Senate Health Care Vote: What to Expect

The Senate majority leader, Mitch McConnell of Kentucky, says it is time for a vote.

On Tuesday, he will have the Senate vote on a motion to proceed — in this case, on whether to take up a health care repeal bill that narrowly passed the House in May.

Nobody expects that bill to become law. Instead, it would essentially serve as the vehicle for the Senate’s legislation. The House bill’s text would be swapped out for the Senate’s preferred language, whatever that ultimately is.

How does the vote math break down?

Republicans hold 52 seats in the Senate, and to be successful, they need a majority for the motion to proceed. In a deadlock, Vice President Mike Pence would break the tie in favor of proceeding.

Only days after announcing he has brain cancer, Senator John McCain, Republican of Arizona, plans to return to the Senate on Tuesday. His presence means Mr. McConnell can afford for only two Republicans to vote against the motion. If Mr. McCain had been absent, Mr. McConnell would have been able to lose only a single Republican.

At least one defection is all but certain: Senator Susan Collins of Maine indicated on Monday that she would vote against proceeding in just about every imaginable circumstance.

Which senators are pivotal votes?

One big factor is what Mr. McConnell plans to do after the procedural vote.

For example, Senator Rand Paul of Kentucky is an expected “no” vote if after clearing the procedural hurdle, the Senate turns to a bill by Mr. McConnell to repeal and replace the health law. Mr. Paul detests that bill.

On the other hand, Senators Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska indicated last week that they would not vote to proceed if Mr. McConnell afterward scheduled a vote on a bill to repeal the health law without providing a replacement.

In addition, a number of other Republican senators have expressed varying qualms, with varying degrees of certitude. They include Mike Lee of Utah, Jerry Moran of Kansas, Rob Portman of Ohio and Dean Heller of Nevada.

What happens if the vote succeeds?


Senator Mitch McConnell, the majority leader, last week on Capitol Hill.

Tom Brenner/The New York Times

Such a vote would start the debate in the Senate on health care. At some point, Mr. McConnell is expected to offer an amendment that would substitute a new measure for the text of the bill that passed the House. But it remains to be seen what that new measure would be. Republicans are trying to pass the bill using special budget rules that limit debate to 20 hours and prevent a Democratic filibuster.

What happens if the vote fails?

Republicans are not expected to abandon their repeal effort, but its future would appear bleak, at least in the short term.

“We’ll go back to the drawing board,” Senator John Thune of South Dakota, a member of the Republican leadership, said on “Fox News Sunday.” Of voting to repeal and replace the health law, he said, “It’s not a question of if, it’s a question of when.”

Recent history provides some support for Mr. Thune’s optimism. The repeal bill in the House was declared dead before coming back to life — and Republicans there ultimately were successful in passing a bill.

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