WASHINGTON — Republicans narrowly advanced their campaign to roll back the Affordable Care Act on Tuesday, as the Senate voted by a slim margin to begin debating legislation to repeal and potentially replace large sections of the 2010 law signed by President Barack Obama.

But the partisan 51-50 vote — with Vice President Mike Pence breaking a tie — does not assure the success of the GOP’s seven-year quest to dismantle the sweeping law, often called Obamacare.

With health coverage for tens of millions of Americans at stake, it remained unclear Tuesday what kind of health care bill — if any — might emerge by the time a final Senate vote is held, possibly as early as Thursday.

Senate Majority Leader Mitch McConnell, R-Kentucky, has set up a series of votes this week on competing proposals to repeal much of Obamacare, or repeal and replace pieces of the law.

Tuesday’s procedural vote to kick off that process marks a victory for McConnell, who has been laboring for months behind closed doors to rally his divided caucus, and for President Donald Trump, who has been publicly calling out GOP senators to stick with the repeal push.

But to get to the vote, McConnell abandoned customary legislative process, foregoing public hearings and committee debate in a way almost never seen for major legislative proposals.

And he left Republican lawmakers with a series of legislative options — which polls show are also deeply unpopular with Americans — that would leave as many as 32 million more people without health coverage and weaken health protections for tens of millions more.

The GOP plans have been widely panned by independent analysts and vigorously opposed by every major patient advocacy group and every leading organization representing physicians, nurses and hospitals.

Opponents include the American Diabetes Association, the March of Dimes, the AARP, the American Medical Association, the American Lung Association, the National Multiple Sclerosis Society, the American Heart Association and the advocacy arm of the American Cancer Society.

Republican Sens. Susan Collins of Maine and Lisa Murkowski of Alaska voted against the motion.

Collins posted on Twitter on Tuesday afternoon that she voted against the motion to proceed with debate on the bill because “when dealing w/ a complex issue that affects millions of Americans & ⅙th of our economy, we must proceed carefully.”

“Making sweeping changes to the 50-year-old Medicaid program without a single Senate hearing is a mistake,” she tweeted. “We must work in a bipartisan way to to fix the ACA’s serious flaws.”

In a statement Tuesday, Maine’s junior senator, independent Angus King, called the legislation “misguided,” adding that any version of the bill “will hurt millions of people across the country and tens of thousands of hardworking people across Maine.”

“I’ve never seen a process like this before with no hearings and it will almost certainly produce a terrible bill that will drastically raise costs for people in Maine, put coverage out of reach for many others, and reduce Medicaid funding, causing states to choose between helping seniors or children or people with disabilities,” King said. “As the Senate advances with this bill, I will continue to support and protect people in Maine and work to find solutions that keep people covered and make health care more affordable.”

GOP leaders were aided by the dramatic return to the Capitol by Sen. John McCain, R-Arizona, after surgery last week and a diagnosis of brain cancer. He arrived in the chamber to cheers and a standing ovation from his colleagues.

As Republicans next move to crafting a final bill, one leading GOP option, favored by conservatives, is to simply repeal most major parts of Obamacare, and then try to pass a new health care law in the future.

Another idea, supported at one point by GOP leaders, would replace most of the law while at the same time dramatically scaling back federal funding of the Medicaid insurance program that covers some 74 million low-income, elderly and disabled Americans.

GOP centrists have complained both of those versions would leave too many Americans without insurance, and have urged McConnell to start the process over, working on a bipartisan approach that will protect those covered under Obamacare.

So far, none of these approaches has garnered the necessary 50 votes from the Republicans’ 52-seat Senate majority.

The lack of GOP consensus prompted Senate Republican leaders to float a new idea Tuesday — a far more limited repeal bill that would target the most unpopular parts of Obamacare, including its insurance mandates.

That plan — dubbed “skinny repeal” — would eliminate only a medical device tax established by Obamacare and two mandates requiring Americans to have coverage and requiring large employers to offer health benefits.

The approach would fall far short of what Republicans have been promising for years.

If it passes, Senate Republicans could at least send something to a conference committee where lawmakers could work out a compromise with a sweeping repeal bill passed by House Republicans in May, giving them yet another shot at unwinding Obamacare.

That would all have to be done without Democrats, who remain fiercely opposed to the GOP repeal push and voted together Tuesday to try to block the beginning of Senate debate.

