GOP 'Skinny Repeal' Health Care Bill Fails in Late Night Senate Vote

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Senator Susan Collins

The final vote was 49-51. Republicans Lisa Murkowski of Alaska and Susan Collins of Maine joined John McCain in voting no.

Dealing a serious blow to President Donald Trump’s agenda, the Senate early Friday rejected a measure to repeal parts of former President Barack Obama’s health care law after a night of high suspense in the U.S. Capitol.

Unable to pass even a so-called “skinny repeal,” it was unclear if Senate Republicans could advance any health bill despite seven years of promises to repeal “Obamacare.”

A key vote to defeat the measure was cast by Sen. John McCain, R-Ariz., who returned to the Senate this week after receiving a diagnosis of brain cancer. In an impassioned speech the day he returned, McCain had called for bipartisanship on major issues of national concern, and a return to the “regular order” of legislating by committee.

Three Republicans joined with all Democrats to reject the amendment, which would have repealed a mandate that most individuals get health insurance and suspended a requirement that large companies provide coverage to their employees. It would have also delayed a tax on medical devices and denied funding to Planned Parenthood for a year.

The final vote was 49-51. Republicans Lisa Murkowski of Alaska and Susan Collins of Maine joined McCain in voting no.

The amendment was a last resort for Senate Republicans to pass something — anything — to trigger negotiations with the House.

“This is clearly a disappointing moment,” said Senate Majority Leader Mitch McConnell, R-Ky. He put the health care bill on hold.

Buoyed by a signal from House Speaker Paul Ryan, McConnell had introduced a pared-down health care bill late Thursday that he hoped would keep alive Republican ambitions to repeal “Obamacare.”

“It’s time to turn the page,” said Senate Minority Leader Charles Schumer of New York. “We are not celebrating. We are relieved.”

McConnell had called his measure the Health Care Freedom Act. It was not intended to become law, but to open a path for a House-Senate conference committee to try to work out comprehensive legislation Congress could pass and send to Trump.

The measure would have repealed the unpopular Affordable Care Act requiring most people to have health insurance or risk a fine from the IRS. A similar requirement on larger employers would be suspended for eight years.

Additionally, it would have denied funding to Planned Parenthood for a year, and suspended for three years a tax on medical device manufacturers. States could seek waivers from consumer protections in the Obama-era law, and individuals could increase the amount they contribute to tax-sheltered health savings accounts for medical expenses.

Ryan, R-Wis., seemingly opened a path for McConnell earlier Thursday evening by signaling a willingness to negotiate a more comprehensive bill with the Senate. Some Republican senators had been concerned that the House would simply pass the “skinny bill” and send it to Trump. That would have sent a shock wave through health insurance markets, spiking premiums.

Ryan sent senators a statement saying that if “moving forward” requires talks with the Senate, the House would be “willing” to do so. But shortly afterward, his words received varied responses from three GOP senators who’d insisted on a clear commitment from Ryan. It was not immediately clear whether the maneuver would succeed.

“Not sufficient,” said McCain, who returned to the Capitol Tuesday to provide a pivotal vote that allowed the Senate to begin debating the health care bill, a paramount priority for Trump and the GOP. The 80-year-old McCain had been home in Arizona trying to decide on treatment options for brain cancer.

He later took to Twitter to offer a full explanation. "Skinny repeal fell short because it fell short of our promise to repeal & replace Obamacare w/ meaningful reform," he wrote with the link to his full statement.

McCain's full statement reads: “From the beginning, I have believed that Obamacare should be repealed and replaced with a solution that increases competition, lowers costs, and improves care for the American people. The so-called ‘skinny repeal’ amendment the Senate voted on today would not accomplish those goals. While the amendment would have repealed some of Obamacare’s most burdensome regulations, it offered no replacement to actually reform our health care system and deliver affordable, quality health care to our citizens. The Speaker's statement that the House would be ‘willing’ to go to conference does not ease my concern that this shell of a bill could be taken up and passed at any time.

“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. We should not make the mistakes of the past that has led to Obamacare’s collapse, including in my home state of Arizona where premiums are skyrocketing and health care providers are fleeing the marketplace. We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of aisle, heed the recommendations of nation’s governors, and produce a bill that finally delivers affordable health care for the American people. We must do the hard work our citizens expect of us and deserve.”

Sen. Lindsey Graham, R-S.C., initially said “not yet” when asked if he was ready to vote for the scaled-back Senate bill. But later, he told reporters that Ryan had assured him and others in a phone conversation that the House would hold talks with the Senate.

“I feel comfortable personally. I know Paul; he’s a man of his word,” said Graham.

“Let’s see how everything turns out here, guys,” Sen. Ron Johnson, R-Wis., told reporters.

The convoluted developments played out as a divided Senate debated legislation to repeal and replace the Obama-era law. With Democrats unanimously opposed, the slender 52-48 GOP majority was divided among itself over what it could agree to.

After a comprehensive bill failed on the Senate floor, and a straight-up repeal failed too, McConnell and his top lieutenants turned toward a lowest-common-denominator solution known as “skinny repeal.”

It would have been the ticket to negotiations with the House, which passed its own legislation in May.

But that strategy caused consternation among GOP senators after rumors began to surface that the House might just pass the “skinny bill,” call it a day and move on to other issues like tax reform after frittering away the first six months of Trump’s presidency on unsuccessful efforts over health care.

Ryan responded not long after with a discursive and far from a definitive statement that blamed the Senate for being unable to pass anything, but said, “if moving forward requires a conference committee, that is something the House is willing to do.”

“The reality, however, is that repealing and replacing Obamacare still ultimately requires the Senate to produce 51 votes for an actual plan,” he said.

But leaders encountered problems. The Senate parliamentarian advised that the waiver language violated chamber rules, meaning Democrats could block it.

The insurance company lobby group, America’s Health Insurance Plans, wrote to Senate leaders Thursday saying that ending Obama’s requirement that people buy insurance without strengthening insurance markets would produce “higher premiums, fewer choices for consumers and fewer people covered next year.”

And a bipartisan group of governors, including John Kasich of Ohio and Brian Sandoval of Nevada, also announced their opposition.

On their own, the changes in the skinny bill could roil insurance markets. Yet the scenario at hand, with senators trying to pass something while hoping it does not clear the House or become law, was highly unusual.

“We’re in the twilight zone of legislating,” said Democratic Sen. Claire McCaskill of Missouri.

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