A dramatic vote last night ended with another significant setback for Republican hopes to repeal and replace the Affordable Care Act (ACA) as Sen. John McCain (R-AZ) cast the deciding vote against a “skinny” version of ACA repeal in a 49-51 defeat. Sen. McCain joined two other Republicans — Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK), who had also voted against a motion to proceed to the underlying legislation earlier this week — and all 48 Democrats in opposing the skinny repeal amendment that represented the best chance for a bill to make it past the Senate floor in this week’s process. Specifically, the amendment would have replaced the House-passed repeal bill, known as the American Health Care Act (AHCA), with a more limited version designed as a “least common denominator” between Republican conservatives and moderates. A timeline of developments from overnight, including analysis of the skinny proposal and the political dynamics preceding the remarkable final vote, are provided in the attached email.
As in other previous Republican defeats on health care, some observers and lawmakers are suggesting that this could be a fatal blow to Republican efforts to repeal the ACA. It appears certain that Senate Republicans don’t have the 50 votes necessary to pass the underlying health care legislation they’ve been debating all week, and it is hard to envision the potential changes that would move one of the three Republican defectors to a “yes” vote. Nevertheless, the Republican political capital already invested in the repeal effort and the instability of insurance markets likely mean that the issue is far from settled. Republican leadership has yet to signal what comes next, and the impending August recess may provide time for the majority party to reset ahead of a busy fall.
The Senate still plans to take advantage of its extra two weeks in session during August, with a vote scheduled on Monday to invoke cloture on the nomination of Kevin Newsom to be a judge for the Eleventh Circuit Court of Appeals. Further confirmations and legislative work on less contentious issues, such as the fiscal 2018 National Defense Authorization Act (NDAA), are expected to consume the remainder of the Senate’s time before they leave for a shortened summer break on Aug. 11.
With the health care effort stalled, the House is officially out for the August recess. Lawmakers in the lower chamber are scheduled to return after Labor Day on Sep. 5.