The skinny repeal plan risks major disruptions to the nation’s insurance markets, as the lack of any insurance mandate could free Americans to buy health insurance only when they get sick, driving up costs.

But it would leave in place other critical parts of the 2010 law, including hundreds of billions of dollars of federal aid to state Medicaid programs and insurance subsidies that help low- and moderate-income Americans

That assistance is credited with helping extend coverage to more than 20 million previously uninsured Americans.

Also untouched would be landmark rules established by Obamacare that require insurers to cover a basic set of benefits and prohibits health plans from discriminating against Americans with preexisting medical conditions.

It remains unclear whether House Republicans would agree to this more limited repeal plan.

But with centrist and conservative GOP senators in deep disagreement, the skinny repeal may be all McConnell can pass.

The repeal-only plan — which is favored by the most conservative GOP senators — would leave an estimated 32 million more people without health coverage over the next decade, according to the nonpartisan Congressional Budget Office, or CBO.

It is opposed by multiple centrist GOP senators.

The alternative proposed by McConnell that repeals and replaces major parts of the law while also dramatically scaling back federal Medicaid assistance is only slightly less disruptive, CBO analysts have concluded.

The McConnell proposal, which has drawn fire from both centrist and conservative Republicans, would leave 22 million more Americans without insurance by 2026.

That plan would be most devastating to the Medicaid safety net, which currently covers some 70 million poor Americans, including children. Federal Medicaid funding would be reduced by more than a third over the next two decades.

And while CBO concluded the “repeal-and-replace” plan could lower premiums for some consumers, it would likely put health insurance out of reach for older and sicker Americans who could be forced to pay larger deductibles or higher premiums than under the current law.

Still unclear is the effect of yet other GOP proposals that could come up for votes in coming days, including one by Sen. Ted Cruz, R-Texas, to allow health insurers to sell skimpier plans that do not include basic benefits such as prescription drugs, maternity care and mental health and substance abuse services.

The Cruz proposal is widely expected to make health coverage more expensive for sick Americans who need to buy more extensive health coverage and has been panned by health insurers as “unworkable.”

But McConnell elected to proceed with voting Tuesday before CBO had an opportunity to assess the potential impact of Cruz’s proposal. </s> On the same day that the United States Senate cast a crucial procedural vote that could lead to abolishing the nation’s health care law, the Affordable Care Act, Donald Trump will hold a campaign rally that will live stream from the Trump stronghold of Youngstown, Ohio, on Tuesday. A live stream of the Trump speech, coming just a day after Trump delivered a controversial speech to the Boy Scouts of America, may be viewed by scrolling down on this page.

The Trump campaign rally is scheduled to get underway at 7 p.m. Eastern Daylight Time, 4 p.m. Pacific, at Covelli Centre in Youngstown, about four hours after the Senate cast a razor-close vote to proceed with debate on whether or not to repeal the Affordable Care Act, better known as “Obamacare;” the signature legislation passed during the term of President Barack Obama.

An actual vote on whether to repeal “Obamacare” will likely take place later this week. On Tuesday, the Senate split 50 votes to 50 on the move to proceed with debate on repeal. All 46 Senate Democrats plus the Senate’s two independents — Bernie Sanders of Vermont and Angus King of Maine — voted against moving ahead with the repeal debate. Two Republicans also voted “no,” breaking ranks with their party and with Trump, who has demanded that Republicans show “loyalty” to him by voting in favor of repealing the Affordable Care Act.

Watch a live stream of Trump’s Youngstown rally celebrating the Senate vote by clicking on the video below, courtesy of Right Side Broadcasting.

Republican Senators Susan Collins of Maine and Lisa Murkowski of Alaska were the two GOP members joining Democrats in the “no” vote. In cases of a tie vote in the Senate, the vice president is called upon to cast a tie-breaking vote, which Mike Pence did, giving the “no” vote a 51-50 majority win.

Youngstown is considered a bellwether of how white working class voters will tilt in presidential elections, and Trump visited the city — with its small population of only 60,000 residents — three times during his 2016 presidential campaign. Youngstown voters supported Trump in that election, and polls show that support for Trump in the Youngstown region remains strong.

Nonetheless, those same voters worry about how Trump’s effort to repeal the Affordable Care Act will affect their lives and their own health care. In interviews with the Associated Press, area residents expressed mixed opinions about Trump and his health care repeal push.

