WASHINGTON (AP) — Facing assured defeat, Republican leaders decided Sept. 26 not to even hold a vote on the GOP’s latest attempt to repeal the Affordable Care Act, surrendering on their last-gasp effort to deliver on the party’s banner campaign promise.
“The bill is dead as a door nail,” said Sen. John Kennedy, R-La., leaving a luncheon where GOP senators decided against holding a futile roll call.
The decision marked the latest stinging rejection on the issue for President Donald Trump and Senate Majority Leader Mitch McConnell. In July, the Republican-controlled Senate rejected three similar GOP measures. The latest was proposed by Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., late last week.
McConnell, R-Ky., and other Republicans characterized the decision as a short-term setback. They needed to vote on the measure this week because procedural protections against a bill-killing Democratic filibuster expire Sept. 30, though they could revisit the issue in future months.
“We haven’t given up on changing the American health care system,” McConnell told reporters. “We aren’t going to be able to do it this week.”
Alaska U.S. Sen. Lisa Murkowski, who was one of three Republicans who voted against three other repeal measures that failed in July, did not reveal a definitive opinion on the bill but said that while changes in the law are needed, “substance matters.”
Alaska has extremely high health care costs, in part because of its many remote communities.
“I appreciate the efforts of my colleagues, Sen. Graham and Sen. Cassidy, but they have run up against a hard deadline and a lousy process,” Murkowski said in a news release. “Time has not been on their side. The U.S. Senate cannot get the text of a bill on a Sunday night, then proceed to a vote just days later, with only one hearing — and especially not on an issue that is intensely personal to all of us.”
Numbers matter for a state that suffers the highest healthcare costs and lowest population density, Murkowski said.
But she hasn’t given up search for solid answers to problems weighing down the ACA. With the help of fellow Alaska Sen. Dan Sullivan, she feels good headway was made educating colleagues in Washington, D.C., through committee work and testimony from Alaska Insurance Division Director Lori Wing-Heier Sept. 6 before the Senate’s Health, Education, Labor and Pensions Committee.
Sullivan said he was disappointed that Congress hasn’t been able to replace the ACA with a system that works for Alaska.
He liked provisions in the Graham-Cassidy bill that would have sent federal healthcare dollars and decision-making back to the states to decide how to meet the needs of their constituents.
“The Graham-Cassidy bill, which I’m convinced would have brought more funds and more flexibility to Alaska, was compelling,” Sullivan said. “Unfortunately, the process was rushed and we ran out of time to fully vet the data.”
Alaska’s Gov. Bill Walker, who joined nine other governors in opposing the Graham-Cassidy bill last week, also weighed in his hope that revisions to the ACA don’t end with the latest bill’s demise. He intends to convene with other state governors to work on a bipartisan option. He sent a team to Washington, D.C., this week to meet with administration officials.
“As governor of Alaska, the state with the highest health care costs in the country, I have been working with members of the Trump Administration, our congressional delegation, and other governors to ensure that any health care bill is not only good policy, but also protects Alaskans,” Walker said Sept. 26. He appreciated that the Trump Administration made several proposals that considered Alaska’s needs.
“These concepts are sound policy for all high-cost, low-population states and we hope these concepts will be incorporated in future health care discussions,” Walker said.
McConnell made it clear that it was time for Republicans to turn away from trying to repeal President Barack Obama’s health care. They’ve been promising to erase that law since its 2010 enactment but have never rallied behind a plan to replace it.
“Where we go from here is tax reform,” he said, citing the next big GOP goal.
Rejection became all but inevitable Monday after Maine GOP Sen. Susan Collins announced she opposed the legislation. She joined Republican Sens. John McCain of Arizona, Rand Paul of Kentucky and Texas’ Ted Cruz who’d already said they opposed the measure. Cruz aides said he was seeking changes that would let him vote yes.
Because of their narrow majority and unified Democratic opposition, Republicans could lose just two GOP votes and still push the legislation through the Senate.
The retreat left the GOP’s next steps on health care unclear, especially with a president who in recent weeks has reached out to congressional Democratic leaders on high-agenda items like the budget and immigration.
Trump said in a meeting Sept. 26 with Republican and Democratic House members that he would work with Democrats on health care if the Republicans “didn’t get repeal done,” according to Rep. Richard Neal, R-Mass. Neal quoted Trump as saying, “You get a better deal if it’s bipartisan.”
It was unclear what compromise Trump could strike with Democrats between his stated desire to uproot the health care statute and Democrats defending what was perhaps Obama’s proudest domestic achievement.
Democrats rejoiced over the GOP’s retreat.
“Today, Americans breathe a sigh of relief because the health care of millions has been protected and preserved,” said Senate Minority Leader Chuck Schumer, D-N.Y.
He and other Democrats called on Republicans to join a bipartisan effort aimed at buttressing Obama’s law and stabilizing individual health care markets.
Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., have been working on a bipartisan bill that would continue federal subsidies to insurers for reducing costs for lower-earning consumers. Trump has threatened to block those payments.
In choosing whether to hold the roll call, McConnell faced some Republicans arguing that lawmakers can’t be seen as abandoning a pledge that Trump and countless GOP have run on. Others challenged the value of shining a fresh spotlight on their inability to pass the bill.
“Putting it out on the floor and forcing a lot of people to make a vote that maybe they don’t want to make isn’t the best, in my view, long term pathway to success,” No. 3 Senate Republican leader John Thune of South Dakota said before the decision was announced.
The abandoned bill would transform much of the ACA, or “Obamacare,” spending into $1.2 trillion worth of grants through 2026 that states could spend on health programs with few constraints. It would also give states far more power — without federal approval — to loosen strings on insurers, letting them charge seriously ill people higher premiums and sell low-cost, low-coverage policies.
It was sponsored by Graham and Cassidy.
The nonpartisan Congressional Budget Office said “millions” of Americans would lose coverage under the bill and projected it would impose $1 trillion in Medicaid cuts through 2026.
GOP leaders revised the measure several times, adding money late Sept. 24 for Alaska, Arizona, Maine, Kentucky and Texas in a clear pitch for Republican holdouts.
Earlier Sept. 26, Trump lashed out at GOP lawmakers for deserting the measure, telling reporters, “We are disappointed in certain so-called Republicans.”
Associated Press congressional correspondent Erica Werner and writers Ken Thomas and Marcy Gordon contributed to this report. Comments from Alaska elected officials were added by Journal reporter Naomi Klouda.