Sen. Lisa Murkowski, R-Alaska is surrounded by reporters as she walks toward the Senate floor on Capitol Hill in Washington, Tuesday, July 18, 2017. (Manuel Balce Ceneta | The Associated Press)

Sen. Lisa Murkowski, R-Alaska is surrounded by reporters as she walks toward the Senate floor on Capitol Hill in Washington, Tuesday, July 18, 2017. (Manuel Balce Ceneta | The Associated Press)

The simple (Alaskan) guide to what happened in Congress this week

The Affordable Care Act is here to stay, and that’s in large part because of Sen. Lisa Murkowski.

Alaska’s senior U.S. Senator cast one of three decisive votes early Friday, joining fellow Republicans Sen. John McCain (Arizona) and Sen. Susan Collins (Maine), plus all of the U.S. Senate’s Democrats.

The Friday vote is only part of the story, however, and Murkowski isn’t the only U.S. Senator from Alaska. If you’re just catching up with the health care story, or you’re looking for a quick summary of the past week, this is it.

How did we get here?

In 2009, Congress passed the Affordable Care Act, commonly known as Obamacare. Murkowski voted against it, but then-Sen. Mark Begich, D-Alaska, voted for it.

Obamacare expanded Medicaid, enacted new taxes, distributed subsidies to states, banned insurers from discriminating against people with pre-existing conditions and required Americans to have some kind of health care insurance. Obamacare created a subsidized marketplace for poorer Americans who couldn’t otherwise afford insurance.

As the program got started, Republicans maintained their opposition to the program even as the number of uninsured Americans dropped. The U.S. House, which became majority Republican after the 2010 election, has voted more than 60 times to repeal the program.

The U.S. Senate in 2015 also voted to repeal the program, and Murkowski voted to repeal it at that time. The Senate’s vote was vetoed by President Barack Obama, but the election of President Donald Trump meant no one would veto any repeal approved by Congress.

After Trump’s inauguration, it was up to Congress to repeal the program.

Before this week

After Trump was inaugurated, the U.S. House drafted and passed yet another Obamacare repeal bill. Because the House has a broad Republican majority, this happened relatively quickly.

The Senate has a much smaller Republican majority. There are 52 Republicans and 48 Democrats there, if you include the two independents who side with the Democrats on most issues.

In an attempt to keep moderate Republicans on the side of the majority, Senate leaders crafted the Better Care Reconciliation Act, a replacement for Obamacare that would cut the federal deficit by $420 billion but increase the number of uninsured Americans by 22 million.

This week

On Tuesday, the Senate voted 51-50 (Vice President Mike Pence cast a tiebreaking vote) to advance the BCRA to a vote of the full Senate. Murkowski voted against advancing the bill to a vote; Sen. Dan Sullivan voted in favor.

Two amendments were passed on the Senate floor in an attempt to garner more support, but on Tuesday night, the BCRA was defeated 43-57. Murkowski voted no and Sullivan voted yes. Murkowski was joined in the “no” column by nine other Republicans.

On Wednesday, Senate leaders offered a “straight repeal” of Obamacare. Instead of replacing it with the BCRA, the vote was to simply turn back the clock on the nation’s health care system to 2008.

That vote also failed, 45-55. Murkowski again voted no, and Sullivan again voted yes.

On Friday, Senate leaders offered one last option. This choice, called the “skinny repeal,” would just eliminate the requirement for Americans to buy insurance, and it would delay a tax on medical devices.

It failed 49-51. Murkowski, McCain, Collins and the Senate’s Democrats voted “no.” Sullivan voted yes.

Why vote no?

If you’re an Alaskan, Obamacare (as currently structured) is fairly generous. Because health care is expensive here, most people get big subsidies if they have to buy insurance on the federal marketplace.

One-quarter of Alaskans use Medicaid, including one-third of Alaska children and more than half of Alaska’s disabled residents. All of the repeal options this week would affect Alaska significantly and according to repeated nonpartisan reviews by the Congressional Budget Office and Kaiser Health, among others, Alaskans would see health care costs rise rapidly and insurance become more scarce.

Why vote yes?

