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The Guardian - US
The Guardian - US
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Ben Jacobs and Lauren Gambino in Washington

US Senate rejects bill to repeal Obamacare in huge blow for Trump – as it happened

From left: Lindsey Graham, John McCain, Ron Johnson and Bill Cassidy.
From left: Lindsey Graham, John McCain, Ron Johnson and Bill Cassidy. Photograph: J. Scott Applewhite/AP

Senate Obamacare Repeal Fails

  • The Senate effort to pass a “skinny” repeal of Obamacare failed dramatically early Friday morning by a 51-49 vote.
  • John McCain joined Susan Collins and Lisa Murkowski, who had previously made their objections known to defeat the bill.
  • The failure of efforts to repeal Obamacare meant that Donald Trump is likely to start the next six months of his presidency without any major legislative victories.
  • Although it hasn’t permanently foiled Republican efforts to replace Obamacare, it serves as major impediment with an August recess approaching as well as other major pending issues like the budget and the debt ceiling.

Updated

Here’s footage of the notebook falling on Tim Scott on the Senate floor

The Guardian’s Lois Beckett talked to David Perdue of Georgia about McCain’s vote and what that means for the Senate:


“You could see, honestly, the body language in the entire chamber change the last two hours,” Sen. David Perdue said. “You guys were up there, you could see it. One side was kind of ebullient and talking, and the other side was very subdued, and all of a sudden, it began to change. And I think it was an instinctive reaction to maybe, ‘This thing’s not going to pass tonight.’ And nobody knew for sure until you saw three votes.”

“This is what democracy is,” Perdue said. “It’s messy.”

“This isn’t about wins and losses. I actually respect Chuck Schumer’s comments tonight. He admitted Obamacare’s broken, we’ve got to fix it,” Perdue said.

The Georgia Republican said that the feeling in the Senate now was, “Let’s move on.”

“I think there’s a mood right now in the senate, from McCain’s comments the other day to Schumer’s comments tonight, I think there’s a growing sense that, ‘Let’s get this done.’”

“I’m standing here ready to work with them,” Sen. David Perdue said of Democrats.

“I don’t think he turned on anybody,” Perdue said of McCain. “I think he voted his conscience. He loves America.”

Lisa Murkowski Talks About Her No Vote

For all the attention given to John McCain, Lisa Murkowski also faced a lot of pressure this morning. NBC’s intrepid Vaughn Hillyard got an exclusive interview with her.

Bill Cassidy had a rather understated take on tonight’s events.

Schumer Shares Inside Story On McCain's Vote

Lauren Gambino talked to Senate Democratic leader Chuck Schumer after the vote:


Schumer said he and McCain had spoke “three or four” times a day for the last several days, discussing the bill and the exceptionally secretive process Republicans were using to try to pass the measure.

“Given his stature, his remarks at the beginning when he came in, moved everybody and I think that helped,” Schumer said. “He’s a hero. He’s a hero of mine.”

“And can we also not forgot the two women senators who were there from the beginning,” Senator Amy Klobuchar interjected.

Asked if he could remember a more dramatic night than this, Schumer said no. Then he turned around and corrected his response: “The birth of my daughter.”

Mashups of McCain’s vote are already making their way across the Internet. This is one of them.

McCain was apparently messing with the reporters in the gallery when he mouthed “fuck” earlier tonight on the Senate floor.

McCain Issues A Statement

President Trump Issues A Statement On The Vote

On Twitter, Trump insisted that it was his idea all along just to let Obamacare implode rather than try to repeal and replace it.

The blog is going to keep going as reaction continues to come in. Worth noting though that a disproportionate number of press releases so far have come from Democrats/progressive groups and not the right.

Despite all the drama, Lauren Gambino reports that Democratic leader Chuck Schumer knew how McCain was voting earlier tonight.

Dozens of reporters were leaning from the gallery to try to listen in on what was happening on the floor and John McCain was very much aware as my colleague Lois Beckett reports.

