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Getting a health care bill through Congress fraught with difficulties


  • Former Rep. Bart Stupak, D-Mich., now a lobbyist for Venable LLP, is pictured in this July 18 photo at the Washington law firm and lobbying shop. Stupak says he is holding out hope that members of both parties in the U.S. Congress will come together and fix the Affordable Care Act. (CNS photo/Chaz Muth)
  • Rep. Francis Rooney, R-Fla., is pictured in this July 20 photo in Statuary Hall at the U.S. Capitol in Washington. Rooney says he doesn't see a way to fix the Affordable Care Act and favors the GOP health-care reform bill passed by the House of Representatives last spring. (CNS photo/Chaz Muth)
  • Jim Capretta, a heath care policy and entitlement reform expert for the conservative think tank American Enterprise Institute, is pictured in this July 24 photo in a studio at his Washington office. Capretta, who was an associate director at the White House's Office of Management and Budget during President George W. Bush's first term, says a bipartisan approach to future U.S. health care legislation will serve the citizens of the country best. (CNS photo/Chaz Muth)
  • U.S. Senate Majority Leader Mitch McConnell, R-Ky., arrives to speak with reporters following the successful vote to open debate on a health care bill on Capitol Hill in Washington July 25. (CNS photo/Aaron P. Bernstein, Reuters)
  • Sens. John McCain, R-Ariz., and Lindsey Graham, R-S.C., depart Capitol Hill in Washington July 25. (CNS photo/Eric Thayer, Reuters)

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WASHINGTON (CNS) -- When the vice president has to cast a vote to break a tie in the Senate on whether to debate U.S. health care policy, let alone revise it -- as Mike Pence did July 25 -- it is obvious that passing legislation to repeal, and/or replace, and/or reform the Affordable Care Act is going to be a heavy lift in Congress.

Democrats, who boasted of a veto-proof majority to avoid a Senate Republican filibuster, got the ACA passed in 2010. Now, they're in the minority in both the Senate and the House.

Yet in the rush to reject Obamacare, as the ACA is popularly known, there lacks unanimity among Republicans in each chamber to make changes.

The first House effort to pass the American Health Care Act never got to a vote before it was withdrawn. A second version passed 219-215 despite GOP defections.

The Senate's Better Care Reconciliation Act never came to a vote, either, when enough Republican senators gave it a thumbs-down for leaders to recognize its chance of passage was nil. The procedural vote July 25 required not only Pence's tiebreaker but the return to the Senate floor of Sen. John McCain, R-Arizona, who had undergone eye surgery that revealed brain cancer, to create the tie in the first place.

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