In the end, it took the return of senator recuperating from brain surgery and a tie-breaking vote by Vice President Pence to even proceed to debate Obamacare repeal. Which version or versions they were agreeing to vote on, nobody knew.
This was a fitting for a process that began when Mitch McConnell drafted the BCRA in secret, hiding its details from the public and the very senators who would be voting on it. That didn’t work out so well for him. So naturally, he’s doubling, tripling — or is it quadrupling by now? — the number of darts he’s throwing at Obamacare repeal in hopes that one of them will hit the mark.
The House’s AHCA? Or the BCRA again? What about the straight ACA repeal the Senate passed in 2015 when there was no chance it wouldn’t be vetoed by the president for which the Affordable Care Act was (originally derisively) nicknamed? Or, or, or, maybe “skinny repeal,” which would strip the ACA’s unpopular provisions, the individual insurance mandate, the requirements for employer coverage, as well as a tax on medical devices.
Oh, I know, how about all of the above?
The Senate parliamentarian didn’t exactly help when she ruled that the provisions defunding Planned Parenthood for a year and banning tax credits from insurance that covers abortions violate the Byrd rule. That’s the process McConnell is using to pass whatever bill he can make stick with a bare majority of fifty votes, plus the veep’s tie-breaking vote. Otherwise, he would need 60 votes to prevent a Democratic filibuster.
John McCain was recuperating at home from brain surgery that revealed he has an aggressive and usually fatal form of brain cancer, but ever the loyal Republican, he flew across the country to add his crucial vote.*
The parliamentarian also ruled that a provision prohibiting people who had gaps in their insurance coverage from enrolling for six months violated the Byrd rule. This was supposed to be the GOP alternative to Obamacare’s unpopular, but necessary, insurance coverage mandate. Without a stick to force people to maintain insurance coverage, healthy people would drop out until they faced a health emergency, leaving only the sick.
That’s why President Obama reversed course from his 2008 primary stance opposing Hillary Clinton’s inclusion of mandates in her version of healthcare reform. As usual, Hillary found that taking the responsible position got her nowhere. She knew that not requiring insurance would guarantee an insurance death spiral.
Indeed, that’s the insurance industry’s definition of the term. That would be the result if skinny repeal passes. McConnell is banking on conning moderates into voting on this version. I say con because the draconian Medicaid cuts they oppose could be sneaked into the final version negotiated wit the House.
The Donald is now trying to bully the Senate into passing…anything. Still, it’s unlikely that debate over the AHCA would ever proceed. Instead, there would be a vote to substitute the repeal and replace bill the Senate passed in 2015 when there was no danger it would survive then-President Obama’s veto pen.
And in the runup to today’s squeaker of a vote, Ol’ Mitch put on a full court press on GOP senators to at least vote on the motion to proceed.
Please, please, please! But you promised….
John McCain: Voting Yes and No on Obamacare Repeal
John McCain’s return from his post-surgery recovery added a particularly emotional tenor to the debate. Arizona is a Medicaid expansion state, and McCain has publicly stated that he’ll vote however his governor wants him to. Like most Republicans, Governor Ducey has stated in the past that he want to repeal Obamacare. But he’s also expressed concerns about the AHCA’s and the BCRA’s evisceration of Medicaid.
As Ducey said in a radio interview:
I am talking with Sens. Flake and McCain and I’m telling them what my opinion is, and I’m letting them know that I don’t want to see any Arizonan have the rug pulled out from underneath them.
It was therefore not surprising that the visibly scarred McCain took to the Senate floor after the vote to declare that — though he voted to proceed to debate — he vowed to vote against the BCRA without a number of changes requested by Ducey.
Yet McCain didn’t end there, he made an impassioned paean to bipartisanship and the longstanding deliberative traditions of the Senate. While he took pains to upbraid the Democrats for passing Obamacare on a strictly party-line vote, he also dinged the Republicans for doing the same. (I would argue it was more so on the GOP side, since there were months of committee meetings and debate over the drafting of the ACA. McConnell himself quashed the bipartisan negotiations of the Gang of Six.)
McCain predicted that McConnell would lose his “vote-a-rama” and called on the Senate to go back to the drawing board with bipartisan negotiations. Well, he at least managed to draw one bit of bipartisanship, receiving a standing-O from both sides of the aisle.
Let’s hope the senior senator from Arizona is right. So far, so good. Straight repeal and the BCRA have already gone down to defeat. Yet, if any of Mitch McConnell’s darts hits a bullseye in the next couple of days, it would deny millions the very healthcare John McCain is counting on to save his life.
*It seems McCain’s unsteady questioning of James Comey wasn’t a retreat from his steady drumbeat of stark warnings about Russia’s interference with the 2016 election. The tumor was discovered in his frontal lobes, which control, among many other things, reasoning abilities.
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