- In a dramatic pre-dawn vote, the U.S. Senate voted down legislation to partially repeal the Affordable Care Act early Friday morning, dealing a stunning setback to President Donald Trump’s top legislative priority.
In a 49-51 vote, Sen. John McCain, R-AZ, joined Senators Susan Collins, R-ME, and Lisa Murkowski, R-AK, in voting against the scaled-down so-called “skinny” repeal measure that would have caused an estimated 15 million people to lose health coverage in 2018, according to the Congressional Budget Office.
Senate Majority Leader Mitch McConnell introduced the Health Care Freedom Act late Thursday night and, after several hours of debate, put the legislation to a floor vote over objections from Democrats.
The defeat caps a disappointing week for McConnell who failed in efforts to pass three Affordable Care Act repeal measures, all of which were crafted in secrecy without a single hearing and with limited input from stakeholders and lawmakers outside of a handpicked group of 13 Republican male senators.
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Senator McCain, who returned to Washington after undergoing cancer surgery, had called for bipartisan efforts to repair the health law earlier this week. His “no” vote early Friday morning provided the margin of victory for Democrats who had criticized McConnell’s efforts to push the repeal legislation through.
The defeat leaves Republicans in an uncomfortable holding pattern after seven years of promising to repeal the ACA. With control of both houses of Congress and the White House, they appeared to have a clear legislative path to fulfilling their promise.
But public support for the ACA and stubborn resistance to repeal efforts from patient, provider and advocacy groups proved stronger than expected.
“If millions of Americans had not raised their voices at town hall meetings, made phone calls to their senators, posted on social media, and resisted in other ways, this bill might already be law,” said a statement from Anna Galland, executive director of MoveOn.org. “We know this fight is not over: the threat of repeal remains real. Republicans in Congress will not give up. Neither can we.”
A disappointed Mitch McConnell was clearly shaken by the vote. “I regret that our efforts were simply not enough this time,” he said afterwards.
In a Twitter post, President Trump also expressed his dismay: “3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let ObamaCare implode, then deal. Watch!”
An emotional Senate Minority Leader Chuck Schumer, D-NY, expressed no joy with the victorious vote.
“We are relieved, not for ourselves, but for the American people.” Schumer said. He called for the Senate to go back to regular order and begin a bipartisan effort to fix Obamacare.
In a statement, Democratic National Committee Chair Tom Perez said the fight to preserve the Affordable Care Act was not over.
"After trying to pass a secret bill in the dead of night, Republicans failed once again to take health care away from millions of Americans,” Perez said. “This bill was a moral abomination and its defeat is a victory for every family whose health care was put in jeopardy by Donald Trump, Mike Pence, and Republicans in Congress. But our fight is not done yet and we can't let up.”
Unlike previous Republican repeal bills that would have slashed Medicaid funding, cut financial assistance for marketplace coverage and repealed most Obamacare taxes, the Health Care Freedom Act would have repealed the individual mandate that requires most people to purchase health coverage and the employer mandate that requires them to provide coverage.
In a letter to McConnell on Thursday, America’s Health Insurance Plans said they would oppose any plan that scraps the individual mandate without a mechanism to require continuous coverage.
“Targeted proposals that would eliminate key elements of current law without new stabilizing solutions – will not solve the problems in the individual market, and in fact will result in higher premiums, fewer choices for consumers and fewer people covered next year.”
The Health Care Freedom Act would have suspended the ACA medical device tax for three years. It also would have de-funded Planned Parenthood for a year, while steering $422 million in additional funding to community health centers, which were presumed to provide the same services.
In addition to an estimated 400,000 who would lose their care if Planned Parenthood is defunded, the Congressional Budget Office previously estimated that anywhere from 150,000 to 650,000 patients could face reduced access to care.
The legislation would also have made it easier for states to waive provisions of the ACA and required the Health and Human Services secretary to decide waiver applications in 45 days rather than the current 180 days. The bill would also have extended state waivers from five to 8 years.
The Congressional Budget Office estimates the bill would reduce the federal deficit by nearly $136 billion.
Stung by the defeat, Michael A. Needham, chief executive officer of Heritage Action, said Republicans must let Obamacare wither.
“The only way to force Senators back to the table is to block efforts to prop up Obamacare,” Needham said in a statement. “After seven years of promises, Republicans cannot simply retreat to embracing the status quo.”
Correction: An earlier version of this story incorrectly listed Sen. Chuck Schumer’s party affliation.