In the weirdness that is the state of American politics in 2017, Congress is developing a flair for late night high drama. Last night, enough Senators spoke out against the Senate’s plan to repeal and replace the Affordable Care act that the bill was determined dead — but Republicans in Congress aren’t exactly giving up yet.
The cascade began when Sens. Mike Lee (UT) and Jerry Moran (KS), both hardline conservatives, announced they would not support the bill late on July 17. As Sen. Susan Collins (ME) and Sen. Rand Paul (KY) had both already stated opposition to the bill, that meant there were four “no” votes out of 52, and the measure would need at least 50 votes to pass.
Once it became clear that the bill did not have the necessary support, Senate Majority Leader Mitch McConnell (KY) officially gave up on pushing it — but not on killing off the Affordable Care Act.
“Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful, McConnell said in a statement.
After the measure fell apart, the White House urged Congress to move on with a straight repeal instead.
“Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate,” President Trump said in a statement on Twitter. “Dems will join in!,” he added.
And indeed, it seems that instead of going back to the drawing board or trying to craft a bipartisan bill in the normal procedural way, McConnell is instead suggesting full repeal, with “replace” to follow later or never.
“In the coming days,” McConnell said, “the Senate will vote to take up the House bill with the first amendment in order being what a majority of the Senate has already supported in 2015 and that was vetoed by then-President Obama: a repeal of Obamacare with a two-year delay to provide for a stable transition period to a patient-centered health care system that gives Americans access to quality, affordable care.”
The House bill McConnell is referring to is the American Health Care Act, which the House narrowly passed, 217-213, in May. The Senate’s BCRA was based on and very similar to the AHCA, but was not actually the same bill.
So the plan, McConnell is saying, is for the Senate to leave the dead bill alone, and instead directly take up the House bill and transform it into a straight repeal bill with amendments, using language from 2015.
The reason McConnell is approaching it this way, instead of starting over with a new bill and a traditional committee-and-hearings process, is because the BCRA isn’t a standard bill. Instead, it is a budget resolution. That puts some limits on the kind of long-standing policy changes Senators can put in it, but the trade-of is that it allows the bill to pass with only 50 votes, instead of the 60 votes regularly needed to break an opposition filibuster.
While the Republicans do have a majority in the Senate, it’s slim — 52 to 48. Hence the drastic measures to slip something through as part of the budget, instead of taking the slow road.
Does “repeal only” have a chance?
But will the senate go for it? That’s the trillion-dollar question, and once again the answer lies somewhere on the spectrum between “maybe,” “maybe not,” and ¯\_(ツ)_/¯.
While repeal measures did succeed in the past, they were basically a bluff, or an empty gesture. Both Representatives and Senators knew that then-President Obama would veto any ACA repeal bill that made it to his desk, and so every Republican could feel free to vote for one, knowing that it would provide them with a talking point and campaign issue but would not create any real change.
With President Trump sitting in the Oval Office, however, any measure Republicans pass can actually become law and affect millions of Americans — so lawmakers are having to tread a little more carefully.
In 2015, the Congressional Budget Office report on the repeal bill found that in just the first year after repeal, 18-19 million people would lose health coverage. That would increase to 32 million who currently have coverage losing it by 2026 — significantly worse even than the 22 million currently-covered Americans projected to lose access to care under the BCRA.
But as Axios notes, there are a lot of moving parts to consider. Even “repeal” in this case is not in fact actually a straight, 100% repeal — because it’s still tied to the budget reconciliation process, rather than being a freestanding bill in its own right.
Hardline conservatives who felt that the BCRA didn’t go far enough are more likely to favor an outright repeal. That includes Sen. Lee, who tells Politico that he will support a motion to proceed on a bill that includes repeal.
Will others follow Lee’s lead? It’s anyone’s guess. As Axios notes, the repeal wouldn’t be able to include “all of the insurance regulations conservatives say they hate.” But while it would still cut Medicaid, it might not do so as drastically as the BCRA did.
Still, experienced Hill-watchers suspect that repeal — which Axios calls McConnell’s “nuclear option” — is a long shot at best.
Update: Before 1:00 p.m., any plans to go forward with a vote on the plan to repeal only had already lost the votes it would need to pass.
Senators Shelley Moore Capito (WV), Susan Collins (ME), and Lisa Murkowski (AK) all came out against a plan to vote on a repeal, saying they would vote “no” on any such measure.
The math is the same as the BCRA: A measure would need a to lose no more than two Republican votes in order to succeed and this one has already lost three. Combined with “concerns” from other Republican Senators that also did not seem to be particularly enthusiastic about a repeal-only plan, it’s toast.
Editor's Note: This article originally appeared on Consumerist.