John Kennedy of Louisiana, who is uniquely quotable, still thinks Republicans can move ahead.

Heritage Action, a major outside conservative group, is also unhappy

In contrast, Ted Cruz noted that many Republican base voters will be very disappointed with tonight’s result.

Reporters caught up with John McCain leaving the building tonight.

If you’re enjoying the blog, check out our story as well on tonight’s remarkable drama

The Senate had long planned to move on to a defense authorization bill but Rand Paul objected to doing so tonight. The result is that its next vote will be on a judicial nomination on Monday.

Lois Beckett has the reaction from a protester to tonight’s drama.

Schumer says “it is time to turn the page” and hopes the Senate can return to regular order and notes that both parties share blame for the deterioration of the Senate.

Mitch McConnell says “it’s time to move on.”

Vote over. Obamacare repeal fails 51-49

Mitch McConnell describes it as “a disappointing moment.”

Updated

Among those who were considered skeptics of the bill, both Dean Heller of Nevada from the center right and Ted Cruz of Texas on the right ended up voting yes.

Senate Obamacare repeal fails

With at least three Republicans voting no, Susan Collins, John McCain and Lisa Murkowski, the Senate bill to repeal Obamacare has failed. This puts efforts at health care reform back at square one for Republicans and is a gigantic blow to President Donald Trump.

Updated

McCain votes no

The Senate effort to repeal Obamacare fails

Updated

Murkowski and Collins vote no

McCain is off the floor with Mike Pence and the drama builds

Updated

The final vote on skinny repeal has just begun

Mike Pence is not in the chair

Updated

We are now almost an hour into this vote as John McCain has gone into the cloakroom to apparently take a phone call. In the meantime, he hugged Democratic senator Amy Klobuchar on the way out

Worth noting that even if McCain votes against the bill, it could still pass if Republicans manage to flip either Susan Collins, who is a hard no, or more likely, Lisa Murkowski. The Trump administration has already threatened retribution against Murkowski for her opposition to the motion to begin debate on Tuesday.

Updated

In case you need more drama, McCain just went over to a cluster of Democrats including Chuck Schumer who all seemed happy to see him. They started a conversation where Schumer asked a question and then McCain dramatically seemed to imitate someone saying “fuck” while shaking their fists.

The conversation with Pence and McCain has finally ended.

Senate Republicans are delaying Obamacare repeal vote

Senate Republicans have now kept the procedural vote preceding the vote on repeal open long after everyone has voted. As this is happening, Vice President Mike Pence has been talking to John McCain, long considered the most likely Republican to provide the third no vote that would kill the bill, for over 20 minutes.

Updated

McCain and Pence are still talking in a circle that includes Susan Collins, Lisa Murkowski and Murkowski’s colleague Dan Sullivan from Alaska. The vote is still being held open, ten minutes after every senator has voted and Mitch McConnell is now talking Dean Heller of Nevada, the most vulnerable Senate Republican in 2018.

The procedural vote is still being held open. Despite the fact every senator has voted, they are not moving forward with the next vote. In fact, Mike Pence is now talking to McCain, Murkowski and Collins. This is a strong indicator that the Republicans may not actually have the votes right now to move forward.

The Procedural Vote Fails

We are now getting ready for the main event as Mike Pence and Mitch McConnell are having a long conversation together. Potential Republican defectors are also chatting.

The body language and social interactions on the Senate floor around John McCain are being eagerly watched right now.

Procedural vote has begun

The Senate is now voting on a “motion to commit” which would table the bill. A yes vote is against the bill and a no vote is for the bill. However, senators often vote along party lines on these votes and may not necessarily tip their hands if they are planning on breaking ranks on the final bill.

Updated

All eyes are on John McCain as the Senate goes through a procedural vote before the final vote. He’s speaking in a corner of the Senate with John Hoeven of North Dakota and Lindsey Graham of South Carolina.

