McConnell
Senate Majority Leader Mitch McConnell speaks with reporters following the successful vote to open debate on a health care bill on Capitol Hill in Washington, U.S., July 25, 2017. Aaron P. Bernstein/REUTERS

After a successful motion to proceed was passed Tuesday, the Senate was allowed to begin debate on health care reform. Republicans are trying to pass a bill to either repeal and replace or just replace the Affordable Care Act (ACA), better known as Obamacare. The Senate has taken two failed votes: one for a fuller replacement to the ACA and one for just repealing the ACA and coming up with a replacement in two years. A “skinny repeal” might be the Republican Party's last hope.

A “skinny repeal” is a bill that would knock down just some parts of the ACA. It would roll back the ACA individual mandates, which requires people to have insurance or pay a penalty and roll back company mandates, which requires companies of a certain size to offer health care coverage. If passed, this would get the bill to conference committee, in which the senate would reconcile their bill with a version the House passed earlier this year.

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There is also a possibility that the bill would include knocking down a medical device tax.

Some senators believe that the point of the skinny repeal isn’t necessarily to make it the law of the land, but rather to pass at least something in the Senate so they can get to conference committee. The skinny repeal avoids slashing Medicaid like a fuller repeal, a provision disliked by, among others, Republican Sens. Susan Collins of Maine and Lisa Murkowski of Alaska. While a skinny repeal doesn’t completely dismantle the ACA as some conservatives like Rand Paul want, it at least gets Republicans closer to their ultimate goal.

“What a skinny repeal does is it gets it to a conference committee,” said Sen. Mike Rounds to CNN Thursday. “At that stage, then we can begin the process of rebuilding again as one option.”

The Congressional Budget Office, a nonpartisan office that measures possible outcomes of bills, reported that a skinny repeal could still knock 16 million people off of insurance and raise premiums by 20 percent.

Republican health care bills are being considered and designed to come under the budget reconciliation process which means that they require only a 51 simple majority to pass as opposed to the customary 60 vote majority. All 48 Democratic and Independent Senators they caucus with are against the bill. Republican Senate Majority Leader Mitch McConnell needs to get 50 out of the 52 Republican Senators on board with a bill to get it passed. Vice President Mike Pence casts the deciding vote in a tie breaker.

President Donald Trump has been urging the Senate to get something down both from his bully pulpit on Twitter and in public appearances in the past few weeks.

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“Come on Republican Senators, you can do it on Healthcare. After 7 years, this is your chance to shine! Don't let the American people down!” tweeted the president Thursday morning.

Because budget reconciliation only allows for so many hours of debate, the Senate will move into a “Vote-a-Rama.” This is where Senators can offer unlimited amendments to the bill and they are voted on without debate.