In a 51 to 50 vote, the U.S. Senate voted today to officially begin debating repeal of the Affordable Care Act (ACA, or Obamacare). As president of the Senate, Vice President Mike Pence cast the tie-breaking vote.

The procedural vote allows senators to formally debate, amend and vote on legislation repealing the health care law, which would then need to be reconciled with the House bill, called the American Health Care Act (AHCA).

Two Republicans — Susan Collins of Maine and Lisa Murkowski of Alaska — voted no. Collins was among the Republicans who announced July 17 that they would not support the original Senate bill, called the Better Care Reconciliation Act (BCRA).

The Republican senators who also said they would not support BCRA but nonetheless voted yes to open debate include Mike Lee of Utah, Jerry Moran of Kansas and Rand Paul of Kentucky.

Their reluctance prompted Senate Majority Leader Mitch McConnell of Kentucky on the same day to propose repealing Obamacare without a replacement. Murkowski joined Collins in opposing that move, along with Shelley Moore Capito of West Virginia.

Capito voted yes to open debate, along with John McCain of Arizona. After the July 17 setback, McCain said he supported opening the process to regular order, which would allow Democrats and Republicans to hold hearings and offer amendments.

McCain reiterated his support for regular order after casting his yes vote to open debate. McCain’s vote marked the legislator’s first appearance in the Senate after surgery to remove a brain clot and a subsequent brain cancer diagnosis.

So what’s next? According to The New York Times, Senate Republican leaders have not yet revealed which version of their legislation will be debated. However, a period of debate lasting up to 20 hours will now begin.

Senators will first debate AHCA, the House bill. After that, they will begin voting on amendments in a run-up to a final vote. If the bill passes, the House and Senate would have to produce a reconciled version before President Trump can sign it into law.

Health care advocates, including HIV/AIDS and viral hepatitis activists, have expressed their continued dedication to stopping Obamacare repeal, which would leave millions of people without coverage.

Following is a statement from Paul Kawata, executive director of NMAC (the National Minority AIDS Council):

“The Senate’s vote to move forward with legislation to repeal the Affordable Care Act is heartless and cruel. It will impose greater hardships on struggling American families, including millions of Americans living with or affected by HIV.


“Data show that communities of color are at a higher risk for HIV and, should the ACA be repealed, they will see the care they’ve come to rely on be stripped away with no alternative.


“It’s no exaggeration to say that people will die if this repeal becomes reality. We implore the Senate to keep the Affordable Care Act in place and work together to make it stronger so we can improve the lives of all Americans.”

Search social media hashtags #KillTheBill and #SaveACA for the latest updates.