Here is how the four-step “skinny repeal” plan would work, as outlined by NBC’s Leigh Ann Caldwell:
First, Mitch McConnell would have to wrangle 50 votes on the motion to proceed. That isn’t guaranteed. But the conventional wisdom right now says Republicans will play along, basically as a courtesy to John McCain, who is hauling himself to Washington from Arizona despite his brain cancer diagnosis. (Update, July 25, 4:00 pm: The motion to proceed has passed! Afterwards, McCain gave a long, rousing speech about how the Senate should return to normal order, even though he had just cast a vote allowing it to continue ignoring those very procedures.)
Republicans would vote on a bill to repeal Obamacare without immediately replacing it. This will almost certainly fail but will provide a great emotional release for Sen. Rand Paul.
The party would then vote on the Better Care Reconciliation Act, its full repeal-and-replace plan, complete with the controversial Cruz amendment, which lets insurers sell unregulated insurance policies as long as they also offer Obamacare-compliant plans. Because that provision hasn’t been scored by the Congressional Budget Office, however, it can’t pass through the reconciliation process and will need 60 votes to overcome a filibuster. In other words, it’s also dead on arrival.
Finally, they’ll trot out the “skinny repeal,” which would kill the individual mandate requiring Americans to buy health insurance, the rules requiring large employers to offer their workers coverage, and the medical device tax. These are basically the only pieces of health care reform that count as consensus among Senate Republicans.
As a piece of health care policy, the “skinny repeal” bill is a travesty. To repeat what health care writers have written at least a gazillion times now, repealing the individual mandate while leaving the rest of Obamacare unchanged would likely push the individual insurance markets into a death spiral, as young and healthy Americans stopped buying insurance, leaving behind a customer pool full of older patients with extensive medical costs.
But the skinny bill does not appear to be a real policy compromise. Instead, it seems like a legislative tactic aimed at keeping Obamacare repeal alive by winning 50 votes, then kicking the legislation over to a conference committee, where Republicans in the House and Senate can hash out a final piece of legislation. Of course, if this truncated, nonsensical bill is the only thing upper-chamber Republicans can pass now, it’s unclear why anybody thinks they’d be able to strike a workable bargain with the more conservative House—other than the possibility that lawmakers will feel they’re too deep in at that point to turn back.[/quote]
So far I’ve seen no information on how senators are likely to vote on the skinny repeal.