Intrigue over McCain’s vote is building on the Senate floor

John McCain is still publicly undecided on the bill and is not tipping his hand. McCain has had a dramatic week after returning to the Senate after a diagnosis of brain cancer and giving an emotional speech about the constitutional role of the chamber.

The Guardian’s Lois Beckett has a dispatch from the protest outside the Capitol:

Jill Jacobs, mother of two 24-year-olds with cerebral palsy, has been camped outside of the Russell Senate office building for the past four days as part of a protest organized by Adapt, a disability rights group. She said she was one of dozens arrested earlier this week.


Addressing a group of at least 250 protesters outside the Capitol on Thursday night, Jacobs said that if Congress destroys healthcare and slashes Medicaid, “My son will die...they will die.”


She said the last time she had to protest at the federal level was the late 1990s when she pushed for a public statue of FDR in a wheelchair. “I don’t come out and protest,” she told me. This is “my children’s lives

As the Senate ticks down the final minutes of debate over the health care bill introduced less than two hours ago, Republican Mike Enzi is talking about the definition of live births in European countries.

In a moving appeal to Republicans, Mazie Hirono, a Democratic senator from Hawaii who is undergoing treatment for kidney cancer, urged them to vote down the healthcare bill.

During her nearly five-minute remarks on the Senate floor, Hirono became emotional as she described the death of her sister as a child in Japan.

“She died at home, not in a hospital where maybe her life could have been saved,” Hirono said, her voice swelling with emotion. “It’s hard for me to talk about this. I think you can tell. Give me a moment.”

Hirono then addressed her own diagnosis and said she was grateful to have healthcare so she could focus on the treatment she needed and not on how to pay for it.

“I will yield the floor by asking my friends to show the compassion to everybody in this country that you showed me,” she said, in closing. “We should all be voting to send this vote to committee so we can debate it.”

Watch her full remarks here:

Outside groups are already denouncing the new skinny repeal plan. One of the most notable is the American Medical Association.

Mike Pence is in the Capitol

Vice President Mike Pence has arrived in the Capitol to be prepared to cast a potential tiebreaking vote. Two Republicans, Susan Collins of Maine and Lisa Murkowski of Alaska, are expected to vote no. If all other Senate Republicans support the bill, there will be a 5o-50 tie and it will require Pence to break the tie.

Updated

Mike Enzi is burning the clock and refusing to let any Democrat ask any questions at all. He just announced “I expect to have this hour even if some of it is in silence” when a Democrat tried to ask him a question.

Republicans are letting Mike Enzi, the chair of the Senate Budget Committee, close out debate. He is not taking questions and not giving time for Democrats to speak. They are not happy about it.

CBO releases score on repeal bill

The CBO has just released its score on the bill which was introduced in the Senate an hour ago by Mitch McConnell.

It will increase the number of uninsured Americans by 16 million and decrease the deficit by $178.8 billion over the next ten years.

Updated

The Guardian’s Lois Beckett is at a protest just outside the Capitol where opponents of Obamacare repeal are gathering.

CBO score: 15 milllion would lose insurance under Senate Republican bill

The nonpartisan budget office has estimated that 15 million people would lose insurance coverage under the new healthcare plan compared to current law by 2026. It also found that premiums would increase by roughly 20% relative to current law of the same decade.

Read the reporter here [pdf]: https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/s.a.667.pdf

We’re not just blogging tonight but reporting as well. Check out our latest most up-to-date on the efforts to repeal Obamacare.

Democrats are making a series of emotional appeals on the floor of the Senate in hopes of thwarting the bill. One of the most emotional came from Senator Mazie Hirono from Hawaii who is suffering from cancer herself.

