After midnight on the East Coast, Republicans in the Senate continued to struggle to put together a vote in favor of so-called “skinny repeal,” a bill promising light changes to Obamacare. Philip Klein at the Washington Examiner has a good breakdown:
The only thing that's repealed are the penalties for the individual mandate (the mandate itself could not be repealed due to the restrictions imposed by the reconciliation process). Though news reports had suggested that they would also be repealing the employer mandate and the medical device tax, in reality, the tax would only be suspended for three years, and the employer mandate penalties would go to zero at first, but would come back in 2025… Taken together, as conservative health policy analyst Chris Jacobs has illustrated, the bill would keep 411 of Obamacare's 419 sections of legislative text intact.
Senate Republicans were being urged to vote for the bill, even though it would essentially exacerbate the individual market death spiral, necessitating a bailout in the near future. That’s because Senate Majority Leader Mitch McConnell (R-KY) attempted to get a promise from Speaker of the House Paul Ryan to completely re-do the “skinny repeal” and the House’s Better Care Reconciliation Act in conference committee, creating a new bill. Ryan, however, didn’t make a clear promise not to simply pass the “skinny repeal” and call it a day.
As the conference continued deep into the night, Senator John McCain (R-AZ) gradually moved into Democratic camp, hanging out with Senators Chuck Schumer (D-NY) and Diane Feinstein (D-CA). And indeed, along with Senators Susan Collins (R-ME) and Lisa Murkowski (D-AK), McCain voted no.
This is a major defeat for Senate Majority Leader Mitch McConnell (R-KY), who after 7 years of promises wasn’t even able to get small changes to Obamacare past his caucus. It’s also a major defeat for President Trump, who wanted a major bill he could call his own, especially given the similarly uphill battle of crafting and passing a tax reform bill.
On the other hand, it also means that Republicans won’t pass an unworkable bill in the dead of night, call it a repeal, and then own the fallout – a fallout which would likely necessitate massive bailouts to insurance companies, given the reality of the pusillanimous moderate Senate Republicans. And this won’t be the last attempt to repeal Obamacare; as things get worse, calls for a Republican fix will grow louder.
Democrats are celebrating this evening because Obamacare has been preserved intact. But they won’t be celebrating for long as the death spiral continues and prices continue to rise. The only question is whether the public will hang Obamacare’s failures on its creators or on the Republicans who were unable to change it with a majority in both houses as well as the presidency come 2018.