Jeni and Kevin Potter, whose 13-year-old daughter Erin is a three-time leukemia victim, told the AP that they might be forced to move to Canada — which has a national health insurance program — or the state of Massachusetts, which has its own state-level health care program similar to “Obamacare,” if the health care repeal strongly backed by Trump passes and is signed into law.

By contrast, 72-year-old Judy Martin told the AP that even though she has spent her entire life savings after working 51 years in a factory on medical expenses and now spends $400 of her $1,500 monthly Social Security benefit on medications and other health care costs, she believes that Trump will lower her medical expenses “and that he will take care of the little people.” </s> WASHINGTON (AP) – The Senate has voted to move ahead on health care legislation aimed at dismantling the Obama health law.

The vote was 51-50 on Tuesday, a victory for Majority Leader Mitch McConnell and President Donald Trump. Last week, McConnell was forced to postpone the vote, lacking the support of conservatives and moderates.

In a dramatic turn, Sen. John McCain returned from Arizona where he is battling brain cancer to cast a crucial vote on proceeding on health care.

The vote sets up days of debate and votes on repealing and replacing Barack Obama’s health care law. Whatever the Senate approves still requires a vote in the House.

A short time later, President Donald Trump praised the Senate for moving forward on health care repeal. He says a vote Tuesday to take up the Republican health care bill “was a big step.”

Trump adds that he wants “to congratulate the American people” because better health care is on the way.

Shouting “Kill the bill” and “shame,” the demonstrators stood in the visitors’ gallery and chanted. They were led out of the chamber by police but could still be heard.

The Senate chamber was packed, with lawmakers standing to cast their votes.

Join The Conversation On The KDKA Facebook Page

 Stay Up To Date, Follow KDKA On Twitter </s> Vice President Mike Pence forced to cast the tie-breaking vote on moving forward with the senate healthcare debate.

US Senate Republicans narrowly agreed on Tuesday to open debate on a bill to end Obamacare, but the party's seven-year effort to roll back Democratic President Barack Obama's signature healthcare law still faces significant hurdles.

The senate deadlocked 50-50 on moving forward with the healthcare debate, forcing Vice President Mike Pence to cast the tie-breaking vote.

Senator John McCain, who was diagnosed this month with brain cancer and has been recovering from surgery at home in Arizona, made a dramatic return to the US Capitol to cast a crucial vote in favour of proceeding.

READ MORE: The Obamacare debate is not just about healthcare

The outcome was a huge relief for President Donald Trump, who had pushed his fellow Republicans hard in recent days to live up to the party's campaign promises to repeal the 2010 Affordable Care Act, commonly known as Obamacare. Minutes after the vote, Trump called it "a big step".

But the narrow victory on a simple procedural matter raised questions about whether Republicans can muster the votes necessary to pass any of various approaches to repeal. Moderates are worried repeal will cost low-income Americans their insurance and conservatives are angry the proposed bills do not go far enough to gut Obamacare.

Al Jazeera's Kimberly Halkett, reporting from Washington DC, said that Trump's celebrations were a "premature victory lap".

"[It was very difficult] just to get the passage of that vote just to begin the debate - requiring a senator who has recently been diagnosed with brain cancer pivotal in getting that passed and even having the vice-president being called in to break the tie," said Halkett.

"In no way is there any certainty that [Trump] will be able to deliver legislatively on his key campaign promise to repeal the Affordable Care Act."

John McCain said he voted for the motion to proceed to "allow debate to continue and amendments to be offered".

"I will not vote for the bill as it is today," he said." It's a shell of a bill right now."

'We have a duty to act'

Senators Susan Collins and Lisa Murkowski were the only Republicans to oppose the measure, and with Republicans controlling the Senate by a 52-48 majority, those were the only votes the party leadership could afford to lose. Democrats were united in opposition to the motion to proceed.

Republican Senator Ron Johnson, who cast the last and deciding vote to open debate, engaged in a heated discussion with Senate Majority Leader Mitch McConnell before casting his vote and ending the suspense.

A loss on Tuesday could have been a death blow for Republican efforts to repeal Obamacare, as well as casting doubt on Trump's prospects to achieve any of his other top legislative agenda items, including tax reform.

