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The Republican-controlled U.S. Senate has taken the first step in scrapping President Barack Obama’s healthcare program.
Republicans have made repealing the Affordable Care Act, also known as Obamacare, one of their top priorities when President-elect Donald Trump takes office.
By a vote of 51-48, the Senate voted early Thursday to approve rules that allow repeal legislation to go forward with a simple majority and not be subject to a filibuster by Democrats. Republicans control 52 of the Senate’s 100 seats.
“The Senate just took an important step toward repealing and replacing Obamacare by passing the resolution that provides the legislative tools necessary to actually repeal this failed law while we move ahead with smarter healthcare policies,” Senator Majority Leader Mitch McConnell said.
The House of Representatives, where Republicans also have a majority, is expected to vote on the resolution this week. Republican leaders plan to have the actual repeal legislation drafted by the end of January.
The big outstanding question is what would happen if they do undo the program. So far, there has not been a consensus Republican plan about how to replace the healthcare law that brought insurance to 20 million Americans who previously lacked coverage.
Trump said Wednesday he wants both the repeal and replace efforts to take place at the same time.
Democrats passed the ACA in 2010 when they controlled both houses of Congress and Obama was in office, and have celebrated it as a way to help slow the growth in healthcare spending while also bringing coverage to the poor and those who had previously been denied because of pre-existing conditions.
But Republicans have staunchly opposed it, arguing it is too expensive and that individual states should have more control over healthcare spending and not the federal government.
Obama said Tuesday in his farewell address that if anyone creates a plan that is “demonstrably better” and covers as many people at a lower cost, then he will publicly support it.
Republican Senator David Perdue said the program is “collapsing under its own weight” and that his party does have proposals to make it better.
“There are various common-sense Republican healthcare solutions that would provide greater coverage options, drive down costs, and improve continuity of care,” he said.
Democratic senators criticized the vote, particularly the effort to move forward with dismantling the program without a clear replacement.
“It’s official, Senate Republicans have taken the first step to take away your healthcare without a replacement. Shameful,” Senator Bob Menendez tweeted after the vote.
Senator Ben Cardin said repealing the law would make protections such as letting children stay on their parents’ plan until age 26 and eliminating lifetime coverage limits disappear.
“The Republican repeal of the ACA is an outrageous and reckless partisan move that will leave millions of middle-class Americans and small businesses at financial risk,” he said.