Meadows says “We are still in,” after Obamacare “skinny repeal” fails in the Senate

Aaron P. Bernstein—Reuters
Senator John McCain (R-AZ) speaks with reporters after voting against the "skinny repeal" health care bill on Capitol Hill in Washington

WASHINGTON, D.C. — A measure to repeal Obamacare failed a vote in the Senate early Friday. Supporters said the “skinny repeal” measure was designed to send the issue into conference committee with the House but opponents, including Sen. John McCain, said they were not convinced the House would not send it, as is, to President Donald Trump’s desk. Voting in the early hours, three Republican senators, John McCain, Susan Collins and Lisa Murkowski, crossed party lines to join Democrats in a dramatic 49-to-51 vote to reject the bill that would have eliminated some parts of Obamacare.”This is clearly a disappointing moment,” Senate Republican leader Mitch McConnell told the Senate floor right after the vote. “The American people are going to regret that we couldn’t find a better way forward.”The vote sent the dollar down against a basket of other currencies on Friday.”3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let Obamacare implode, then deal. Watch!” Trump tweeted after the vote.Trump has repeatedly berated congressional Republicans for being unable to overcome internal divisions to repeal Obamacare, but has offered no legislation himself, nor any clear guidance on what he would like to do about replacing the law.The president has demanded at various times that Obamacare should be allowed to collapse on its own, that it should be repealed without replacement, and that it should be repealed and replaced.The Affordable Care Act, approved by Democrats in 2010, was President Barack Obama’s centerpiece domestic policy initiative. It provided health insurance to millions of uninsured Americans, but it also left millions of families with double digit increases in health insurance rates and fewer options in coverage. The voting down of the bill still leaves uncertainty in the healthcare industry, with insurers not sure how long the Trump administration will continue to make billions of dollars in Obamacare payments.Insurers have until September to set rates for 2018 health plans in many marketplaces. Some insurers, including Anthem Inc , Humana and Aetna have pulled out of Obamacare markets, citing unsustainable losses and the uncertainty over the payments.Republicans hold 52 seats in the 100-seat Senate. McConnell, whose reputation as a master legislative tactician was on the line, could afford to lose support from only two Republican senators, with the tie-breaking vote to be cast by Vice President Mike Pence, who was on the Senate floor.After the House passed a bill to repeal and replace Obamacare in May, McConnell grappled to get Republicans in the Senate to agree on their version of the bill. Conservatives wanted a bill that would substantially gut Obamacare, while moderates were concerned over legislation that could cost millions of Americans the new healthcare coverage.Republicans released the skinny bill three hours before voting began. It would have retroactively eliminate the mandate in Obamacare, the penalty on individuals who do not purchase health insurance. It would also have repealed for eight years a penalty on certain employers who do not provide employees with insurance and repealed a medical device tax until 2020. The nonpartisan Congressional Budget Office estimated that if it became law, 15 million fewer Americans would be insured in 2018 than under existing law. However, the CBO also found that most of those who would lose insurance would do so because the mandate was removed; they would no longer be required to have it under penalty of law.DRAMA OVER MCCAINAs the vote approached, all eyes in the Senate chamber were on McCain. The former Republican presidential nominee and Vietnam war hero flew back from Arizona after being diagnosed with brain cancer in order to vote, and sat talking to Collins, Murkowski, and Republican Senator Jeff Flake, also from Arizona.Collins and Murkowski both voted this week against more comprehensive Republican proposals to repeal and replace Obamacare and they were both known to have concerns about the pared-down proposal. Trump had criticized Murkowski, tweeting that she had let down the Republican Party and the country.McCain was then approached before voting began by Pence and Republican Senator Lindsey Graham, who had said on Thursday he would support the skinny repeal bill after reassurances from House Speaker Paul Ryan that it would not become law.After speaking to Pence and Graham, McCain walked across the Senate floor to tell Senate Minority Leader Chuck Schumer and other Democrats that he would vote with them. They laughed as McCain said that the reporters in the balcony could probably read his lips. Democratic Senator Dianne Feinstein embraced him.When McCain walked to the front of the Senate chamber to cast his deciding “no” vote, giving a thumbs down, Democrats cheered, knowing the bill would fail.After the bill’s defeat, Schumer told the Senate that it was time to heed McCain’s call this week to return to a more transparent and bipartisan legislative process.Schumer told reporters that he and McCain had been talking four or five times a day this week about the pared-down bill and that McCain had made up his mind on Thursday afternoon. “John McCain is a hero,” Schumer said.Democrats, and some Republicans, said the bill’s failure could present an opportunity for the two parties to work together to fix problematic areas of the Obamacare law without repealing it.”We now have an opportunity to regroup and pull things together through an open and full committee process, bipartisan participation,” Murkowski told reporters.McCain also urged a bipartisan approach, saying in a statement after the vote, “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.” Other Republicans said it was time to move on to other legislative priorities such as tax reform.”This was a heavy lift. We should have taken our time. We should have first turned to tax reform and that’s what we’ll do now,” Republican Senator Ron Johnson told reporters.The vote was a stinging blow to Republicans. Obamacare’s repeal was a major campaign promise of most Republicans in the 2016 election as rates climbed and millions lost access to their existing insurance and doctors. Later Friday morning Sen. Ted Cruz (R-Texas) said on a morning news program that the voters who elected Republicans after they ran on Obamacare’s repeal would feel betrayed by the vote.Rep. Mark Meadows (R-NC) said on a morning talk show that they will continue to work toward repeal and take their time. Meadows assured viewers that Republicans in Congress and Trump are still committed to Obamacare’s repeal.”I can tell you one thing,” said Meadows. “The president is still in.”The House’s Freedom Caucus, chaired by Meadows, is pushing Congress to work through the planned August recess.