McCain says he’ll vote no on health bill,

Opposition by key senator likely to doom GOP effort.

Sen. John McCain of Arizona announced Friday that he would oppose the latest proposal to repeal the Affordable Care Act, leaving Republican leaders with little hope of succeeding in their lastditch attempt to dismantle the health law.

McCain — who killed the previous repeal effort with a dramatic “no” vote in July — released a statement saying he could not support the proposal by Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina, McCain’s closest friend in the Senate.

“I cannot in good conscience vote for the Graham-Cassidy proposal,” McCain said. “I believe we could do better working together, Republicans and Democrats, and have not yet really tried. Nor could I support it without knowing how much it will cost, how it will affect insurance premiums, and how many people will be helped or hurt by it.”

With two other Republican senators likely to vote no, McCain’s opposition to the bill could be fatal, as Senate Republicans could afford to lose no more members.

Sen. Rand Paul, R-Ky., said this week that he would not vote for the bill because it did not dismantle enough of the Affordable Care Act. And Sen. Susan Collins, R-Maine, has expressed broad concerns about the legislation, strongly suggesting that she, too, would vote against it, just as she voted “no” in July.

McCain has for months lamented a Senate legislative process that avoided hearings or formal bill-drafting procedures and assumed that an Affordable Care Act repeal bill could clear Congress with no Democratic votes. Those concerns were compounded by the decision of Republican leaders to press forward with a vote next week before the nonpartisan Congressional Budget Office could complete a full analysis of the Graham-Cassidy legislation. The budget office is expected to estimate the cost of the bill early in the week, but could not complete an analysis of its impact on health insurance coverage or premiums by Sept. 30.

That date is critical because Republicans, who hold 52 seats in the Senate, have until the end of this month to make use of special budget rules that would allow them to pass a repeal bill in the Senate with only a simple majority, rather than 60 votes.

“Of course, I’m disappointed,” Cassidy said in an interview, “but that doesn’t mean that I’m going to stop working for those folks who can’t afford their premiums. We are still working. We are still hoping.”

Cassidy said he had not spoken to Senate Republican leaders, so he did not know what might happen on the Senate floor next week.

But Cassidy said: “The Affordable Care Act has become too unaffordable for too many people. As long as that’s the case, I’m going to continue working for something that works for that fellow with a daughter who has a pre-existing condition who’s right now paying about $40,000 a year. That’s unaffordable.”

Democrats have vowed that if the legislation could be killed, they would press to resume bipartisan negotiations on legislation to stabilize health care markets under the Affordable Care Act. Republican leaders squelched those talks as they pressed for passage of a full repeal bill.

“John McCain shows the same courage in Congress that he showed when he was a naval aviator. I have assured Sen. McCain that as soon as repeal is off the table, we Democrats are intent on resuming the bipartisan process,” said Senate Democratic leader Chuck Schumer.

The Graham-Cassidy bill would take much of the money provided under the Affordable Care Act and send it back to the states.