The Senate Republicans’ push to dismantle Obamacare collapsed in dramatic fashion early Friday morning, when two centrist GOP women and Sen. John McCain of Arizona teamed to sink an already scaled-back effort to dismantle the 2010 health care law.
McCain and GOP Sens. Susan Collins of Maine and Lisa Murkowski of Alaska sided with all 48 Democrats to reject the Republicans’ so-called skinny repeal plan, tanking the measure by a vote of 49-51. The Senate GOP had already pretty much shunned the proposal, viewing it mostly as a route to go into negotiations with the House.
But in gripping floor drama that began to unfold after midnight Friday, it appeared McCain had his mind made up that he would be the pivotal third vote to kill off the GOP's Obamacare repeal effort. Vice President Mike Pence talked to him at length, but it didn’t seem to change the Arizonan’s mind.
"I do my job as a senator," McCain said after he left the Senate chamber, saying he voted against the Obamacare repeal bill "because I thought it was the right vote." He said he wouldn't go through his thought process.
Later, McCain issued a statement offering a more thorough explanation of his vote, saying that he has always believed that Obamacare should be repealed and replaced with a solution that "increases competition, lowers costs and improves care for the American people."
McCain said the "skinny repeal" that he voted down "would not accomplish those goals." While it would repeal "some of Obamacare’s most burdensome regulations" McCain said it didn't offer an adequate replacement. McCain said the "skinny repeal" that he voted down "would not accomplish those goals." While it would repeal "some of Obamacare’s most burdensome regulations" McCain said it didn't offer an adequate replacement. He called for committee work, hearings and bipartisan input in the weeks ahead, the same tone he’d taken when a different repeal and replace effort collapsed earlier this month.
McCain previewed what was to come shortly before he entered the chamber, telling reporters: “Watch the show." Still, the veteran Republican and self-styled maverick ended up stunning his colleagues and others inside the chamber, who audibly gasped when he voted "no" on the Obamacare repeal measure.
"I don't think we all knew until he actually did it," said Sen. Shelley Moore Capito (R-W.Va.).
“This is clearly a disappointing moment,” Senate Majority Leader Mitch McConnell (R-Ky.) said shortly after the vote failed at 1:40 a.m. Friday. “We worked really hard to try to develop a consensus for a better way forward.”
He added: “Yes, this is a disappointment. A disappointment indeed.”
Republicans now have no obvious solution to healthcare policy that does not involve working with Democrats.
“This thing we tried to pass tonight? If you can’t get all Republicans to agree to that stuff, I’m not sure what we’re going to pass with Republicans,” said Sen. John Thune (R-S.D.), the No. 3 GOP leader in the Senate.
The bizarre turn of events — GOP senators were gearing up to vote for a bill few if any of them actually support — came on a frenetic day of the Republican Party’s tortured bid to upend the Democratic health care law.
On Thursday afternoon, McCain had already threatened to tank the bare-bones bill, along with Lindsey Graham (R-S.C.) and Ron Johnson (R-Wis.). Saying the bill would wreak further havoc on the health care system, the trio demanded that the bill, if they voted for it, would be just the starting point for negotiations with the House. They worried that if the Senate approved the bill, the House would quickly follow suit and send it to President Donald Trump for his signature.
After Speaker Paul Ryan (R-Wis.) offered a somewhat ambiguous commitment to go to a conference committee, several GOP senators said they still weren’t satisfied. The House leader then personally reassured a handful of senators in phone calls that the House will enter negotiations with the Senate if it passes its bill. That was enough for at least Graham and a handful of others to move forward.
The House "will go to conference, and under no circumstances does he believe the skinny bill is good policy or good politics," Graham said of the discussion with Ryan. "He doesn't want us to be the party that repeals part of Obamacare and leaves most of it in place … The bottom line here is I think Paul sees the skinny bill as a vehicle to find a better solution.”
McCain received a personal phone call from Ryan. But it didn’t work. He also spoke with his governor, who tweeted that he didn’t support the bill earlier Thursday.
But not — ultimately — for McCain.
"I wanted to talk to him some more," McCain said, referring to Arizona Gov. Doug Ducey. "It's always important to talk to your governor."
Asked how he would vote in the early evening, the normally voluble McCain said: "I am not discussing that."
The so-called skinny repeal bill would have killed Obamacare’s individual coverage mandate permanently and its employer mandate for eight years. It would also give states flexibility to opt out of some Obamacare regulations, defund Planned Parenthood for a year, repeal the medical device tax for three years and allow more pre-tax money to pay for health savings accounts.
It was a far less dramatic rollback of the law than most Senate Republicans have previously supported.
The Congressional Budget Office estimated late Thursday that the finalized GOP bill would leave 16 million fewer people insured than under the current law by 2026, while reducing the deficit by nearly $179 billion over that same time frame.
Senate GOP leaders had viewed the measure as a bridge to continued negotiations, not a policy solution. They didn't want to be blamed for being the chamber that killed Obamacare repeal, and aimed to pass the slimmed down repeal plan in the wee hours of the morning Friday.
Still, the outcome had remained murky late into the night. Ahead of the vote, Capito said she’d decided how she would vote but would not announce her position until bill comes up. Murkowski said the same. A spokesman for Sen. Mike Lee (R-Utah) said he was still undecided after the text was unveiled. But most other Republicans had signed on by Thursday evening, boosting confidence after doubts crept in hours earlier.
Graham, Johnson and McCain had demanded an ironclad commitment from Ryan that the House would not take up and pass the Senate’s bill. In a statement a few hours later, Ryan sought to reassure the Senate while declining to guarantee that the Senate’s bill, which would cause a spike in premiums and millions more to be uninsured, would not become law.
It was a tepid endorsement of the Senate leadership's drive to pass something — anything — in order to keep moving forward, but hardly more than that.
"It is now obvious that the only path ahead is for the Senate to pass the narrow legislation that it is currently considering. This package includes important reforms like eliminating the job-killing employer mandate and the requirement that forces people to purchase coverage they don’t want," Ryan said. "Still it is not enough to solve the many failures of Obamacare. Senators have made clear that this is an effort to keep the process alive, not to make law. If moving forward requires a conference committee, that is something the House is willing to do."
Most senators agreed that the skinny repeal was not good health care policy and was just a bridge to keeping the debate alive.
“The skinny bill as policy is a disaster,” Graham said, explaining it would cause a crisis in the insurance markets. “I need assurances from the House speaker … if I don’t [get them], I’m a no.”
On Thursday evening, before the “vote-a-rama” kicked off, GOP leaders were cautiously optimistic they would succeed despite the differing views on Ryan’s commitment.
At a party lunch Thursday, McConnell made one last frantic plea to his Senate Republican members to keep the party’s Obamacare repeal bid alive. Republicans must get 50 of their 52 members on board; Pence would break a 50-50 tie to pass the bill.
The Senate majority leader picked up some key votes, including Sen. Rob Portman (R-Ohio). Not everyone was sold, but GOP leaders were emphasizing that the bill, which would slash Obamacare’s coverage mandates and result in millions more uninsured, is not the ultimate goal. The bill also did not cut Medicaid.