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What's Next For Health Care Reform? The Process Could Get Complicated

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The current state of health care reform, much like the nation itself, is a complete mess. After a series of votes on Wednesday afternoon to repeal the Affordable Care Act (or Obamacare) without a replacement plan failed, and further amendment votes already looking grim, it is hard to pinpoint exactly what's next for health care reform. Those wondering what may be to come should sit back, relax, and read up, because the process can only get more complicated from here.

First, the vote. On Wednesday morning, senators planned to vote on several amendments, one of which would partially repeal Obamacare and give Congress two years to come up with a replacement. The idea would essentially get rid of the most "unpopular" parts of the ACA and not replace it with anything. But by Wednesday evening, Senate had rejected the plan in a 45-55 vote, according to ABC News. This comes on the heels of Tuesday's session, where senators voted to advance to a floor debate the motion to re-write health care policy. There have only been two votes made by Senate so far, including Wednesday's vote. The vote to repeal the ACA and replace it with the Better Care Reconciliation Act failed on Tuesday night due to the fact that it had not yet been scored by the Congressional Budget Office, according to The New York Times.

While the Senate voting against these repeals seems like good news, there is still more to come. With the president publicly shaming Republicans who vote against reforming Obamacare and Senate Majority Leader Mitch McConnell determined to repeal the ACA with anything, the fight is far from over. Here is what will (and could) happen next:

The Debates Will Continue Until Thursday

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Wednesday night's vote was not the only healthcare related vote to be debated on. Throughout this week, according to ThinkProgress, the Senate will continue to vote on "dozens of amendments" to the current health care bill written by both parties (its likely more amendments will be voted on during an all night session on Thursday).

During this time, a "skinny repeal" — which picks and chooses which parts of the ACA to keep and which to get rid of — is also likely to change, according to ABC News. The "skinny repeal" will, according to The New York Daily News, likely cut some of the ACA's mandates and taxes but leave the law largely intact. But even that would be a poor replacement (more on that later).

This debate time is supposed to allow the Senate to put together its ideal version of the health care bill, but who knows if it will be something that everyone will agree on.

If Obamacare Isn't Repealed...

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Republican senators haven't been able to see eye to eye on what they want the health care bill to look like. But they're willing to repeal the ACA by any means. According to ThinkProgress, Senate will at least try to pass some kind of health care legislation by Friday, especially since the president is so determined to see the ACA repealed, he has started shaming his party.

But that doesn't mean they'll be successful. If nothing comes of this round of voting, then we start this whole process all over again, and it could be months before anything happens, if at all.

If The "Skinny Repeal" Is Passed...

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If Republicans succeed and the ACA is repealed by the end of the week, the future could still be bleak. According to HuffPost politics reporter Jennifer Bendery, the CBO determined the skinny repeal would leave 16 million Americans without insurance and raise insurance premiums by 20 percent.

The skinny repeal gets rid of one major mandate that allows so many people to have health insurance. If the skinny repeal is passed, it would end the mandate which states all Americans must have insurance and not require bigger companies to provide insurance to all of their employers. It would also remove a tax on medical-device manufacturers, according to NBC News. Without a shadow of a doubt, Obamacare's repeal (even a skinny, partial repeal) will leave millions without insurance and leave those who are lucky enough to still have their insurance paying more money than they did before.

History shows that agreeing upon health care reform is not a simple process. It took Obamacare almost a full year to pass after it was introduced to the House of Representatives in 2009, and was finally passed after months of revisions and amendments. Repealing the ACA could take just as long.

This week is only just the beginning.