Los Angeles Times

Obamacare repeal loses a key vote

McCain announces opposition and leaves Senate sponsors with no margin for error.

- By Noam N. Levey and Lisa Mascaro noam.levey@latimes.com

Sen. John McCain says he will not support the GOP plan to roll back the Affordable Care Act.

WASHINGTON — Sen. John McCain (R-Ariz.) dealt a critical blow to Republican­s’ last-ditch attempt to roll back the Affordable Care Act on Friday, announcing that he could not “in good conscience” vote for sweeping repeal legislatio­n that GOP leaders plan to bring to the Senate floor next week.

Echoing concerns he raised over the summer when he helped defeat an earlier repeal bill in a dramatic late-night vote, the senior Arizona senator also delivered a stern rebuke of his party’s attempt to push through the large, complex measure with little public scrutiny, only one hearing planned and no support from Democrats.

“We should not be content to pass healthcare legislatio­n on a party-line basis,” McCain said in a lengthy statement criticizin­g the GOP.

“I take no pleasure in announcing my opposition. Far from it. The bill’s authors are my dear friends,” he said, referring to Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.). “I hope that in the months ahead, we can join with colleagues on both sides of the aisle to arrive at a compromise solution that is acceptable to most of us, and serves the interests of Americans as best we can.”

McCain’s move raises serious questions about whether Republican­s have the votes to advance their latest repeal effort, which only days ago seemed to be gaining considerab­le momentum.

The party, which has 52 members in the Senate, can lose no more than two votes or the bill will fail, even with Vice President Mike Pence’s ability to cast a tiebreakin­g vote.

Already, Sen. Rand Paul (R-Ky.) has said he would oppose the bill, which he complained maintains too much of the current law’s government spending on healthcare.

“I won’t vote for Obamacare Lite that keeps 90% of the taxes & spending just so some people can claim credit for something that didn’t happen,” Paul tweeted Friday. “Calling a bill that KEEPS most of Obamacare ‘repeal’ doesn’t make it true. That’s what the swamp does. I won’t be bribed or bullied.”

Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, two centrist Republican­s who joined McCain to help sink the GOP repeal effort in July, have signaled strong reservatio­ns about the current proposal.

“I’m leaning against the bill,” Collins said at an event in Maine, according to the Portland Press Herald newspaper.

Senate Majority Leader Mitch McConnell (R-Ky.) did not immediatel­y respond to McCain’s announceme­nt or signal how he would proceed.

McConnell had indicated he wanted to put the Graham-Cassidy proposal to a vote next week, as Republican­s face a Sept. 30 deadline under Senate rules to be able to advance a repeal bill with only 51 votes. After that, the threshold rises to 60 votes.

The Graham-Cassidy proposal, which first emerged over the summer, was initially dismissed by many GOP senators, but the end-of-month deadline and pressure from the party’s conservati­ve base to fulfill the repeal pledge prompted a scramble by Senate Republican leaders and the White House to round up the votes to revive their push.

President Trump and Pence have been calling senators for days trying to build support. And GOP leaders have been offering various sweeteners to win votes, such as more money for specific states, including Alaska.

“Rand Paul, or whoever votes against Hcare Bill, will forever (future political campaigns) be known as ‘the Republican who saved Obama-Care,’” Trump said Friday on Twitter.

Pence met Friday morning with Maine Gov. Paul LePage, a Republican, while calling on Collins to support the bill. And Pence conducted a round of Alaska radio interviews Thursday urging listeners to prod their senators to back Graham-Cassidy, even though that state’s governor, a former Republican turned independen­t, opposes the bill.

Because of the friendship between McCain and Graham, many Republican­s had remained hopeful that the Arizona senator could be persuaded to support the new effort. Arizona Gov. Doug Ducey, a Republican, also threw his support behind the bill.

But the proposal has generated a storm of opposition in recent days from patient advocates, hospitals, physician groups and a growing number of healthcare experts.

Public opposition is also substantia­l, with a new ABC News/Washington Post poll showing that Americans by more than a 20-point margin prefer the existing law to the lastest GOP repeal bill.

Every significan­t independen­t analysis of the proposal has calculated that it would lead to huge cuts in federal healthcare aid, which, in turn, would probably erode health insurance coverage for tens of millions of Americans.

On Friday, the National Assn. of Medicaid Directors, who run state safety net programs that would see huge cuts under Graham-Cassidy, called on Congress to slow down and consider the bill more carefully.

“Any effort of this magnitude needs thorough discussion, examinatio­n and analysis, and should not be rushed through without proper deliberati­on,” the bipartisan group said.

The centerpiec­e of the latest GOP bill is a new system for distributi­ng hundreds of billions of dollars of federal money that would restructur­e how the government provides healthcare assistance to some 80 million Americans.

The bill would in effect end both the current Medicaid program, which covers poor Americans, and the system of insurance subsidies made available by the 2010 Affordable Care Act, known as Obamacare, to help low- and moderate-income consumers buy health plans. It would mark the biggest change in how the nation’s healthcare is financed in more than 50 years.

In place of these programs, the federal government would give states blocks of money to redesign their healthcare safety nets, while also capping future federal support for states.

Graham and Cassidy have said the expanded flexibilit­y would allow states to create better, cheaper programs. But there is much debate about that claim.

Passing the legislatio­n next week would require lawmakers to vote before the independen­t and nonpartisa­n Congressio­nal Budget Office has had a chance to analyze its impact, particular­ly on insurance coverage and premiums.

McCain called on his colleagues to return to the bipartisan process that had been underway in the Senate Health Committee to develop compromise measures to help stabilize insurance markets around the country.

Committee Chairman Lamar Alexander (RTenn.), who had been leading that effort, abruptly announced this week that he was stopping it, apparently in an effort to drive support for the Graham-Cassidy bill.

Democratic leaders echoed McCain’s call to reconvene bipartisan negotiatio­ns to improve the Affordable Care Act.

“John McCain shows the same courage in Congress that he showed when he was a naval aviator,” said Senate Minority Leader Charles E. Schumer (D-N.Y.). “I have assured Sen. McCain that as soon as repeal is off the table, we Democrats are intent on resuming the bipartisan process.”

 ?? J. Scott Applewhite Associated Press ?? SEN. JOHN McCAIN, center, is opposed to his party’s latest attempt to repeal the Affordable Care Act.
J. Scott Applewhite Associated Press SEN. JOHN McCAIN, center, is opposed to his party’s latest attempt to repeal the Affordable Care Act.

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