The so-called “skinny repeal” is here. Here’s what it would do:

  • Repeal the individual mandate, the requirement that all Americans must have health insurance or face a penalty.
  • Repeal the employer mandate, the requirement that employers of a certain size to provide health insurance for their workers.
  • Delay the ACA’s medical device tax, which imposes a tax on the sale of certain medical devices by the manufacturer.
  • Defund Planned Parenthood for one year
  • Increase funding for Health Savings Accounts
  • Bolster funding for community health centers

Reminder that there is not a budget analysis for the bill yet but an early estimate anticipated that a rumored version of this bill would leave 16 million people without health insurance compared with current law. It would also raise premiums by 20%.

Republicans say they do not want this bill to become law.

Bernie Sanders, echoing the Larry David impersonation of him on Saturday Night Live, just said the Affordable Care Act was “not great but pretty good.”

Mitch McConnell made the following pitch on his skinny repeal bill in his speech introducing it:

“The legislation I just laid down is called the Health Care Freedom Act, and it restores freedom to Americans that Obamacare took away. It does so in a number of ways.

“First, the Health Care Freedom Act repeals the core pillars of Obamacare. It eliminates the so-called individual mandate that forces many Americans to buy Obamacare insurance they don’t want, can’t afford, or can’t use — and taxes those who don’t. It also repeals the employer mandate that cuts hours, take-home pay, and job opportunities for workers.

“Second, the Health Care Freedom Act provides significant new flexibility to states. The Health Care Freedom Act gives states just the kind of flexibility they need to implement reforms that provide more options for consumers to buy the health insurance they want. These reforms also help make insurance more affordable and flexible, so it’s something Americans actually want to buy.

“Finally, the Health Care Freedom Act frees Americans from Obamacare in several other ways too. It provides three years of relief from the medical device tax that increases costs, hurts innovation, and has drawn significant criticism from both sides of the aisle. It expands for three years the contribution limits to health-savings accounts so Americans can better manage their health costs and pay down more of their medical expenses, like prescriptions, with pre-tax dollars.”

The skinny repeal is here

Mitch McConnell is now on the floor introducing what will be formally called “the Health Care Freedom Act.”

Updated

However, as my colleague Lauren Gambino reports, McCain is still upset by the process as relayed to her by the Arizona senator’s close friend Lindsey Graham

Earlier tonight, McCain called Ryan’s statement “not sufficient.”

Now, he’s playing coy.

Updated

And now, Lindsey Graham is officially satisfied with voting for a bill that he has described as a fraud. It seems the vote-a-rama is on.

It looks Paul Ryan has pledged to wavering senators that there will be no vote on skinny repeal in the House.

It’s a long night so senators are finding hobbies to engage in. Orrin Hatch, who sidelines as a composer and musician, is writing songs tonight.

Some skeptical Republicans have made up their minds but are not showing their cards, at least to reporters.

McCain: Ryan's statement not sufficient

Entering the Senate, John McCain told reporters that Ryan’s statement was “not sufficient” for the Arizonan to vote for skinny repeal.

With Susan Collins of Maine and Lisa Murkowski opposed, the 52 member Republican conference cannot afford a single defection on the bill.

Senator Ron Johnson of Wisconsin also approached Ryan’s statement skeptically.

However, one skeptical Senate Republican has been comforted by Ryan’s statement. David Perdue of Georgia told reporters “I am taking a chance on this skinny bill. I would not want the skinny bill to become law. . . I think the reassurance from Paul Ryan tonight is good enough for me.”

Updated

The Senate now voting yet again. This round of votes includes a Democratic attempt to shelve the bill. It is likely to fail. However, it marks the start of what will be a late night on Capitol Hill.

If you want to catch up with the Guardian’s latest writeup of what’s happening on Capitol Hill, check it out right here.

Democrats are now on the Senate floor warning that whatever is passed tonight will become law and citing Republican criticism of it.

As Chris Murphy from Connecticut said “This isn’t going to conference, this is becoming law.”

It’s dinner time on Capitol Hill as there is still an hour left to go before the vote-a-rama can begin.

