It appears that any chance of repealing (and replacing?) the Affordable Care Act died last night as Lisa Murkowski and Susan Collins were joined by John McCain in opposing the Senate’s “skinny repeal” bill.
Here’s how it went down.
Yesterday afternoon, the Senate voted against a straight repeal of the Affordable Care Act. It was a floor vote Mitch McConnell had promised after the failure of a joint repeal-and-replace bill last week, when defections from both the conservative and the moderate wings of the GOP caucus killed it before it reached a vote.
With both repeal-and-replace and the full repeal bills dead in the water, it was time for Plan C (or D or E or X at this point): “Skinny Repeal.”
“Skinny Repeal” was a frankly terrible bill that would get rid of some of the more problematic aspects of Obamacare, but come nowhere close to a full repeal. The idea was that taking away the individual mandate and the employer mandate, but leaving everything else for the time being, would have been enough to make sure the conservatives and the moderates were all on board.
But, it did not happen. The CBO almost immediately announced 16 million more people would go uninsured (because they would not be forced to buy insurance, but semantics and all that) and insurance companies complained skinny repeal would be disastrous for the market.
As a result, Lisa Murkowski, Susan Collins, and John McCain voted against the skinny repeal deal. The final vote was 49-51. Mike Pence had been in attendance in order to break the tie, but McCain’s defection from the caucus threw the bill onto the path of defeat that not even Pence could save it from.
After the vote, McConnell’s statement was simple: “It’s time to move on.”
The GOP has now been given the signal to go ahead and skip on to the next big project: tax reform – a subject I am sure will be much easier to tackle for a body that couldn’t even pass something it had campaigned on for the last 7 years.
The failure of every GOP health care reform initiative is significant because it shows a real weakness within the party in power, and it shows Donald Trump’s weakness as a leader of his party. Both of these weaknesses could potentially play against the GOP in 2018, a year that is (as of now) expected to be particularly harsh on House GOP members.
What’s next for health care reform is anyone’s guess at this point. McConnell has seemingly conceded that it won’t happen, but there are a good many conservative lawmakers who still want to keep that promise. We just don’t know where or when the time to keep that promise will come up again.