 

It repeals the expansion of Medicaid adopted by 30 states as well as many of the law’s tax increases, which the House bill left in place.

It cuts funding for the Prevention and Public Health Fund and eliminates risk adjustment programs from insurance companies that lose money because of the law.

The House bill eliminates the individual and employer mandates, the "Cadillac tax" on expensive insurance plans and the medical device tax.

The question of how to handle Medicaid was a thorny one for McConnell because it pitted conservatives, who demanded a repeal, against Republican colleagues from states that expanded the safety-net program.

“I am very concerned about the 160,000 people who had Medicaid expansion in my state. I have difficulty with that being included,” Sen. Shelley Moore Capito, a Republican from West Virginia, told The Hill earlier this month.

Vulnerable GOP incumbents face reelection next year in several states that have expanded Medicaid: Illinois, New Hampshire, Ohio and Pennsylvania.

McConnell eased their concerns by phasing in the repeal over two years to give the federal government and states time to come up with a replacement program.

The Senate bill also repeals the over-the-counter medicine tax, the prescription drug tax, an annual fee on health insurers and the tax on indoor tanning services. It reduces the threshold of healthcare costs that can be deducted from 10 percent to 7.5 percent of adjusted gross income.

Cruz and Rubio signaled to GOP leaders earlier in the week that they would vote for the package but Cruz held out, keeping his colleagues guessing.

The GOP leadership braced itself for the possibility that Cruz might attempt to force the Senate to vote on a one-sentence provision repealing the entire bill, which the Senate Parliamentarian Elizabeth MacDonough had ruled out of order.

Cruz could have attempted to overturn the ruling of the presiding chair, who almost always follows the advice of the parliamentarian, with a simple-majority vote. But he decided not to, a pragmatic move since he colleagues were unlikely to back him.

Collins and Kirk voted against the repeal package after an amendment they offered earlier in the day to strike the language defunding Planned Parenthood failed by a vote of 48-52.

Murkowski, another sponsor of the amendment to protect Planned Parenthood funding, voted yes for the broader bill after declining to take a public position before the floor debate.

The Senate voted throughout the afternoon on a variety of amendments, many of them intended to send a political message.

Democrats sought to score political points by offering an amendment sponsored by Sen. Dianne FeinsteinDianne Emiel FeinsteinThe Hill's Morning Report — Presented by the Coalition for Affordable Prescription Drugs — Pollsters: White college-educated women to decide if Dems capture House Trump, Feinstein feud intensifies over appeals court nominees American Bar Association dropping Kavanaugh review MORE (D-Calif.) to bar suspected terrorists from buying guns. It failed by a vote of 45-54.

The Democratic Senatorial Campaign Committee blasted vulnerable Republicans who opposed it.

“It’s reprehensible that with everything going on in the world, these senators won’t stand up to the special interests and pass a commonsense measure like closing the terrorist gun loophole,” said Lauren Passalacqua, a spokeswoman for the committee.

An amendment sponsored by Sen. Rand PaulRandal (Rand) Howard PaulSaudi mystery drives wedge between Trump, GOP Noisy democracy, or rude people behaving like children? Lawmakers, Wall Street shrug off Trump's escalating Fed attacks MORE (R-Ky.), another presidential candidate, to loosen restrictions on concealed weapons permits fell six votes short of the 60 it needed as a nongermane proposal. 

Senators passed by a vote of 90-10 an amendment sponsored by Sen. Dean Heller (R-Nev.) to repeal the "Cadillac tax" on expensive health plans. The provision was included in the House bill but had to be sunset to pass parliamentary muster in the upper chamber. Heller’s amendment removed the time-limiting language.

Jordain Carney contributed to this story.

- Updated at 8:46 p.m.