Each party has its own separate dinner

Reporters are still relying on the Senate carryout inside the Capitol. One of the options there is Senate Bean Soup, which has been served every day for over a century. This picture is courtesy of the Guardian’s Lois Beckett

Updated

Paul Ryan: 'The only path is for the Senate to pass the legislation'

Speaker Paul Ryan just issued a somewhat vague statement on the House’s willingness to go to conference on whatever the Senate passes.

“It is now obvious that the only path ahead is for the Senate to pass the narrow legislation that it is currently considering. This package includes important reforms like eliminating the job-killing employer mandate and the requirement that forces people to purchase coverage they don’t want. Still it is not enough to solve the many failures of Obamacare. Senators have made clear that this is an effort to keep the process alive, not to make law. If moving forward requires a conference committee, that is something the House is willing to do. The reality, however, is that repealing and replacing Obamacare still ultimately requires the Senate to produce 51 votes for an actual plan. The House remains committed to finding a solution and working with our Senate colleagues, but the burden remains on the Senate to demonstrate that it is capable of passing something that keeps our promise, as the House has already done. Until the Senate can do that, we will never be able to develop a conference report that becomes law. We expect the Senate to act first on whatever the conference committee produces. Obamacare is collapsing and hurting American families. We have to keep working at this until we get the job done.”

Updated

The drama is building over what will happen in the House. The Guardian’s Lauren Gambino can confirm that House Republicans who hold a meeting at 9AM tomorrow morning, according to a senior GOP aide.

Meanwhile, we expect a statement from Speaker Paul Ryan’s office tonight. It’s unclear what he will say but earlier we were told the Speaker would consult with House Republicans before making any decisions on healthcare.

Updated

In case you were hoping it would be an early night

In contrast to other House Republicans, Mark Meadows, the chair of the conservative House Freedom Caucus, told reporters that “skinny repeal” would not pass the lower chamber.

“If it comes over with just minimal elements of a replacement, there is not enough votes to send it to the president,” said the North Carolina Republican.

He also said he didn’t like calling it a “skinny repeal”.

Updated

Per a senior House leadership aide, Paul Ryan will “consult before making any decisions” on putting “skinny repeal” to a vote or going to a conference committee

Updated

Senators will only vote for bill if assured it won't become law

Right now, the situation on Capitol Hill is that the “skinny repeal” will not pass if it appears there is any chance for it to become law. If assured that it will be junked in a conference committee after passage, the bill may receive support from a majority of senators.

If you are confused, you should be. But this is American politics in 2017.

Updated

Graham calls skinny repeal 'a fraud'

In their press conference, the three senators (now joined by Bill Cassidy of Louisiana) are making clear that they will not vote for “skinny repeal” unless they are assured that it will not become law.

Graham was particularly scathing about clean repeal, calling it “a fraud” as well as “terrible policy and horrible policy.”

If the skinny bill were to become law, Graham said it “politically would be the dumbest thing in history”.

Senator Ron Johnson, of Wisconsin, offered an apology to voters, conceding that the Republicans have failed to fulfill seven years of promises to repeal the healthcare law.

“I’m sorry that the skinny bill in the Senate doesn’t even come close to our promise of repealing Obamacare,” Johnson said.

From left: Lindsey Graham, Ron Johnson, Bill Cassidy and John McCain.
From left: Lindsey Graham, Ron Johnson, Bill Cassidy and John McCain. Photograph: J. Scott Applewhite/AP

Updated

While senators are freaking out about the potential of the House voting on “skinny repeal,” some members of Congress are more open to it.

Chris Collins, a moderate Trump ally from upstate New York, compared the choice on skinny repeal to the 2016 election. “This becomes not unlike Trump and Clinton, there was not a third candidate. There wasn’t going to be another choice. It was a binary choice. People voted. This would be a similar type of situation.”

Graham, McCain and Ron Johnson to hold a press conference soon

Lindsey Graham, John McCain and Ron Johnson just announced a press conference to be held in 15 minutes on “skinny repeal.”

All three have been deeply skeptical of the bill so far and Graham has insisted that he would not back skinny repeal without the guarantee of a conference committee. It’s unlikely that they will unilaterally torpedo the bill.

