The U.S. Senate voted Thursday to repeal major portions of President Barack Obama's signature domestic achievement: the Affordable Care Act, also known as Obamacare.
The Republican-led chamber also defeated an amendment proposed by Democrats to restrict U.S. gun sales in the aftermath of Wednesday's mass shooting in San Bernardino, California. In addition, it voted to withhold federal funds from abortion provider Planned Parenthood.
Unlike dozens of previous Republican attempts to scrap, defund or otherwise gut the ACA, the current bill is all but certain to reach the White House, where a presidential veto has been promised.
The legislation is widely seen as drawing battle lines ahead of U.S. elections next year, when the presidency, all House seats, and one third of the Senate will be up for grabs.
‘Ideology before people’
Enacted in 2010, Obamacare has been a lightning rod for fierce partisanship since its inception. A 2013 Republican attempt to defund the law shut down the U.S. government for more than two weeks.
"It's a law that puts ideology before people, that hurts many of the very Americans it was supposed to help," said Senate Majority Leader Mitch McConnell before Thursday's 52-47 vote.
"It resulted in millions of cancellation notices for hardworking Americans who had (health care) plans they liked and who had done nothing wrong," McConnell added. "It raised premiums; it raised co-pays (out-of-pocket expenses); it raised deductibles and taxes for Americans who were already struggling."
Rallied behind law
Although initially nervous during the ACA's glitch-ridden rollout, Democrats have since rallied behind the law and become more vocal in defending it.
"We've never had more people insured in modern history, because of Obamacare," said Democratic Sen. Barbara Boxer. "It doesn't mean it's perfect. But millions and millions of Americans now have the peace of mind of being insured."
In a statement, the White House said, "Repealing key elements of the Affordable Care Act would result in millions of individuals remaining uninsured or losing the insurance they have today."
The ACA is highly complex and has taken years to implement. It seeks to reduce the number of uninsured Americans, expand a federal health care program for the poor, and make insurance more consumer-friendly by allowing young adults to remain on their parents' policies and barring insurers from excluding enrollees with existing health conditions.
Republicans don't dispute that the ranks of the uninsured have fallen under Obamacare. But they argue the progress has come at enormous costs for many Americans.
"What Obamacare did was to expand a broken system that everyone knew was too expensive," said Sen. Lamar Alexander.
"Obamacare at its heart is a massive consumer fraud. It has been a miserable failure, and the promises made under it were abject lies," said fellow-Republican Ron Johnson.
"Obamacare saves lives," countered Senate Minority Leader Harry Reid, a Democrat. "The share of Americans without insurance is at the lowest point in history."
Message to voters
Political observers note that Obamacare continues to animate some voters, especially core Republicans who will cast ballots in primary elections across the nation in coming months.
"Repeal of Obamacare has been a mantra of the GOP (Republicans) since it was enacted in 2010, and the party continues to pursue the issue of repeal as a way to rally their troops and define their differences from Democrats," said congressional expert Sarah Binder of the Brookings Institution.
"The entirety of the repeal effort is political messaging," Binder noted. "Lawmakers know that the president will veto the bill. So the GOP pursues repeal to send a message to voters about GOP promises if they win the White House."
Even before the vote, McConnell acknowledged the repeal bill would not become law and the ACA would endure.
"Obviously we are not expecting a presidential signature, but I think the president should have to take credit for the debacle that this legislation has created," McConnell said.
"This is really about political accountability," said Republican Sen. John Cornyn.
‘Waste of time’
Democrats noted that the bill consumed a day of Senate floor time one week before the U.S. government's spending authority expires.
"Obama is not going to sign a bill repealing Obamacare," said Independent Sen. Bernie Sanders, who is running for president as a Democrat. "What we are doing today is just a waste of time."
Democrats engaged in messaging of their own by forcing votes on a gun control amendment as the nation reeled from the latest deadly shooting rampage. Republicans defeated a proposal barring those on the federal government's terrorist watch list from buying guns or obtaining a license for firearms.
The ACA repeal proceeded as a budgetary item, subject to a simple-majority Senate vote rather than the three-fifths majority usually required to advance legislation.
The bill includes language halting federal funding for Planned Parenthood, a nonprofit women's health care provider and the nation's leading performer of abortions.
Full repeal pledge
Looking ahead, analysts say Republicans will continue to pledge a full repeal of Obamacare. Actually doing so will become harder the longer the law remains on the books.
"Typically, the longer laws are in place, the more Americans come to value the benefits that they receive under the law," Binder said. "The political question is whether the GOP can ever succeed in total (ACA) repeal since it requires taking away health care for voters."
"Ultimately, the challenge would be for a future GOP government to propose a program to ‘repeal and replace' rather than merely to repeal," Binder added.