Late Thursday night, it appeared the Senate was poised to pass a “skinny repeal” health-care bill after receiving assurances from House Speaker Paul Ryan that it would not become law, and was merely the beginning of a House-Senate collaboration on a comprehensive plan to replace Obamacare.
But as the bill’s passage appeared imminent in the small hours of Friday morning, it became clear that Republicans did not have the sufficient votes to move forward, with at least three senators — Maine’s Susan Collins, Alaska’s Lisa Murkowski, and Arizona’s John McCain — holding out. As the minutes ticked by, senior GOP leadership made a highly dramatic attempt to convince the holdouts on the floor of the Senate.
After seven years of campaigning on replacing the Affordable Care Act with something better, GOP senators wrote their latest bill just hours before the vote, which was to take place early on Friday morning. It is a deeply inhumane piece of legislation that repeals the individual mandate and employer mandate, defunds Planned Parenthood, cuts the Affordable Care Act’s public funding, and may even allow states to eventually waive essential health-benefit regulations. If it becomes law, it is expected to leave millions more uninsured as soon as next year, and cause a quick spike in premiums for those who buy health insurance on the exchanges.
Democrats raged against the law, taking to the Senate floor to voice their outrage, and influential organizations such as the American Medical Association and the AARP also indicated their strong opposition. Even many Republicans in the Senate seemed to agree that it was horrible legislation. In a surreal moment earlier on Thursday, Senators Lindsey Graham, John McCain, Ron Johnson, and Bill Cassidy staged a press conference in which Graham called the bill “terrible policy and terrible politics.” The senators said they would only vote for the bill if they could be guaranteed that it would not become law, and that the final product would be a collaborative effort between the House and Senate. House Speaker Paul Ryan issued a noncommittal statement to that effect and talked to some of the holdout senators on the phone, which was apparently enough for Graham, Johnson, and Cassidy to get to “yes.”
McCain remained uncommitted, but given his long record of un-maverickness, he seemed likely to fall in line. Still, there was last-minute tension surrounding him, as he left reporters guessing about his ultimate intention, and his body language on the Senate floor sparked speculation that he would buck party leadership.
Despite Ryan’s quasi-assurance, it was plausible that, if the Senate moved the bill forward, it would pass the House as is and become law. Some of the more draconian measures, like the defunding of Planned Parenthood, seemed designed to appease the House Freedom Caucus, the ultra-conservative wing of the lower chamber that will likely hold great sway over what happens next.
