The Senate effort to repeal and replace the Affordable Care Act stalled out Monday night as two additional Republican senators – Jerry Moran and Mike Lee – announced they would vote against even debating the bill being pushed by Majority Leader Mitch McConnell.
McConnell conceded the bill was dead late Monday, saying in a statement he would change tactics, moving to open debate on a repeal bill without a replacement plan. (Trump tweeted his support for that course of action Monday night – only to tweet Tuesday morning that the ACA should be allowed to “fail” on its own, perhaps unaware that doing so would mean leaving the legislation in place.)
“I regret that the effort to repeal and immediately replace the failures of Obamacare will not be successful. That doesn’t mean we should give up,” McConnell said on the Senate floor Tuesday morning. “We will now try a different way to bring the American people relief from Obamacare.”
It was a short-lived plan. By early afternoon, three Republican senators – Susan Collins, Shelley Moore Capito and Lisa Murkowski – had announced they would vote against even opening debate on a bill to repeal the ACA without creating a replacement.
Senators had been signaling their discomfort with the idea all morning. “I’ll have to look and see what the so-called repeal bill entails, but if it is a bill that simply repeals, I believe that will add to more uncertainty, and the potential for Ohioans to pay even higher premiums, higher deductibles,” Sen. Rob Portman told reporters. “So we’ll have to see. Obviously, we would look for a CBO analysis of that to see what it involves in terms of not just premiums and deductibles, but also coverage. I’ll take a look at it.”
In fact, Portman already reviewed the CBO score back in 2015, when he voted in favor of an Obamacare repeal-only bill. McConnell had hoped this week to introduce this same piece of legislation, which the Republican majority passed at the time, but which was vetoed by President Obama.
Back in 2015, the CBO said that under the repeal-only bill, 22 million people would lose health insurance within two years. When the office revisited the plan this January – Republican senators had briefly considered reviving it this winter – it revised its estimate upwards, saying as many as 32 million Americans would lose insurance by 2026. That’s 10 million more than would have lost coverage under the Better Care Reconciliation Act (the Senate bill that died Monday night), with more than half of those unlucky individuals, 18 million, losing coverage within the first year.
Under the repeal bill, people who could still afford to purchase insurance in the market would have seen their premiums skyrocket: The CBO estimated costs would increase by 20 to 25 percent in the first year, and double by 2026.
“Repeal and replace” has been a GOP rallying cry since 2010, and one that delivered the party scores of seats in the House and Senate and, ultimately, the White House. It’s easier to agree on a catchphrase than policy, though, and the closer Republicans got to actually being able to repeal the bill, the more Americans learned about the consequences of doing so, and the less they liked the idea.
In fact, the day Donald Trump was sworn in was the first day ever that more Americans approved of the Affordable Care Act than disapproved of it. Approval for Obamacare only grew as Republicans in the House fumbled their first effort at a replacement plan and jammed through a second. Today, disapproval for the ACA is near an all-time low.
Even so, it’s unclear whether Republicans are ready to abandon the effort once and for all. As Trump himself reportedly said to a group of senators dining at the White House Monday night, “If the Republicans have the House, Senate and the presidency and they can’t pass this health care bill, they are going to look weak. … How can we not do this after promising it for years?” (By Tuesday afternoon, he’d changed his tune, declaring to reporters that that ACA would fail, adding “I’m not gonna own it.”)
As ill-conceived as McConnell’s plan appears to have been, it’s striking how quickly Republicans abandoned the majority leader. Only one Republican senator, Susan Collins, voted against the repeal-only bill back in 2015. Like Portman, both Capito and Murkowski voted in favor of the bill when there was no danger it would actually become law.