Tuesday night was a big night for the Trump administration’s attempt at health care reform, with yet another version of the Better Care Reconciliation Act (aka the Republicans’ new health care bill) up for a Senate vote after months of debate (and other failed votes). Republican Senator John McCain, who was diagnosed with brain cancer last week, traveled 2,300 miles from Arizona to participate in the Senate vote just nine days after he’d undergone surgery. Trump appeared optimistic that the senator’s return would be the tipping point the new healthcare bill needed to pass, tweeting, “Thank you for coming to D.C. for such a vital vote. Congrats to all Rep. We can now deliver grt healthcare to all Americans!”
.@SenJohnMcCain-Thank you for coming to D.C. for such a vital vote. Congrats to all Rep. We can now deliver grt healthcare to all Americans!
— Donald J. Trump (@realDonaldTrump) July 25, 2017
However, as the night went on, it became clear that McCain did not agree that the bill would result in “grt healthcare,” and neither did over half the Senate. (Protesters shouting “kill the bill” from the Senate gallery, who were removed by police, also seemed to be skeptical about the proposed law’s benefits.)
Before the Senate even voted on whether to pass the bill, they first had to vote on whether to continue talking about it at all—and the vote came down to a tie-break, requiring a vote from Vice President Mike Pence. Not exactly a resounding endorsement. Pence voted “yes,” to continue debate, allowing the bill to proceed by a 51-50 margin. While McCain also voted “yes,” he then took the floor for a 15-minute speech that held nothing back. “All we’ve managed to do is make more popular a policy that wasn’t very popular when we started trying to get rid of it,” he said. “I voted for the motion to proceed to allow debate to continue and amendments to be offered. I will not vote for the bill as it is today. It’s a shell of a bill right now. We all know that.”
Apparently, his feelings were shared. The bill failed to pass the Senate, with nine Republicans breaking ranks to deliver a 43-57 vote that missed the 60-vote cutoff for approval by a long shot. Now it seems as though the easiest path forward in passing any kind of health care reform would be with a “skinny repeal“—a pared-down version of the bill that simply repeals a few aspects of the Affordable Care Act, but not all of it. Though no official new bill has been drafted, The Washington Post reports it would probably abolish three aspects of the ACA: the requirement that most Americans be insured, the requirement that employers with over 50 employees provide health insurance, and a medical devices tax that helped fund other initiatives of the bill.Â
While the “skinny repeal” might be able to garner enough Senate support to actually pass (as a similar bill did in 2015 before then-President Obama vetoed it), it doesn’t do much to fulfill Republicans’ seven-year campaign promise to repeal Obamacare—a promise that never included the word “skinny.”