READ MORE: Can Muslim politicians survive in today's US?

"We have a duty to act," McConnell told senators before the vote, reminding Republicans they had promised to repeal Obamacare in four straight elections. "We can't let this moment slip by."

As the vote opened, more than two dozen protesters in the senate chamber chanted "kill the bill" before they were removed.

The senate will now launch what McConnell has promised will be a robust debate on healthcare that could include a variety of amendments.

Senators said several approaches have been discussed, including a straight repeal of Obamacare with no replacement plan, or repealing and replacing the law while also overhauling Medicaid, the federal health insurance programme for the poor and disabled.

Senate Republicans also could consider a shortened version of repeal, called a "skinny repeal," which would end the mandates in Obamacare on individuals and employers to obtain or provide health insurance, and a medical device tax, a senate aide and a lobbyist said.

"Ultimately they voted on opening debate on an amendment process - that really leaves it wide open in terms of what could look like," said Al Jazeera's Kimberly Halkett.

Halkett said there are only 40 hours of debate scheduled - including 20 hours each for the Republicans and the Democrats.

"It's very hard to see how anything constructive can be accomplished, the prospects for its success are very bleak. At the same time Democrats are digging in deep, intensifying their efforts to see that it fails," she said. </s> Senate Majority Leader Mitch McConnell of Ky. walks to the Senate Chamber on Capitol Hill in Washington, Tuesday, July 25, 2017. (AAP)

Republicans have won a narrow vote in the United States Senate to begin formal debate of healthcare legislation as they look to repeal Obamacare.

The US Senate has voted to begin formal debate of healthcare legislation that would repeal major elements of Obamacare and possibly replace it with a less costly program.

By a vote of 51-50, with Vice President Mike Pence breaking a tie, the Republican effort cleared an important procedural hurdle in the Senate, but it was still unclear whether there would eventually be enough votes to pass a bill.

The outcome was a huge relief for President Donald Trump, who had pushed his fellow Republicans hard in recent days to live up to the party's campaign promises to repeal the 2010 Affordable Care Act, commonly known as Obamacare.

Senator John McCain, who has been battling brain cancer at home in Arizona, made a dramatic return to the Capitol to cast a vote to open the healthcare debate. He received an ovation from his fellow senators when he entered the chamber.

Senators Susan Collins and Lisa Murkowski were the only Republicans to oppose the measure. Democrats were united in opposition to the motion to proceed.

A loss on Tuesday could have been a death blow for Republican efforts to repeal Obamacare, and also cast doubt on Trump's prospects to achieve any of his other top legislative agenda items, including tax reform.

"We have a duty to act," Senate Majority Leader Mitch McConnell told senators before the vote, reminding Republicans they had promised to repeal Obamacare in four straight elections. "We can't let this moment slip by."

As the vote opened, more than two dozen protesters in the Senate chamber chanted "kill the bill" before they were removed.

The Senate will now launch what McConnell has promised will be a robust debate on healthcare that could include a variety of amendments.

Senators said a variety of approaches have been discussed, including a straight repeal of Obamacare with no replacement plan, or repealing and replacing the law while also overhauling Medicaid, the federal health insurance program for the poor and disabled.

Senate Republicans also could consider a shortened version of repeal, called a "skinny repeal," that would end Obamacare's individual and employer mandates and the medical device tax, a Senate aide and a lobbyist said. </s> WASHINGTON – Republicans finally cleared a key hurdle in their years-long effort to repeal Obamacare, the landmark law that reshaped health care and redefined campaign priorities for multiple election cycles.

Tuesday's high-stakes vote allows the Senate to simply begin debate with a likely vote on a straight repeal bill and perhaps a GOP health care reform plan next week.

The vote narrowly passed along party lines, with Vice President Mike Pence breaking the 50-50 tie.

It was preceded by the dramatic return of Sen. John McCain, who recently announced he has brain cancer. The Arizona lawmaker walked onto the Senate floor to a standing ovation, offering a critically needed vote to help Republicans break the deadlock.

President Donald Trump congratulated his colleagues on Capitol Hill immediately following the vote.

"This was a big step," he proclaimed. "I want to thank Senator John McCain and all of the Republicans."

"I want to congratulate [the] American people," he added. "We're going to give you great health care."

