Updated July 28, at 9:30 a.m.:
The Senate rejected a "skinny repeal" of the Affordable Care Act, a partial repeal that was debated in the middle of the night between July 27 and 28.
According to CNN, Sens. Lisa Murkowski, Susan Collins and John McCain opposed the bill that would have resulted in 16 million people losing their health insurance by 2026. The bill was considered the minimum repeal option that Republicans could agree on, according to the BBC. McCain's opposition came as a surprise to many, particularly after he voted in favor of allowing discussion on a repeal and replace package.
After yet another blow to the Republican effort to repeal the Affordable Care Act in favor of a GOP-approved option, President Trump tweeted his disappointment.
"3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let ObamaCare implode, then deal. Watch!" he wrote.
Previously...
The Senate voted to reject a repeal of the Affordable Care Act without a replacement plan on Wednesday, July 26. According to the New York Times, senators will spend the rest of the week debating three possible amendments: Repeal and replace, partial repeal, and what has been called 'skinny’ repeal.
A day prior, the Senate voted twice: first, to begin discussing a bill that would repeal major components of the Affordable Care Act, which resulted in a 50–50 tie broken by Vice President Mike Pence, who voted to allow the debate. Later, a vote to repeal and replace with a replacement plan was rejected, with 43 votes for the bill and 57 against.
Despite having announced a brain cancer diagnosis just days earlier, Republican Senator John McCain traveled from Arizona to Washington, D.C., to cast his vote in favor of advancing first vote to allow the discussion.
Senator McCain lamented the dubious process his colleagues employed to get their legislation to the brink of a vote, saying from the Senate floor, "We’ve tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them it’s better than nothing, asking us to swallow our doubts and force it past a unified opposition. I don’t think that is going to work in the end.... Why don’t we try the old way of legislating in the Senate, the way our rules and customs encourage us to act?”
Many, however, were quick to point out the hypocrisy of Senator McCain's speech, considering that he voted to proceed with debates.
Prior to that, Republicans had worked to pass a revised health care bill in private despite major concern from the public, in yet another failed attempt. One of the main causes, besides the daunting prospect of over 22 million people going uninsured under the first proposed bill, was the GOP’s opaque legislative process.
On June 22, legislators unveiled a new Senate health care bill, again written in secret, featuring key differences with the one originally passed by the House, CNN reported. According to CNN, the Senate bill would continue the Medicaid expansion funding put in place by the Affordable Care Act through 2021, then phase it out over the course of three years. While the phasing out is more gradual than the House bill, The Washington Post reported that the cuts to the health care program for low-income people would be larger. As for the House bill, Planned Parenthood would be subjected to severe cuts in federal funding for one year, with future cuts imminent if the health care provider elects to continue performing abortions, according to The Washington Post.
After failing to get the June 22 legislation off the ground, Senate Republicans revealed a new draft of their health care plan on July 13 with hopes of voting on the new bill the following week.
The New York Times reported that this version of the Senate bill aimed to prevent rising premiums, which means that health care costs wouldn't increase as much as they may have under previous drafts. Those with high incomes would still be taxed, a point Republicans had planned to eliminate. The bill would reportedly provide an additional $70 billion in funds to offset rising premiums and out-of-pocket costs in an effort to reduce the overall cost of health care, but keeps changes to Medicaid that would make funding to states a series of fixed payments, rather than an open-ended entitlement.
The New York Times added that the Senate bill would hand broad tax cuts to the wealthy, as it eliminates taxes imposed under the Affordable Care Act meant to help pay for other parts of the health bill. The Senate bill could also to allow states to drop benefits, including maternity care and mental health services.
This version of the legislation did not pass on July 16, so Republican senators began working on compromises to get Obamacare repealed instead. The group met with Health and Human Services secretary Tom Price on July 19 to collaborate on efforts to undo the health care legislation. Senators who opposed the legislation, such as Susan Collins and Rand Paul, were not invited to the emergency meetings. According to a report from the Congressional Budget Office, a repeal of the Affordable Care Act would result in 32 million people losing health care coverage and an increase in premiums for seniors.
On the same day as the emergency meetings, at least 155 protestors were arrested at numerous Senate office buildings in Washington while working to pressure elected officials to vote against their proposed repeal and replace of the Affordable Care Act. Citizens from across the United States, including red states such as Arkansas, converged on the capital to share their stories about health care coverage and their opinions regarding the necessity of a functional health care system.
After Republican lawmakers’ latest failed attempt to radically restructure the American health care system, President Trump issued an early morning tweet on July 24 demanding that members of his party find a way to repeal and replace Obamacare before their August recess.
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Two possible routes Senate Republicans weighed included legislation that would repeal and replace Obama's signature domestic legislative achievement (with what remains unclear), and another bill that would only repeal Obamacare, leaving a two-year lag for Congress to decide how to replace the health care bill. For either of the potential bills to pass, Republican lawmakers must hold their 52-48 majority in the Senate—a prospect made ever more dubious by the fact that at least two Republican senators reaffirmed their intention to vote against the motion should it involve the latest iteration of the GOP’s health care proposal, according to Time.
One of those Republicans was Senator Susan Collins of Maine, who criticized both her party's proposed bill and the process it took to reach it. “We don't know whether we're going to be voting on the House bill, the first version of the Senate bill, the second version of the Senate bill, a new version of the Senate bill, or a 2015 bill that would have repealed the Affordable Care Act,” the senator said on CBS’s Face the Nation.
“I don't think that's a good approach to replacing legislation that affects millions of people,” she said.
Related: We Fact-Checked Donald Trump’s Statements About Health Care and Preexisting Conditions
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