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Thursday, July 27, 2017

McConnell's 'skinny repeal' bill is defeated, with John McCain casting the key vote

As Sen. Mitch McConnell watched, Sen. John McCain turned thumbs down and voted "no" on the bill.
UPDATE, 1:30 a.m. July 28: Three Republicans voted against the bill: Lisa Murkowski of Alaska, John McCain of Arizona and Susan Collins of Maine. The bill's 51-49 defeat pulled the plug, for now, on Republican efforts to repeal and replace President Obama's signature law.

Collins had long opposed McConnell's bills. Murkowski feared the effects they would have in her state, and like Collins she voted against the motion to start debate earlier in the week. But it was McCain who cast the most important vote, because if he had voted yes, Vice President Mike Pence would have broken the tie (as he did on the start-debate motion) and sent the bill to the House. UPDATE: In statements Friday, McCain said the bill didn't lower costs or improve care and called the chamber's inability to craft wide-ranging legislation "inexcusable," The Associated Press reports. "He said Democrats and Republicans should write a bill together," in contrast to its passage in 2010 and its attempted repeal.

"This is clearly a disappointing moment," McConnell said in a speech after the vote. He said most Republicans "kept our commitments. We worked really hard . . . trying to achieve a consensus and go forward. . . . I regret that our efforts were simply not enough, this time." He challenged Democrats to offer alternatives, but said "Bailing out insurance companies without any thought of reform is not something I want to be part of." For McConnell's full speech, click here.

Democratic Leader Chuck Schumer of New York pointed to the speech McCain had made upon his return to the Senate to vote to start debate, calling for "regular order" and a bipartisan solution. UPDATE: Friday morning, Schumer said Republicans shouldn't blame McConnell for their failure to pass a repeal bill, because they are so divided on the issue.

Senate Majority Leader Mitch McConnell introduced what has been generally dubbed his “skinny repeal” of the Patient Protection and Affordable Care Act late Thursday, "setting up a cliffhanger vote slated for midnight," The Washington Post reports.

McConnell's bill would repeal the law requiring almost all Americans to have health coverage or pay a tax penalty, "and suspend for eight years the mandate that firms employing 50 or more workers provide insurance," the Post reports.

It would "eliminate funds for preventive health care provided under the 2010 law and prohibit Medicaid beneficiaries from being reimbursed for Planned Parenthood services for one year," the Post reports. "Instead, the bill dictates the federal funding that would have gone to Planned Parenthood would go to community health centers. It would end a 2.3 percent tax on medical device manufacturers for three years."

Perhaps significantly for Kentucky, the bill would give states more flexibility in running Medicaid, the program that covers almost a million and a half Kentuckians, about 470,000 of them under then-Gov. Steve Beshear's 2014 expansion of the program.

McConnell is touting the bill as the only way to continue the process of repealing and replacing the ACA, by getting the bill to the House, which passed its own bill in May. The House could pass the bill and send it to President Trump; it could pass another version, which is unlikely; or it could reject the Senate bill, prompting a House-Senate conference committee that could write a whole new bill that would not be subject to amendment in either chamber.

Several Republican senators sought assurances that passing McConnell's bill would lead to a conference. House Speaker Paul Ryan gave no guarantees but said that was his hope.

After introducing his legislation, McConnell gave this speech:

“The legislation I just laid down is called the Health Care Freedom Act, and it restores freedom to Americans that Obamacare took away. It does so in a number of ways.

“First, the Health Care Freedom Act repeals the core pillars of Obamacare. It eliminates the so-called individual mandate that forces many Americans to buy Obamacare insurance they don’t want, can’t afford, or can’t use — and taxes those who don’t. It also repeals the employer mandate that cuts hours, take-home pay, and job opportunities for workers.

“Second, the Health Care Freedom Act provides significant new flexibility to states. The Health Care Freedom Act gives states just the kind of flexibility they need to implement reforms that provide more options for consumers to buy the health insurance they want. These reforms also help make insurance more affordable and flexible, so it’s something Americans actually want to buy.

“Finally, the Health Care Freedom Act frees Americans from Obamacare in several other ways too. It provides three years of relief from the medical device tax that increases costs, hurts innovation, and has drawn significant criticism from both sides of the aisle. It expands for three years the contribution limits to health-savings accounts so Americans can better manage their health costs and pay down more of their medical expenses, like prescriptions, with pre-tax dollars.

“This legislation will also prioritize funding for women’s health through community health centers instead of large abortion providers and political organizations.

“The American people have suffered under Obamacare for too long. It’s time to end the failed status quo. It’s time to send legislation to the president that will finally move our country beyond the failures of Obamacare. Passing this legislation will allow us to work with our colleagues in the House toward a final bill that can go to the president, repeal Obamacare, and undo its damage. I urge everyone to support it.”

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