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Health Reform Efforts Stymied as Senators Defect

Drew Thies

Several Republican senators announced this week they do not support the party’s current plan to repeal and replace the Affordable Care Act, postponing indefinitely the effort that has consumed Congressional Republicans this year.

Senate Majority Leader Mitch McConnell (R-KY) operated with zero margin for error. He needed 50 of 52 Senate Republicans to vote for the legislation and Senators Susan Collins (R-Maine) and Rand Paul (R-KY) already announced they were not supportive of the legislation.

McConnell, who planned to hold a vote this week, was forced to delay, as Sen. John McCain (R-AZ) had an operation on Saturday, and needed to stay in Arizona to recover. Absent McCain’s vote, the bill would not be able to pass.

Senators Jerry Moran (R-KS) and Mike Lee (R-UT) declared late Monday night that they would not support a procedural measure to bring the Better Care Reconciliation Act (BCRA) to the Senate floor for a vote. Both Moran and Lee issued statements critical of the drafting process, and called for a more open, collaborative repeal and replace effort.

With four solid “no” votes against the bill, McConnell announced “the effort to repeal and immediately replace the failure of Obamacare will not be successful.” He said the next step for the Senate would be to vote to simply repeal the Affordable Care Act, and include a two-year delay for lawmakers to come up with a replacement plan. Similar legislation passed both chambers on reconciliation instructions in 2015, but was vetoed by then-President Obama.

This plan, however, faces an uphill battle. Tuesday morning, Senators Shelley Moore-Capito (R-WV), Lisa Murkowsi (R-AK.), and Susan Collins all announced they will not vote for a procedural motion to bring a simple repeal bill to the floor of the Senate for a vote. Senator Rob Portman (R-OH) also gave indications he will not support such a measure.

McConnell said Tuesday evening that he will hold a vote to proceed to the legislation “early next week;” a vote that will fail unless the opposed Senators change their position. President Trump is meeting with all Republican Senators today and McConnell said the call for a vote was “at the request of the President and Vice President.”

Regardless of the outcome of the vote to repeal the Affordable Care Act, Medicaid cuts to aged and disabled population in the form of per-capita caps are off the table in the Senate for now.

Some Senators said they will begin bipartisan efforts to fix parts of the Affordable Care Act that are not working. Senators Joe Manchin (D-WV) and Mike Rounds (R-SD) announced they are beginning a group of former governors who are now in the Senate to look for pragmatic solutions. AHCA continues to monitor health care reform efforts as they move forward.

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