U.S. Sen. Jerry Moran cast a key vote Tuesday to push the nation closer to a repeal of the Affordable Care Act.
Moran, a Kansas Republican, stalled a version of the legislation last week, but on Tuesday he joined a majority of GOP senators in voting to proceed with the health care debate even as the ultimate Senate plan remains unclear. The bill’s contents are still to be determined, but each version Congress has considered would rapidly increase the rate of the uninsured.
Two of Moran’s Republican colleagues, Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, opposed the motion. Republicans required Vice President Mike Pence to cast the 51st vote to achieve a majority. A third Republican dissenter would have halted the process, making Moran a decisive vote.
GOP leaders were aided by the dramatic return to the Capitol of U.S. Sen. John McCain, an Arizona Republican, after surgery last week and a diagnosis of brain cancer. He arrived in the chamber to cheers and a standing ovation from his colleagues.
In a statement released seconds after his vote, Moran reiterated his opposition to a version of the bill known as the Better Care Reconciliation Act but said he was voting to allow the process to proceed to accomplish the repeal of the ACA, better known as Obamacare.
He voiced support for passing a repeal-only bill and then crafting replacement legislation through a bipartisan approach.
“For years, I have been committed to repealing and replacing Obamacare. As I’ve said, I will vote to proceed to and pass a bill that fully repeals Obamacare, puts a two-year expiration date on the damaging law and will allow for the full legislative process I have repeatedly called for — involving all 100 senators — to craft a replacement,” Moran said.
He said he would continue to oppose the Better Care Reconciliation Act, or BCRA.
“This bill missed the mark for Kansans, failed to adequately repeal Obamacare and did not address the rising costs of health care. Health care is too important to Kansans, our families and future generations of Americans to get wrong,” Moran said.
Both the BCRA and a repeal-only bill would lead to millions more uninsured Americans, according to analyses by the Congressional Budget Office.
The vote came as a disappointment to health advocates in the Kansas City region.
Uncertainty about what policies the bill ultimately will include is a cause for concern, said Hilary Gee, Kansas government relations manager for the American Cancer Society’s Cancer Action Network.
“What’s particularly troubling is we don’t know,” Gee said when asked about the bill’s potential impact to cancer patients. “Nobody has seen the bill. It seems like there isn’t a bill.”
Gee said versions of the legislation previously weighed by the Senate would weaken patient protections and could limit access to health care for cancer patients and survivors.
Kansas Democratic chair John Gibson blasted Moran, saying in a statement that his decision to “vote for a mysterious and reckless plan makes it clear — he has placed the partisan fights of Washington D.C. over the needs of Kansas families.”
The region’s other GOP senators, U.S. Sen. Pat Roberts of Kansas and Roy Blunt of Missouri, joined Moran in supporting the decision to move forward with the debate.
Blunt said in a statement before the vote that Obamacare “has left Missouri families with higher costs, fewer options and less access to quality health care. We need to move forward with debate in the Senate, which will give all senators the opportunity to look at ways we can improve the final product.”
Tuesday’s vote will enable a floor vote on the actual bill as early as Wednesday. But if the Senate bill differs from the bill passed by the House earlier this year, it will require negotiations between the two chambers to work out a compromise bill to get to President Donald Trump’s desk.
U.S. Sen. Claire McCaskill, a Missouri Democrat, said that decisions about health care “shouldn’t be made in secret backroom deals” but rather “that debate should be had in the light of day, where consumers and experts and doctors can all testify in public hearings.”
“If instead Republican leaders in the Senate ram through this haphazard, backroom strategy, we know what the result will be—higher costs and worse health care for Missouri families,” she said.
Repealing the ACA has been a major campaign promise for both the president and GOP members of both houses, a fact noted by FreedomWorks, a national conservative advocacy group, shortly after the vote.
“This is a step forward in the process. Republicans must remember that they campaigned on Obamacare repeal for more than seven years. The 2015 repeal bill is what conservative activists were promised, and it’s what they expect,” a statement from the group said.
Senate Minority Leader Chuck Schumer, a Democrat from New York, warned that voting to advance the debate Tuesday would serve as a “permission slip” to cut Medicaid, something Moran has previously opposed because of its potential impact to rural health care.
“I’m elected as a Republican but I’m a member of a minority. And that minority is Kansas. That minority is rural,” Moran said at a town hall in Palco, Kan. earlier this month.
Potential cuts to Medicaid, which have been included in versions of the bill, were a top concern for health advocates in both Missouri and Kansas.
A group of 77 Missouri physicians and medical students have signed a letter to Gov. Eric Greitens and other state-level officials urging them to form a united front against the bill, noting the opposition of governors from both parties to repealing the health care law.
“Major reductions of funding for Medicaid would also make it unaffordable for providers to deliver vital care for Missourians,” the letter states. “The effect of those cuts would ripple throughout Missouri, hurting the entire state’s economy and placing more of the burden of paying for care for those on Medicaid on Missouri taxpayers.”
Rachel Mast, an Olathe South student with Down syndrome, posted a video on Twitter Tuesday morning and tagged Moran and Roberts, urging them to vote “no.”
Mast’s mother, Jawanda, is a disability rights activist who has been in touch with Moran’s office about the Republican health care proposals.
She said she remains concerned that Medicaid cuts in the Republican bills will reduce access to home- and community-based support services that help people with disabilities live independently.
“The overhaul of traditional Medicaid is the biggest issue for our family, hands down,” Jawanda Mast said.
Health care advocates gathered at the Kansas Capitol in Topeka as the Senate vote took place. Behind them sat a movie screen-sized poster board peppered with photos of people holding signs saying “I am Medicaid.”
Brooke Longstaff, a 48-year-old Topeka resident who said she has two daughters on Medicaid, called the Senate vote disturbing. “This one is scary to me,” said Longstaff, who said she reads health care news constantly.
Megan Levens, a self-employed cartoonist from Overland Park, was tracking Tuesday’s vote as someone who is insured through Obamacare’s individual market exchange.
Levens said she had also contacted Moran’s office several times, including once to thank him after he said he would vote no on a previous Republican health care bill.
Given Moran’s reliable Republican voting record, Levens said she was “not surprised, but disappointed” when Moran voted to advance debate Tuesday.
She said the uncertainty of what lies ahead for the market where she purchases health care was causing plenty of anxiety.
“If people are voting ‘yes’ on something they haven’t even seen with the idea that as long as they get rid of the ACA it’s good, that’s terrifying,” Levens said.
The Star’s Hunter Woodall and Associated Press contributed to this report.