But both Murkowski and McCain remained publicly undecided on the Graham-Cassidy legislation, and without both of their votes, Republicans are short of the 50 they need for passage before a September 30 procedural deadline. Senator Rand Paul of Kentucky plans to vote against the bill, and Senator Susan Collins has strongly suggested she would as well. (Collins has opposed each of the GOP repeal proposals.) One more “no” vote would kill the bill, along with the GOP’s hopes of scrapping Obamacare without help from Democrats.
In another sign of the party’s ongoing struggle, Senate Majority Leader Mitch McConnell would not commit to holding a vote on the Graham-Cassidy bill after a party meeting in which Vice President Mike Pence sought to rally Republicans behind repeal. “If we were going to go forward, we would have to act before September 30,” McConnell said, referring to the deadline for the Senate to pass a health-care vote on a simple majority vote rather than a filibuster-proof threshold of 60 votes.
McCain and Murkowski are not the only Republican senators who have withheld their support for the Graham-Cassidy bill, but they are the two that supporters of Obamacare are pinning their hopes on to stop it. Other undecided GOP senators, such as Shelley Moore Capito of West Virginia and Ted Cruz of Texas, have come around to support earlier proposals. But both McCain and Murkowski have been deeply critical of the party’s partisan approach to repeal, and each of their states stands to lose out under a proposal that would shift federal money from states that expanded Medicaid—like Arizona and Alaska—to those that did not.
McCain has called for the Senate to pursue “regular order,” the process by which a bill goes first through committee and is subject to amendment before a final vote. In a bid to satisfy his concern, Chairman Orrin Hatch of Utah announced that he would hold a hearing on the Graham-Cassidy bill next Monday. That would be the first GOP repeal bill to receive a Senate hearing, but it would come just days before a vote, and Democrats decried it as “a sham.” McCain reportedly would not say whether that was sufficient for him and questioned whether a single hearing constituted regular order. Adding to the procedural hurry, Republicans have already learned that they won’t receive a complete assessment from the Congressional Budget Office on the bill’s projected impact in time for a vote next week.
McCain is also under intense pressure to stand with Graham, his best friend in the Senate, who has cast his proposal as a choice between the “federalism” of a state block grant and the “socialism” represented by the Medicare-for-All plan unveiled last week by Senator Bernie Sanders of Vermont. Appearing alongside McConnell on Tuesday, Graham told reporters that Speaker Paul Ryan assured him that the House would quickly approve the Senate bill next week if it made it across the Capitol. “Paul Ryan told me to my face, ‘If you pass it, we pass it,’” Graham said. Confident predictions of passage by House leaders have not always been reliable, however, and Republicans from New York who voted for the American Health Care Act in May have already begun raising concerns about the Graham-Cassidy proposal, which would cost the state billions in federal funding.