Donald Trump rails against government checks and balances after defeat of Obamacare repeal in Senate

The US President speaks in the East Room of the White House (Evan Vucci/AP)

Donald Trump has called for a change to Senate voting rules in the wake of a devastating defeat for his push to repeal Obamacare – one of his major campaign promises.

The President wrote on Twitter that in order to pass “great future legislation” the Senate “must immediately go to a 51 vote majority, not senseless 60”.

The Senate’s Republican leadership had been trying to pass their healthcare bill, which would have dismantled the Affordable Care Act (ACA) – otherwise known as Obamacare – under the budget reconciliation process. To conform to the rules of reconciliation legislation – meaning that the Senate only needs 51 votes to push forward a measure – the bill must meet certain requirements, including reducing the budget deficit.

Most other bills can be filibustered – when debate over a proposed piece of legislation is extended – and would need 60 votes to end the filibuster, or invoke closure.

Requiring 60 votes to end debate is a unique characteristic of the Senate and has the effect of requiring some Republicans to work with Democrats to push forward legislation.

By suggesting the Senate change the debate rules surrounding bills, Mr Trump appears to be hoping that he can advance his legislative agenda without having to work with Democrats, who he has frequently referred to as “obstructionists”.

After the Senate on early Friday morning narrowly rejected the Republican leadership’s last proposal to repeal parts of Obamacare, Mr Trump tweeted: “3 Republicans and 48 Democrats let the American people down.”

Senate Majority Leader Mitch McConnell’s multiple failed attempts to pass a healthcare bill show how difficult it has been for him to garner support from members of his own party on a single plan that will uproot the ACA, which Republicans say has driven up premiums and forced consumers to buy insurance they do not want and cannot afford.

The nonpartisan Congressional Budget Office (CBO) estimated that each proposal Mr McConnell put forward for a vote would have caused millions to lose their health insurance. The slimmed-down repeal bill, which failed last night, could have led to 16 million more uninsured Americans, according to CBO estimates, and would have increased premiums by about 20 per cent.

“This is clearly a disappointing moment,” said Mr McConnell following the vote. “I regret that our efforts were not enough, this time.

“It’s time to move on,” he said.

Mr McConnell put the healthcare bill on hold and announced that the Senate would move onto other legislation next week.

Republican Senator John McCain – who provided one of the deciding votes that prevented the “skinny” bill from passing – said he did not believe in forcing through the changes to Obamacare without at least some support from Democrats.

“I’ve stated time and time again that one of the major failures of Obamacare was that it was rammed through Congress by Democrats on a strict party-line basis without a single Republican vote,” he said in a statement explaining his vote. “We should not make the mistakes of the past.”