Both Murkowski and Sullivan have previously promised that they would support repeal efforts. Sullivan in 2014 campaigned on the promise that he would do so. In 2016, Murkowski made similar pledges and urged the program to be reformed.

Furthermore, the Affordable Care Act has failed to stop health care costs from rising in Alaska, and the state’s insurance marketplace is now down to a single company, which is being subsidized by the state government as well as the federal government.

A straight repeal could lead to a system that favors Alaska even more, though there is no guarantee of that outcome.

This week, President Trump offered another incentive for Murkowski and Sullivan: He warned that Alaska projects could be slowed in retaliation for a “no” vote.

If that happens, Murkowski and Sullivan have the ability to retaliate themselves: Murkowski is one of the key figures that decides the budget for the Department of the Interior and appointments to that department. Either senator could also block presidential nominees from progressing to a vote.

What next?

The Affordable Care Act remains law and stays in place. President Trump could take actions on his own to hamper the program, but Congress is out of the picture for now. If legislators have an appetite to return to the subject, they can draft a new bill, something that might draw Democratic support as well as Republican support. If that happens, a repeal becomes much more likely.



Contact reporter James Brooks at or call 523-2258.



More in News

Meals slated for children in Juneau over Thanksgiving weekend are arrayed on tables at Thunder Mountain High School on Nov. 25, 2020. (Courtesy photo / Luke Adams)
Font of plenty: JSD readies meals for Thanksgiving holiday

Nearly three tons of food got distributed for the long weekend.

Travelers arrive at the Juneau International Airport on Wednesday, Nov. 25, 2020, made up only about half of what the airport normally sees in the days leading up to the Thanksgiving holiday. (Peter Segall / Juneau Empire)
Centennial Hall, seen here on Tuesday, Nov. 24, is being used by the City and Borough of Juneau as an emergency facility during the coronavirus pandemic and will not host the annual Public Market which has taken place every weekend after Thanksgiving since 1983. (Peter Segall / Juneau Empire)
Want to buy Alaskan? Closed by pandemic, Public Market goes virtual

Normally throngs of Juneauites would be lined up around the block…

To capture the unexpected action- the unrepeatable moment- it should be instinctive.  In order to build the story you have to shoot the adjective.  In this photo the bald eagle had waited patiently for the right moment to pounce on an unsuspecting vole… the unexpected.  The best way to accomplish this is to master the art of the most difficult subject to photograph– birds in flight.  In order to do this you must learn your gear; it must become part of your muscle memory so you can concentrate on the story you are witnessing.  Canon 5D Mark III, Tamron 150-600mm, shot at 600mm, ISO AUTO (1250), F6.3, 1/3200, Handheld. (Courtesy Photo / Heather Holt)
Focal Point: Great photos are just waiting in the wings

Learn to shoot the verb (and the bird).

Has it always been a police car. (Michael Penn / Juneau Empire)
Police calls for Thursday, Nov. 26, 2020

This report contains public information from law enforcement and public safety agencies.

Construction of the new Glory Hall, above, is going smoothly, said executive director Mariya Lovishchuk on Nov. 24, 2020. (Courtesy photo / Thor Lindstam)
Building a brighter future: New Glory Hall reaches skyward

The structure is rapidly progressing, shouldering aside inclement weather.

This 2020 electron microscope image provided by the National Institute of Allergy and Infectious Diseases - Rocky Mountain Laboratories shows SARS-CoV-2 virus particles which causes COVID-19, isolated from a patient in the U.S., emerging from the surface of cells cultured in a lab. On Monday, Oct. 5, 2020, the top U.S. public health agency said that coronavirus can spread greater distances through the air than 6 feet, particularly in poorly ventilated and enclosed spaces. But agency officials continued to say such spread is uncommon, and current social distancing guidelines still make sense. (NIAID-RML via AP)
COVID at a glance for Tuesday, Nov. 24

The most recent state and local numbers.

A sign seen near Twin Lakes on Sept. 17 encourages residents to wear cloth face coverings while in public. Health officials are asking Alaskans for help with contact tracing. (Ben Hohenstatt / Juneau Empire File)
Health officials seek help with virus notification

Recent surge created a contact tracing backlog.

Most Read