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How the Republican health care bill fell apart
What happens if Congress fails to repeal Obamacare
How the Republican health care bill fell apart
Story highlights
- Republicans no longer have a majority willing to back the Senate GOP health care bill
- Sens. Lee and Moran worked together to announce their opposition Monday night
Washington (CNN)The
Republicans' signature campaign promise to repeal and replace Obamacare
came to a screeching halt Monday night after Sens. Mike Lee of Utah and
Jerry Moran of Kansas came together, shocked Capitol Hill and vowed to
vote against the latest draft of the GOP's health care bill.
"We
should not put our stamp of approval on bad policy," Moran said in a
bold statement that derailed Majority Leader Mitch McConnell's bid to
overhaul the Affordable Care Act. McConnell could only lose two senators
and still pass the bill, and Maine's Susan Collins and Kentucky's Rand
Paul had already defected.
Across
town, over rosemary-grilled rib eye and summer vegetable succotash at
the White House, President Donald Trump and GOP leaders were attempting
to convince a group of reliably conservative rank-and-filers to join
with them and vote for the health care bill. But as they dined on lemon
ricotta agnolotti with heirloom tomato ragout and the "farm stand peach
cobbler," the Senate rebellion against the health care bill was well
underway.
That's because Lee and Moran were working all day Monday on how they could announce their opposition together.
The
goal was to avoid being the notorious and definitive third "no" vote,
aides told CNN. If they announced together, Moran and Lee could share
the heat. But also implicit in their joint opposition was a clear fact:
They represented different, significant concerns with the bill. Their
joint opposition served to provide cover for other on-the-fence
colleagues who may soon join them in publicly opposing the GOP's effort
at finally making good on its cornerstone campaign promise of the past
seven years.
A
Senate GOP aide with direct knowledge of the ongoing upheaval told CNN
that Lee and Moran are likely just the first of many to announce
publicly they oppose the bill.
"More senators are ready to jump," the aide said. "This wasn't done without that knowledge."
The
developments ended any hope that McConnell, with his Republican Senate
majority, can pass the current version of the health care bill he's been
crafting for months. He announced a plan to set up a vote on a straight
repeal of Obamacare, a move that could let some Republican senators
save face but likely wouldn't pass given lawmakers are skittish about
repealing Obamacare without a replacement.
"Regretfully,"
McConnell said in a statement late Monday, "it is now apparent that the
effort to repeal and immediately replace the failure of Obamacare will
not be successful."
Pressure behind the scenes
In
recent days, aides said there had been several exchanges among wary
senators about how and when to announce opposition to the bill. Going
into the weekend, two Republican senators -- Collins and Paul -- were
already publicly opposed to it. It only took one more lawmaker to stop
the health care bill in its tracks.
Of
course, the weekend provided an unexpected turn of events. While
Republicans were scheduled to vote on health care this week, Sen. John
McCain underwent surgery for a blood clot, an unforseen medical episode
that required the senior senator from Arizona to stay at home and rest.
McConnell announced Saturday night the bill would be delayed. Without
McCain in town, McConnell had no chance of passing health care.
Behind
the scenes, leadership applied pressure. They asked Republican
rank-and-filers to keep their powder dry and come quietly to them with
any problems they had with the bill rather than battling it out in the
press. The goal for leaders was to continue working through the week and
lobby members privately, with the idea being to set up the vote once
McCain came back to Washington.
"At this point, every day without another 'no' is a small victory," a senior GOP aide told CNN Monday morning.
A
Lee aide told CNN that Lee did not inform McConnell or his office
directly about his statement. And, the aide said that the closest that
the Utah senator ever got to supporting the bill was "at most
undecided." The simplest explanation for his public opposition: In Lee's
opinion, Texas Sen. Ted Cruz's amendment -- which gave insurers more
flexibility to offer skimpier plans in the health care market -- didn't
go far enough to reduce premiums.
"In
addition to not repealing all of the Obamacare taxes, it doesn't go far
enough in lowering premiums for middle class families; nor does it
create enough free space from the most costly Obamacare regulations,"
Lee said in a statement.
As soon as
the news was out Monday night that the bill was sunk, Republicans from
Trump to the recovering McCain had advice on the best path forward.
