USA TODAY US Edition

Uncertaint­y remains

Republican­s ponder what’s next as bill reveals rift in party

- Susan Page NEWS ANALYSIS

Here’s what the plan’s demise means to you

Repeal and replace: RIP.

A last-ditch proposal by Senate Republican­s to unwind the Affordable Care Act collapsed Tuesday, leaving Obamacare’s critics nearly out of time to meet a procedural deadline this weekend and notably short on ideas for a consensus that could pass.

So after seven years of promising to expunge President Obama’s signature domestic initiative from the books — a commitment that helped the GOP take control first of the House and the Senate and finally of the White House — Republican­s are left with hard choices.

Republican­s face the prospect of going into next year’s elections with Obamacare intact and the immigratio­n law for “DREAMers” being negotiated between President Trump and congressio­nal Democrats.

They risk sufficient disenchant­ment by the GOP’s base voters that they would stay home from the polls next November, or perhaps embrace anti-establishm­ent candidates urging them to throw the current bums out.

Senate Majority Leader Mitch McConnell, R-Ky., had planned to bring the bill, crafted by Sens. Lindsey Graham and Bill Cassidy, to the floor for a vote this week. But the bill did not have enough GOP votes to pass it, with Sens. Susan Collins of Maine, John McCain of Arizona, and Rand Paul of Kentucky all announcing their opposition. With those defections, there was no apparent credible path toward delivering on the campaign promise that has long been shorthande­d as “repeal and replace.”

After Saturday, the parlia- mentary maneuver that would allow approval with no Democratic votes is set to expire. Even some new legislativ­e device that might bypass a Democratic filibuster would do nothing to address the fundamenta­l disagreeme­nt within GOP ranks about what ought to be done on health care proposals that are live-or-die issues for millions of Americans.

Trump famously noted to the nation’s governors in February that campaignin­g against Obamacare was easier than doing something about it in office. “Nobody knew health care could be so complicate­d,” he complained plaintivel­y.

A vote along partisan lines by Democrats to enact the Affordable Care Act was a major factor behind the party’s loss of the House in 2010 and the Senate in 2014. For Republican­s, similar perils loom in next year’s midterms.

One of Obamacare’s core principles — that the government is obligated to guarantee that individual­s with pre-existing medical conditions are able to buy affordable health insurance — is now so widely accepted that Republican­s were unable to unite behind any bill that failed to do that.

Democrats note that it took the prospect of Obamacare’s repeal to convince a majority of Americans they liked the law.

Trump sounded resigned to defeat. “We’re going to lose two or three votes,” he said on the Rick & Bubba radio show, “and that’s the end of that.”

Because health care is complicate­d.

 ?? GETTY IMAGES ?? Lindsey Graham, left, Bill Cassidy and Mitch McConnell.
GETTY IMAGES Lindsey Graham, left, Bill Cassidy and Mitch McConnell.
 ?? GETTY IMAGES ?? Senate Majority Leader Mitch McConnell, R-Ky., decided not to hold a health care vote.
GETTY IMAGES Senate Majority Leader Mitch McConnell, R-Ky., decided not to hold a health care vote.
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