Had it succeeded, the amendment would have cleared the way for passage of legislation that would set up negotiations with the House on a final bill to send to President Trump’s desk. With its failure, Republicans are once again stuck searching for a plan that can unite the party’s narrow majority in the Senate and staring at the possibility of having to work with Democrats to modify rather than roll back the health law.
Democrats tried to refrain from gloating over what appeared—for the moment—to be a major victory in the fight to save the Affordable Care Act. “We are not celebrating. We are relieved,” Senate Minority Leader Charles Schumer said.
The McConnell bill, titled the Health Care Freedom Act, would have scrapped Obamacare’s mandates requiring most people to buy insurance and most businesses to offer it to their employees. It would have also defunded Planned Parenthood for a year, delayed for three years an excise tax on medical devices, and increase allowable contributions to health-savings accounts. The proposal would have made it easier for states to obtain waivers from Obamacare requirements, although it would have maintained, protections for people with preexisting conditions
But the task of writing their own proposal proved no easier for the party’s slim majority in the upper chamber. McConnell first proposal, drafted in secret and broadly similar to the House bill, faced defections from both moderates and conservatives. It fell seven votes shy of a majority earlier in the week. Republicans similarly voted down an amendment favored by conservatives that would have repealed more of Obamacare without a replacement.
What McConnell came up with instead was, by the party’s own admission, the “lowest common denominator” of what 50 Republican senators could agree to. And in an inversion of ordinary legislative motivations, it only stood a chance of passage once a group of senators secured assurances from House Speaker Paul Ryan that the skinny repeal would not immediately become law.
Late Thursday afternoon, McCain and Senators Lindsey Graham of South Carolina and Ron Johnson of Wisconsin held a surreal press conference to denounce a policy that, just hours later, two of them would vote to advance. They said they would only vote for the skinny repeal as a means to an end—a vehicle to set up a House-Senate conference committee that would allow Republicans another chance to work out a broader replacement bill. “The skinny bill as policy is a disaster. The skinny bill as a replacement for Obamacare is a fraud,” Graham declared.
Before the senators spoke, the House had already alerted its members to be prepared to vote on the Senate’s bill in the coming days and set in motion a process for expediting its consideration on the floor. But Ryan reluctantly relented, issuing a public statement and then assuring the senators in a phone call that the House would not immediately take up the bill but would move to establish a conference committee.
“Senators have made clear that this is an effort to keep the process alive, not to make law,” he said. “If moving forward requires a conference committee, that is something the House is willing to do.”
Democrats pleaded with their Republican colleagues to reject Ryan’s offer. “Don’t delude yourself that this bill won’t become law. There is a very good chance that it will,” Senator Chris Murphy of Connecticut warned on the Senate floor. He excoriated Republicans for unveiling their bill just hours before the vote, and he likened the underlying policy to “arson.” “This process is an embarrassment,” Murphy said. “This is nuclear-grade bonkers what is happening here tonight.”
Ryan’s assurance was enough to win over Graham and Johnson. Days removed from a speech decrying his own party’s handling of health care, McCain was not so quick to commit and said he would first need to consult with Arizona’s governor, Doug Ducey.
In floor speeches, Democrats directly appealed for his vote, knowing that with Collins and Murkowski against the bill, McCain’s opposition would be enough to sink the bill. Senator Mazie Hirono of Hawaii, who, like McCain, is undergoing treatment for cancer, implored him to “vote your conscience, vote with us” to defeat McConnell’s bill.
McCain answered the Democrats’ pleas. A vote planned for shortly after midnight on Friday was delayed by more than an hour after top Republicans—first McConnell and Vice President Mike Pence—huddled with the Arizonan in an effort to change his mind. But McCain, trying to live up to his maverick image one more time, would not budge.
He voted against the amendment, preserving at least temporarily the top domestic legacy of the man who defeated him for the presidency. Applause broke out briefly in the Senate chamber, and the plan went down in defeat.