Updated

In case you’re in need of Twitter jokes from octogenarian Utahns in the Senate, Orrin Hatch is making them and looking to vote-a-rama that supposedly occurred back when Congress met in Annapolis, Maryland (and only had one chamber since the United States was still governed by the Articles of Confederation).

Updated

Health care isn’t the only thing that the Senate is voting on today. The chamber is expected to vote around 5pm on a final version of new sanctions on Russia, Iran and North Korea. The bill was approved by the House earlier this week and has been opposed by the White House because it limits Trump’s authority to lift sanctions against Russia without congressional approval. The President has yet to make clear whether he will sign it. An earlier version of the bill passed the Senate by a vote of 98-2.

Updated

The chair of the influential Republican Study Committee has trashed “skinny repeal” on Twitter.

This is, counterintuitively, actually a good sign for its passage as many Republican senators are hesitant to vote for it because they are afraid that the House might pass it.

Lindsey Graham trashes skinny repeal bill

Senator Lindsey Graham of South Carolina trashed the “skinny repeal” bill to reporters earlier today. “The worst possible outcome is to pass something that most of us believe is a placeholder and it becomes the final product,” said Graham.

He added “trying to fix it later is a nonstarter because this placeholder concept - the skinny bill-would destroy insurance markets and not even remotely replace Obamacare.”

Updated

Cornyn insists there will be a conference on healthcare

John Cornyn, the No 2 Republican in the Senate, said his conference is not about to vote on a bill that they hope will never become law even though his colleagues have said exactly that.

“That’s not what’s happening,” dismissing the characterization of what Republican senators are trying to do in their last-ditch attempt to reshape the Affordable Care Act.

“I guess we have to go back to Schoolhouse Rock – both the Senate and the House pass a bill and then they go to conference to reconcile the differences.”

The Texas Republican, speaking to reporters as he walked briskly through the Capitol’s basement, said his party is warming to the idea of the “skinny repeal”, which he preferred to call the “freedom to choose” measure.

Cornyn said he was not troubled by the prospect of the House simply passing the measure passed by the Senate and sending it to the president, forgoing a conference committee. But asked repeatedly if he had a formal assurance from House Speaker Paul Ryan that the measure would go to conference, Cornyn said he had not received one.

“My understanding is that the Speaker has said that they’re preparing for a conference,” he said.

Updated

There’s already one clear sign that tonight is going to be a long night. Cots are already being wheeled out in the Capitol building for Senators to take naps on this evening.

Republicans are preparing to face a political reckoning regardless of what happens tonight.

Senator Ron Johnson of Wisconsin told Al Weaver of the Washington Examiner earlier today that the GOP promise to repeal and replace “was an overpromise.”

Johnson, who was re-elected to his second term in 2016, was first elected in the Tea Party wave of 2010 promising to get rid of Obamacare. In a 55-45 vote yesterday, the Senate rejected a so-called “clean repeal” of Obamacare with seven Republicans joining all 48 members of the Democratic caucus.

House Republicans told to be 'flexible' on travel plans

Things are getting interesting on Capitol Hill as House Republicans have been told to “be flexible” on their travel plans. The House had been scheduled to begin their August recess tomorrow but may now stick around to vote on a bill approved by the Senate. If they approve the Senate bill, it would mean that there would be no conference committee and whatever work product is voted on tonight or tomorrow would become law. This is a nightmare scenario for a number of Republicans.

Updated

On the actual substance of health care form, senators are now facing an unorthodox fear – that the bill they pass may actually become law.

