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Senator Susan Collins (R-ME) speaks with reporters about the withdrawn Republican health care bill on Capitol Hill in Washington, U.S., July 18, 2017. REUTERS/Aaron P. Bernstein - RTX3BYO7

What’s next for the GOP health care bills?

After a rapid-fire, monumental hour of news on the Senate health care bill last night, Republicans of all ranks now find themselves on shaky ground. It’s easy to get lost in conflicting opinions (and presidential tweets); here’s some clarity about the current state of health care reform.

WHAT HAPPENED?

  • Senate Republicans do not have the 50 votes they need to pass their health care plan. (Sens. Mike Lee, Utah, and Jerry Moran, Kansas, became the critical no votes last night.)That bill is dead.
  • Senate Majority Leader Mitch McConnell now wants to have a vote on a bill that is a simple, full repeal of the Affordable Care Act (dropping Medicaid reform along with the rest of the Senate bill).

HOW WOULD A REPEAL WORK?

  • McConnell, R-Ky., needs to start Senate debate on the health care bill passed by the House and then amend it to become a straight repeal of the Affordable Care Act. McConnell proposes allowing two years for Congress to draft and pass a replacement.
  • It’s not clear that Senate Republicans have the 50 votes needed to begin debate on the House health care bill. (A procedure called a “motion to proceed.”)
  • It’s also not clear that Senate Republicans have 50 votes to pass a straight repeal without a replacement plan. (This would be an amendment.)
  • It’s not clear whether House Republicans have the 218 votes needed to pass a straight repeal, either.
  • As a reminder, both chambers passed a straight repeal in 2015. But those House and Senate votes happened in a theoretical environment. Republicans knew President Barack Obama would veto the repeal, and a replacement plan would not be necessary.

WHAT’S NEXT?

  • A growing number of senators, including Sen. John McCain, R-Ariz., are publicly calling for a more regular process, with hearings and a chance for Democrats to give input.
  • This could all have enormous implications for the stability and price of health care in America — as well as for every other major issue Republicans hope to tackle, including tax reform, spending bills, raising the debt ceiling and infrastructure.
  • We do not know when the Senate will vote and whether the Senate will change its August schedule. It is currently set to work for the first two weeks of the month, and recess after that.

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