Vice President Pence casts decisive vote to keep GOP bill alive

Developments on Day 187 of the Trump Administration:

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Approval of Floor Vote Followed by 1st Setback for GOP Legislation

The Senate narrowly votes for floor debate on the GOP’s bill to replace ObamaCare, only for the Republicans to face challenges to the controversial legislation.

Vice President Mike Pence cast the vote to break a 50-50 tie on the procedural motion to allow a final vote on the bill, under which an estimated 22 million Americans will lose coverage, provisions will be reduced for those who still retain it, and premiums will rise, in some cases sharply for the elderly and poor.

The tie came after the dramatic return of Senator John McCain of Arizona, following a diagnosis of brain cancer, to back the vote to proceed.

Two GOP senators — Susan Collins of Maine and Lisa Murkowski of Alaska — voted No. But ten other sceptics on the moderate and conservative wings of the party accepted the move to floor debate, some after warnings from GOP donors about their re-election prospects in 2018.

The conservative Rand Paul of Kentucky indicated that he would not endorse a final bill unless there was a full repeal of ObamaCare:

However, a full repeal is likely to alienate moderates worried about the cuts in coverage and restrictions on Medicaid expansion.

A 1st Setback for a Final Bill

Later on Tuesday, the Senate cast an initial vote pointing to continued uncertainty over the bill’s prospects.

The legislators rejected a measure combining an earlier proposal — the Better Care Reconciliation Act, rejected by several Republican senators — with two amendments: $100 billion in extra money for people on Medicaid, trying to win over moderate GOP sceptics, and a proposal from conservative Senator Ted Cruz of Texas to allow bare-bones health insurance plans alongside more extensive coverage.

The attempt failed 57-48, with nine GOP senators voting No.

Trump, who spent the morning both cajoling and warning GOP legislators on Twitter, had celebrated the initial success to allow a final vote:

I’m very happy to announce that with zero of the Democrats’ votes, the motion to proceed on health care has moved past and now we move forward toward truly great health care for the American people. We look forward to that. This was a big step.

I want to thank Sen. John McCain. A very brave man. He made a tough trip to get here.

He then berated Collins and Murkowski: “We had two Republicans that went against us, which is very sad, I think. It’s very, very sad — for them.”

Trump Administration Cuts Teen Pregnancy Programs

The Trump Administration cuts dozens of teen pregnancy prevention programs by a total of $200 million, reducing five-year grants to only three years.

The American Congress of Obstetricians and Gynecologists credited the programs with contributing to an all-time low rate of teen pregnancies. The teen birth rate has fallen by about 40% nationally since the program went into effect in 2010.

Grantees under the Teen Pregnancy Prevention Program were given no explanation when told their awards will end next June under an initiative which is provided about $100 million a year.

Grantees served a half-million youth from 2010 to 2014 and were on their way to serve an additional 1.2 million through 2019, when the grant was scheduled to end. The focus of the program is on evidence-based interventions. It does not pay for or provide contraceptives.

A Health and Human Services spokesman maintained that an evaluation of the first round of grants released last fall found only four of 37 programs showed lasting positive impacts. Most of the other programs had no effect or were harmful, the spokesman said, including three that it said increased the likelihood that teens would have unprotected sex and become pregnant.

The American Congress of Obstetricians and Gynecologists urged the administration “not to turn back the clock”. ACOG President Dr. Haywood Brown said, “It’s as though the evidence and the facts don’t matter.”

A letter to Health and Human Services Secretary Tom Price signed by 37 Democratic senators called the decision short-sighted. They asked Price for an explanation and questioned the timing of the notifications in advance of Congressional action on next year’s federal budget.