The “skinny repeal” plan has long been touted as simply a vehicle for the House and Senate to go to conference and hash out mutually agreeable legislation on health care reform. However, there has been growing trepidation that whatever the Senate passes may simply be voted on in the House. Senators are now seeking reassurance that the House won’t act on whatever legislation they pass as my colleague Lauren Gambino reports:

Updated

The vote is just about final on single payer. All but four Democrats voted present on the bill. The exceptions are all comparative moderates up for re-election in 2018 in states that Donald Trump won: Joe Donnelly of Indiana, Heidi Heitkamp of North Dakota, Joe Manchin of West Virginia and Jon Tester of Montana. Angus King of Maine, an independent who caucuses with the Democrats, also voted no on the bill.

This was the first amendment offered solely for political gamesmanship today but by no means will it be the last.

John McCain on Capitol Hill.
John McCain on Capitol Hill. Photograph: Shawn Thew/EPA

Updated

The vote on single payer is happening now and senators seem to be having fun with it.

Steve Daines is now on the floor offering his single payer amendment while bashing the concept of Medicare for all. The Montana senator says “Last November, the American people voted to ‘Make America Great Again’, not to Make America Like England Again.’”

One of the first votes today is scheduled to be on an amendment to implement a single payer healthcare system in the United States. However, it has one ardent opponent: Bernie Sanders.

Although Sanders has long been a vocal advocate for single-payer health care, he’s opposing this amendment because it’s actually just a troll.

Republican Steve Daines of Montana is offering the proposal in an attempt to force Democrats to take a divisive vote and make vulnerable incumbents choose between the party’s liberal base and a position that potentially could be problematic with moderate swing voters.

Sanders though has slammed the proposal as part of a “sham process” and will refuse to vote for it. As a result, it’s likely that no other Democrats will support it as well.

Hello and welcome

Good afternoon from Washington, where the latest Republican attempt to overhaul Barack Obama’s signature healthcare reforms is due to come to a head.

This afternoon the Senate is expected to begin a so-called “vote-a-rama” – a long series of votes on dozens of different proposals – as Republicans desperately try to cobble together a compromise plan to repeal and/or replace the Affordable Care Act.

Senators will vote on amendment after amendment after amendment as they prepare for a late night session.

Earlier today it seemed the most likely option to pass was the so-called “skinny repeal”, which would remove Obamacare’s unpopular individual mandate, which requires all Americans to have health insurance or face a penalty, and perhaps the employer mandate as well, which means companies with 50 or more full-time employees must provide health insurance or pay a fine, but would leave in place its expansion of Medicaid, the government health program for low-income Americans.

Doctors, medical organizations and insurer groups have warned that the “skinny repeal” would discourage healthy people from staying in the health insurance markets and could drive up costs, and could therefore lead to the eventual collapse of the Obamacare system.

However, the Republican proposals are changing rapidly and the precise provisions of their final plan are still unclear. No actual legislation has yet been published by the GOP, and the bill remains a moving target, depending on the fate of individual amendments to the underlying legislation.

Read more on the skinny repeal here:

Republicans have been promising - or threatening - for seven years to undo Obama’s legislation, which saw nearly 20 million people gain healthcare. They view it as unwarranted government intrusion into the free market. The 2010 law required all Americans to have insurance or face a penalty, and offered states funding incentives to expand Medicaid coverage.

But despite the fact that since January Republicans have controlled the White House as well as both chambers of Congress, progress towards their goal has been painfully slow. A House bill that would dismantle much of the Affordable Care Act was passed to great fanfare in May, but since then the Senate has failed to agree on a version of its own, which has infuriated Donald Trump.

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

The GOP has not been helped by a series of estimates by the Congressional Budget Office, which has estimated 23 million people would lose health insurance over the next 10 years under the House bill, and 22 million for a now-failed Senate plan. The “skinny repeal” is thought to bring that figure down to “only” 16 million.

If the Senate does pass some form of skinny repeal at some point tonight, that is not the end of the story. It would either have to be reconciled in some way with the House bill via conference committee before it reaches Trump’s desk or the House would have to pass the Senate bill.

But if it fails to pass anything, it could be a fatal blow for Republican attempts to undo Obamacare.

We’ll be following all the action on the Senate floor and around Capitol Hill right here.

Updated

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