Obamacare Lives! Senate Votes Down GOP Scheme to Destroy Our Health Care System

In a crushing blow to President Trump and the Republican Party, the U.S. Senate rejected a plan to dismantle the nation’s system of health insurance early Friday morning by a 51-49 vote.

Republican senators Susan Collins, Lisa Murkowski and John McCain joined 48 Democrats in voting no on Majority Leader Mitch McConnell’s so-called “skinny repeal” bill. The measure would have ended three key features of the Affordable Care Act and allowed the future of the nation’s health care system to be determined behind closed doors by a Senate-House conference committee.

The defeat of the bill means that the massive expansion of health care coverage engineered by President Obama and a Democratic Congress in 2010 survives as the law of the land—albeit under continuing threat of sabotage by the Trump administration.

“It’s a disappointing moment,” said McConnell, blinking back tears moments after the vote was final. “It’s time to move on.”

"We are not celebrating,” said Senate Minority Leader Chuck Schumer. “We are relieved."

Outside the Capitol, a crowd of protesters cheered the news with chants of "Yes, we can," while disability rights activists, nurses and doctors wept in relief. The Senate bill would have resulted in at least 15 million people losing their health insurance and 20 percent annual premium increases for those with insurance, according to the non-partisan Congressional Budget Office.

Within the hour, President Trump weighed in.

Universal Coverage Saved

The vote was a historic victory for advocates of universal health care coverage and a bitter defeat for Trump, Republican congressional leaders and conservative ideologues who had hoped to swiftly undo President Obama’s signature legislation after Trump took office.

The repeal effort foundered when House Republicans passed a bill that would have put 24 million off the insurance rolls, dramatically curbed protection for patients with pre-existing conditions and rolled back the Medicaid program for the poorest Americans. Most of the savings would have gone to fund a tax cut for the wealthiest Americans.

As the reality of repeal set in, the Affordable Care Act gained support in public opinion polls. Hundreds of thousands of Americans rallied in defense of the law at town hall meetings where Republican congressmembers had trouble answering questions from angry constituents fearful of losing access to basic health care.

When President Trump criticized the House bill as “mean,” the Republican-controlled Senate took up the task of writing new legislation. McConnell created a committee of 13 white male senators who could not come up with a repeal plan palatable either to the party's most moderate or most conservative members.  

On Tuesday, the Senate rejected a more sweeping House-approved measure to repeal Obamacare with all Democrats and nine Republican senators voting no. On Wednesday a vote simply to repeal Obamacare with no replacement legislation also failed due to seven GOP defections.

Last-Gasp Gambit

McConnell’s last-gasp gambit was a "skinny repeal," which abandoned previous plans to slash Medicaid while still symbolically gutting the Affordable Care Act. Without establishing mechanisms to regulate insurance markets, the measure would have upended the health care system, prompting the hospital and insurance industries to protest that the law would be unworkable.

Senate supporters described the eight-page bill as a “vehicle” that would be fixed by the House-Senate conference committee. House Speaker Paul Ryan personally promised at least four Senate Republicans he wouldn’t let the bill become law before they agreed to vote on it.

When the parliamentary maneuvering culminated in a roll call vote early Friday, Senate Republicans found themselves in the odd position of having to vote for legislation they had not read until a few hours before and that they hoped would not become law. Still, most Republican senators went along. Murkowski and Collins had signaled all week that they would not vote for any repeal measure, but McCain’s vote was uncertain until he approached the Senate clerk at 1:29am. With McConnell looking on impassively, McCain raised his arm and loudly declared he was voting no.

The majority leader then delayed the vote another hour, while Vice President Mike Pence and others attempted to persuade McCain, Murkowski and Collins to change their votes, to no avail. 

The epitaph to the failed Republican crusade to repeal Obamacare was tweeted by Harvard Law School professor Lawrence Tribe.


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