The president used the bully pulpit of the Oval Office to pressure the Senate into action after repeated failed attempts to cobble enough support among the Republican conference for its plan to replace the Affordable Care Act, President Barack Obama's signature domestic achievement.

Ahead of the procedural vote, Senate Majority Leader Mitch McConnell, R-Ky., called it an "important first step toward repealing Obamacare" and addressing its "failures."

"Any senator who votes against starting debate is telling America that you are fine with the Obamacare nightmare," McConnell said, reiterating President Trump's words.

Republicans who opposed the vote for debate include Sens. Susan Collins of Maine and Lisa Murkowski of Alaska.

Protesters temporarily interrupted with chants of "Kill the bill" and shouts of "Shame." </s> WASHINGTON: Republican senators tried to gather more support on Monday for a last-ditch attempt to repeal Obamacare by revising funding provisions of their bill to make it more attractive to a handful of undecided lawmakers.

The outcome remained in doubt, with several senators in the party voicing concerns in recent days about the legislation to dismantle Democratic former President Barack Obama's signature healthcare law.

Republican senators leading the effort on Monday released a revised version of their bill in hopes of finding more support.

The Senate is up against a Saturday deadline for deciding the fate of the 2010 Affordable Care Act, as it is known formally. That is the day for expiration of a rule that would let the latest Republican plan pass with just a 51-vote majority, instead of the more usual 60 votes. Republicans, who control the Senate 52-48, were finding it difficult even to clear that lower hurdle.

A total of three Republican defections would kill off the latest anti-Obamacare effort and Republican Senators John McCain and Rand Paul already have registered their opposition. Others senators such as Ted Cruz, Susan Collins and Lisa Murkowski have voiced reservations.

A spokesman for Paul said on Monday the senator still opposes the latest version despite the tweaks.

The revised bill released on Monday included a table that said some states where senators have been undecided, such as Alaska and Maine, would get more money under the bill than under current law. The Washington Post first reported the revision.

For seven years, Republicans have hammered Obamacare, which extended health insurance to some 20 million Americans, as an unwarranted and costly government intrusion into healthcare, while also opposing taxes it imposed on the wealthy.

Republican President Donald Trump made repealing Obamacare one of his top campaign promises in 2016. Democrats have fiercely defended it.

Democratic leaders roundly rejected the revised draft of the repeal legislation as a sleight of hand to gain support.

The last attempt to repeal Obamacare fell one vote short in July, in a humiliating setback for Trump and Senate Majority Leader Mitch McConnell.

The new bill, originally introduced by Senators Lindsey Graham and Bill Cassidy, would take federal money spent on the Medicaid program for the poor and disabled, as well as subsidies to help Americans buy private insurance, and divvy it up to the states in block grants. Advocates say that would give states more discretion to manage their own healthcare schemes.

Opponents fear undoing Obamacare will mean millions lose healthcare, including some with pre-existing medical conditions.

U.S. hospital stocks were down across the board, in broadly bearish trading marketwide. Shares of HCA Healthcare Inc and Tenet Healthcare Corp were hit particularly hard, falling 2.8 percent and 5 percent, respectively, in afternoon trading.

"The Graham-Cassidy bill is looking to reduce funding for Medicaid in the longer term," said Jefferies analyst Brian Tanquilut. "That is a benefit that we have seen improve the earnings outlooks for these hospitals."

He said the bill could reduce the number of insured Americans, which would hurt hospitals' bottom lines.

Paul, from Kentucky, said the Graham-Cassidy plan was still too similar to Obamacare. "My promise to the voters was to repeal Obamacare - not block grants and keep Obamacare," Paul said in a statement. Only a "significant reassessment" of the "trillion-dollar spending regime" would get his support, he said.

Cruz, a conservative speaking at an event in his home state of Texas, warned on Sunday that Trump and McConnell could not count on his vote. Cruz has pushed for greater government cost savings in healthcare.

Collins, a moderate from Maine who voted against her party's bill in July, said on CNN's "State of the Union" on Sunday that it was difficult to "envision a scenario where I would end up voting for this bill." She worried about cuts to Medicaid benefits to the poor and disabled.

Graham suggested Republicans could have another shot at repealing Obamacare, even if they do not do it this week, if Senate leadership were to attach a repeal bill to a planned tax reform package.

