Healthcare

The Nightmare is Over, At Least for a While

Written by SK Ashby

The Senate GOP's so-called "skinny repeal" bill failed late last night at approximately 1:30 a.m. eastern time, and the "skinny" bill fattened up considerably just before the vote.

From Reuters:

Three Republican senators - John McCain, Susan Collins and Lisa Murkowski - joined Senate Democrats in the dramatic early-morning 51-49 vote rejecting the bill. The outcome may spell doom for the party's seven-year quest to gut a 2010 law that was Democratic former President Barack Obama's signature domestic policy achievement. [...]

"It's time to move on," McConnell, whose reputation as a master strategist was in tatters, said on the Senate floor after the vote that unfolded at roughly 1:30 a.m.

"The American people are going to regret that we couldn't find a better way forward," McConnell added.

When the name "skinny repeal" first started floating around the halls of Congress, we were told the bill would repeal the individual and employer mandates and the medical device tax included in Obamacare, but the final version that was defeated on the floor of the Senate last night did far more than that.

The final not-so-skinny repeal bill also included provisions to defund Planned Parenthood and waive regulations requiring insurance plans to provide essential health benefits. The final version had all the markings of a bill that probably would have been acceptable to House Republicans and, if it had passed through the Senate last night, I have little doubt that House Republicans would vote on it today.

John McCain voted against the bill at the last possible second because Speaker Paul Ryan did not promise that the House would not vote for it. McCain reportedly met Ryan in person last night seeking his assurances, but he clearly wasn't assured.

Trump spent the morning tweeting that Senate Republicans should ditch the 60 vote threshold for filibusters and move to simple majority rule, but that's exactly what Republicans did in this case. They used the reconciliation process to advance a bill that cannot be filibustered, but they could not muster 50 votes for it or anything resembling it. They could not find 50 votes for "repeal and replace," they could not find 50 votes for "repeal and delay," and they could not find 50 votes for "skinny repeal." Their "repeal and replace" plan, otherwise known as the Better Care Reconciliation Act (BCRA), actually received the least amount of support of all their bills, revealing that there is a greater appetite for simply repealing Obamacare than actually replacing it.

Senate Majority Leader Mitch McConnell could kill the filibuster moving forward for other legislation, but that may not necessarily deliver the results they expect. As we've seen, the political calculus is different for some members of Congress when they may be asked to cast the deciding vote. It's easier to vote for controversial legislation when you know it isn't going to become law and Republicans in Congress no longer have President Obama around to save them from themselves with a veto.

With all of that said, we know some members of Congress are not going to give up their quest to kill Obamacare this easily.

The budget proposal for fiscal 2018 released by House Republicans earlier this month calls for defunding Obamacare and the House Freedom Caucus will almost certainly insist on inserting similar provisions into virtually every major piece of legislation from now until the end of time. They will never stop, but they can be defeated.