"The
Congress must now return to regular order, hold hearings, receive input
from members of both parties, and heed the recommendations of our
nation's governors so that we can produce a bill that finally provides
Americans with access to quality and affordable health care," McCain
said in a statement.
Trump tweeted
Monday night that Republicans should come together to pass a full repeal
and worry about crafting a replacement with Democrats later.
"Republicans
should just REPEAL failing ObamaCare now & work on a new Healthcare
Plan that will start from a clean slate. Dems will join in!" he
tweeted.
McConnell
then said that he'd move forward with a procedural motion and make as
the first amendment a 2015 repeal bill -- which was ultimately vetoed by
President Barack Obama that had earned support two years ago even from
senators who are wavering today.
That
legislation was meant to be a messaging exercise and when leadership
briefly considered bringing it back up again earlier this year, there
was widespread distaste for the idea. The plan would repeal Obamacare,
but delay the repeal for two years.
So much has changed in a week
Republican
leaders unveiled their overhauled health care bill less than a week
ago. GOP leadership aides were upbeat following a lengthy meeting last
Thursday afternoon in McConnell's office when Centers for Medicare and
Medicaid Services Administrator Seema Verma worked with McConnell and
his top aides to convince four Republicans from states that had expanded
Medicaid under Obamacare that the bill would work for their
constituents.
After the meeting,
the aides thought the votes were trending in their direction and that
Rob Portman of Ohio, Lisa Murkowski of Alaska, Shelley Moore Capito of
West Virginia, and Dean Heller of Nevada would come around.
They
were so relieved that soon after the meeting several of McConnell and
Senate Majority Whip John Cornyn's top leadership and health care aides
joyfully bolted from their offices in the Capitol -- with
supermarket-baked cookies and cakes in hand -- to celebrate the birthday
of Eric Ueland, the bow-tied and cheerful staff director of the Senate
Budget Committee who, like them, was deeply enmeshed in the intense and
uncertain negotiations. It was a brief and welcomed sugary relief from
the unrelenting pressure they had been under for months.
Then came the weekend.
In
an attempt to win over a handful of skittish Republican governors, Vice
President Mike Pence and Verma were dispatched to Rhode Island to the
National Governors Association's summer meeting.
But
things went off the rails there. Connecticut Gov. Dan Malloy, a
Democrat, described Pence's outreach as "pretty atrocious" as the vice
president tried to make the case to governors that the nonpartisan
Congressional Budget Office was wrong about its estimate that 15 million
people would lose health care over the next decade.
Republicans
weren't happy either. After a speech in which Pence claimed 60,000
disabled Ohioans were waiting to get health care, Ohio Gov. John
Kasich's office openly dismissed the VP's numbers. It was unclear by the
end of the meeting if Pence had done anything to convince Republican
Brian Sandoval of Nevada to support the bill. Without Sandoval's
blessing there were real questions as to whether Heller could back the
plan.
On Monday evening, things devolved even more. Wisconsin Republican Sen. Ron Johnson,
who had told reporters he'd vote "yes" to advance the GOP's health care
bill last week, suddenly told reporters he was undecided.
Johnson
told reporters he'd come to question leadership after a report in The
Washington Post cited an anonymous lobbyist saying that McConnell had
been telling moderates that a change in the growth rate for Medicaid
wouldn't actually go into effect. Johnson admitted he no longer was
sure if he could support the motion to proceed to the health care bill.
"You
know I was strongly in favor of doing that last week before I read the
comments by Sen. McConnell," Johnson said. "I've confirmed those from
senators that those comments were made too so I find those comments very
troubling, and I think that really does put in jeopardy the motion to
proceed vote."
Johnson called the comments "a real breach of trust."
Of
course, nothing in Washington is ever truly dead. One needs only to
look back to March, when House Republicans pulled their health care bill
from what would have been a failing vote, only to rebound and pass it
two months later.
On the triumphant
day of passage, Trump hosted GOP congressmen at the White House for a
victory celebration on a picture-perfect May afternoon — that now looks
premature given the Senate bill was felled by dissension among several
factions of the Senate Republican caucus.
"We've developed a bond," Trump said at the time. "This has really brought the Republican Party together."
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