John McCain Saves Obamacare Once Again

The Arizona Republican announced his opposition to the latest GOP repeal plan, all but certainly giving its critics the votes to block it.

Jacquelyn Martin / AP

Updated on September 22 at 3:28 p.m. ET

For the second time this year, Senator John McCain appears to have preserved the signature domestic achievement of the man who once kept him from the presidency.

The Arizona Republican on Friday announced that he could not “in good conscience” support the latest GOP proposal to substantially repeal the Affordable Care Act, all but certainly dooming the effort. McCain became the third Senate Republican to oppose the legislation offered by Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, which was headed for a floor vote next week. Republicans could only afford to lose two of their 52 members and have Vice President Mike Pence cast a tie-breaking vote to pass the bill.

Senator Rand Paul of Kentucky has been denouncing the proposal as “Obamacare lite” and “fake repeal” for a week, drawing the ire of President Trump and other supporters of the bill. Senator Susan Collins of Maine has voted against each of the GOP repeal plans, and she strongly suggested she would oppose this one. Republicans were up against a September 30 deadline for using a budget process that would circumvent a Democratic filibuster and allow them to pass health-care legislation with only 51 votes.

McCain torpedoed the last GOP bill in July, returning to the Senate after being diagnosed with brain cancer only to cast a surprising and dramatic 50th vote against a limited-repeal of Obamacare offered by Majority Leader Mitch McConnell. But until Friday afternoon, he was officially undecided on the Graham-Cassidy proposal, apparently torn between his disgust for the party’s rushed, partisan legislative process and his famously close friendship with Graham, its most vocal salesman.

“I would consider supporting legislation similar to that offered by my friends Senators Graham and Cassidy were it the product of extensive hearings, debate, and amendment,” McCain said in a lengthy written statement. “But that has not been the case. Instead, the specter of September 30th budget reconciliation deadline has hung over this entire process.”

He continued:

We should not be content to pass health-care legislation on a party-line basis, as Democrats did when they rammed Obamacare through Congress in 2009. If we do so, our success could be as short-lived as theirs when the political winds shift, as they regularly do. The issue is too important, and too many lives are at risk, for us to leave the American people guessing from one election to the next whether and how they will acquire health insurance. A bill of this impact requires a bipartisan approach.

I cannot in good conscience vote for the Graham-Cassidy proposal. I believe we could do better working together, Republicans and Democrats, and have not yet really tried. Nor could I support it without knowing how much it will cost, how it will effect insurance premiums, and how many people will be helped or hurt by it. Without a full CBO score, which won’t be available by the end of the month, we won’t have reliable answers to any of those questions.

McCain acknowledged that his friendship with Graham put him in a difficult spot. “I take no pleasure in announcing my opposition. Far from it,” he said. “The bill’s authors are my dear friends, and I think the world of them. I know they are acting consistently with their beliefs and sense of what is best for the country. So am I.”

The Graham-Cassidy bill had gained momentum rapidly after its authors introduced it last week, as Republican leaders seized on one final chance to keep the repeal-and-replace promise they had been making to conservative voters for seven years. The legislation was in some ways more modest than previous Obamacare repeal proposals, as it kept most of the tax increases Democrats used to pay for the 2010 law and converted the revenue into block grants for the states. But it went further in other respects by allowing states broad latitude to opt out of the laws core consumer protections, such as requiring insurers to cover “essential health benefits” and forbidding them from charging higher rates to people with preexisting conditions.

Most Republican senators backed the bill’s “federalist” approach even as they acknowledged they did not have time to fully scrutinize its potential effects. The Congressional Budget Office said it would not be able to fully evaluate the proposal for weeks, but with the September 30 deadline looming, McConnell announced his intention to bring the bill up for a vote anyway.

Democrats kicked their opposition campaign back into overdrive, aided by the late-night broadsides Jimmy Kimmel delivered against Cassidy, the first-term Louisianan who had earlier promised not to back legislation that would roll back protections for people with preexisting conditions. Their targets were McCain and Senator Lisa Murkowski of Alaska, who had opposed the legislation in July but remained undecided on Graham-Cassidy.

Hoping to pressure Republican senators, McConnell and House Speaker Paul Ryan leaned on Senator Lamar Alexander of Tennessee to pull out of bipartisan negotiations on a narrower Obamacare fix that he was holding as chairman of the Health, Education, Labor, and Pensions Committee. But that move appears to have backfired: In his statement, McCain urged Alexander to continue seeking a bipartisan solution with Senator Patty Murray of Washington state, the top Democrat on the committee.

Democrats reacted to McCain’s announcement with the same mix of relief and praise as they did after his surprising thumbs-down in July. The word “hero” lit up Twitter timelines, as Obamacare supporters likened McCain’s decision to his years as a prisoner of war in Vietnam.

On Capitol Hill, Democrats quickly called for a return to bipartisan negotiations to shore up the law’s shaky individual-market insurance exchanges. “John McCain shows the same courage in Congress that he showed when he was a naval aviator,” said the Senate minority leader, Charles Schumer. “I have assured Senator McCain that as soon as repeal is off the table, we Democrats are intent on resuming the bipartisan process.”

But it was unclear what Republicans intended to do. There was no immediate word from McConnell on whether he would still bring up Graham-Cassidy for a vote next week that now is likely to fail. Meanwhile, Graham issued a statement saying that while he disagreed with McCain’s position, “My friendship with [McCain] is not based on how he votes but respect for how he’s lived his life and the person he is.” As for his bill, Graham said, “We press on.” But he did not lay out a path forward, either for the legislation he offered or for the GOP’s broader goal of repealing Obamacare—both of which appear, again, to be out of reach.