That package was expected to be designated in 2018 for the once-per-year procedural advantage of being handled under the Senate's 50-vote reconciliation process. Trying to combine the two would be highly unusual.

"If we fall short, then you just continue the effort in putting taxes and reconciliation together," Graham told Reuters. "I think Congress can do two things at once."

U.S. Senate Democratic leader Chuck Schumer dismissed the late effort to revise the bill and add money for a few states, calling it "just as bad for those states and the rest of the states because it still contains a massive cut to Medicaid."

The Senate Finance Committee is scheduled to hold a hearing on Monday in an attempt to build support for the bill and to tamp down Democratic criticism that the measure has not been thoroughly vetted.

The non-partisan Congressional Budget Office is expected to produce as early as Monday a preliminary analysis of the bill that would assess its impact on budget deficits.

More time is likely needed for the CBO to gauge how the bill could affect Americans' access to health insurance. </s> Hours after a replacement for the Affordable Care Act was all-but scuttled by a clutch of Senate Republicans, three lawmakers appear to have doomed Majority Leader Sen. Mitch McConnell's Plan B – to repeal the Affordable Care Act without replacing it.

Sens. Lisa Murkowski of Alaska, Shelley Moore Capito of West Virginia and Susan Collins of Maine have all said they would vote "no" on a motion that would have kicked off McConnell's plan to vote on a straight repeal of Obamacare.

"To repeal, there has to be a replacement," Murkowski told reporters Tuesday. "There's enough chaos already, and this would just contribute to it."

The three no votes were enough to tip the balance against the repeal-only option. With only 52 Republicans in the Senate, the plan for a vote on repeal could only afford to lose two votes. It requires the support of 50 senators for passage. With the defection of Murkowski, Capito and Collins, the bill has no more than 49 in the yes column.

Further, Sen. Pat Roberts of Kansas tells NPR's Susan Davis that there are probably "five or six" Republicans in total who are against the motion.

President Trump said he was deeply disappointed by the collapse of the repeal motion, especially give the years of talk among Republican lawmakers about repealing and replacing it.

"Let Obamacare fail," he said. "I'm not going to own it." </s> Hours after a replacement for the Affordable Care Act was all but scuttled by a clutch of Senate Republicans, three lawmakers appear to have doomed Senate Majority Leader Mitch McConnell's Plan B: Repeal the Affordable Care Act without replacing it.

Sens. Lisa Murkowski of Alaska, Shelley Moore Capito of West Virginia and Susan Collins of Maine have all said they would vote "no" on a motion that would have kicked off McConnell's plan to vote on a straight repeal of Affordable Care Act, also known as Obamacare.

"To repeal, there has to be a replacement," Murkowski told reporters Tuesday. "There's enough chaos already, and this would just contribute to it."

Collins echoed those sentiments. "We can't just hope that we will pass a replacement within the next two years," she said in a statement, adding that it would "create great uncertainty for individuals who rely on the ACA and cause further turmoil in the insurance markets."

The three no votes were enough to tip the balance against the repeal-only option. With only 52 Republicans in the Senate, the plan for a vote on repeal could afford to lose only two votes. It requires the support of 50 senators for passage. With the defection of Murkowski, Capito and Collins, the bill has no more than 49 in the yes column.

Further, Sen. Pat Roberts of Kansas tells NPR's Susan Davis, there are probably "five or six" Republicans in total who are against the motion.

President Trump, speaking to reporters in the Roosevelt Room, dished out plenty of blame for Democrats and Republicans alike.

The president said he was "disappointed" by Monday's collapse of the GOP replacement plan, known as the Better Care Reconciliation Act. He called Democrats "obstructionists" for not supporting the measure. He also vowed that

"For seven years I've been hearing 'repeal and replace' from Congress, and when we finally get a chance ... they don't do it," Trump said.

"I think we're probably in that position where we'll just let Obamacare fail," he said. "We're not going to own it. I'm not going to own it. I can tell you, the Republicans are not going to own it."

Trump vowed on health care that "eventually we're going to get something done, and it's going to be very good."

Senate Majority Leader Mitch McConnell said of the Republican effort "everyone has given it their best shot."

He too said there would be another repeal vote "sometime in the near future."
The United States Senate rejects "repeal only" propositions of the Patient Protection and Affordable Care Act. United States President Donald Trump lashes out at Republican Senator Lisa Murkowski, who voted against the proposal.