Senate Republicans Accept Defeat On Obamacare ‘Repeal And Replace’

The effort to 'repeal and replace' the Affordable Care Act is dead for now.


Senate Republicans have apparently finally accepted defeat on any plan to ‘repeal and replace’ the Affordable Care Act:

Senate Republicans are throwing cold water on the idea of holding another Obamacare repeal vote before their opportunity to gut the law on a party-line vote expires at the end of this month.

Though President Donald Trump and some Senate Republicans are pushing a plan being devised by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) to block grant federal health care funding to the states and keep much of Obamacare’s taxes, the idea of passing the measure by month’s end appears almost impossible, according to senators and aides.

The bill isn’t finished yet, there is no Congressional Budget Office score, and some Republicans are working with Democrats on a bipartisan plan to shore up insurance markets. Furthermore, Republicans don’t have a plan that can get 50 votes.

And that means the dream of repealing the law with all GOP votes is slipping away, at least for now, as Republicans turn to tax reform.

“We’ve seen that we don’t have 51 votes to do it, so we’re going to have to do it bipartisan,” said Senate Majority Whip John Cornyn of Texas in an interview on Thursday morning. Asked whether the Senate would hold an Obamacare repeal vote before the Senate’s budget reconciliation instructions expire, he replied: “I don’t believe so.”

“I don’t think there’s much of a chance,” said Sen. Orrin Hatch of Utah, the Senate Finance Committee Chairman. “I think that was pretty well decided by McCain.”

This isn’t entirely surprising, of course.

After the House of Representatives passed the American Health Care Act with barely a vote to spare earlier this year, the focus of the battle over health care reform shifted to the Senate, where it ultimately died. As a preliminary matter, even as the House was debating the AHCA it was clear that the House proposal would be dead in the Senate. Instead, Senate Republicans proposed something called the Better Care Reconciliation Act. As with the House bill, this bill was created behind closed doors with no committee hearings or public debate of any kind, and no input from Democrats and, just like its House cousin, it quickly ran into road blocks. Mitch McConnell’s plan to vote on the bill before the July 4th recess fell apart as soon as the Congressional Budget Office released a devasting score for the bill. After that, BCRA quickly lost support and was pulled from the floor before voting could begin. After the recess, Senate Republicans put forward a revised plan that also received a bad CBO score and quickly came under fire. When it became obvious that this bill would also fail to get even the fifty votes required to pass the bill under the Senates relaxed reconciliation rules, McConnell proposed yet another plan that would repeal the Affordable Care Act without actually replacing it with anything, but that plan ended up falling apart after only eighteen hours. Undaunted, the Senate still refused to give up and decided to go forward even though it was unclear which direction they were heading.

All of this led to the absurdity that occurred just before the August recess when the Senate voted to proceed to debate on a bill even though they had no idea what they were voting on. Finally, the Senate settled on a bill that ended up receiving the name of “skinny repeal,” which it earned due to the fact that it would only repeal certain parts of the PPACA such as the individual and employer mandates and leave other parts of the law intact. Even while voting on it, though, Republican Senators were making clear that they didn’t want to see it enacted into law. Instead, they intended to use that bill as a vehicle to get to a conference committee with the House in the hope that they could come up with something better that could pass both chambers, perhaps even with some bipartisan support. That effort, however, died in dramatic fashion when an ailing John McCain returned to the Senate to deliver a late-night thumbs down that sealed the bill’s fate. A final nail in the coffin was delivered just before Labor Day when the Senate Parliamentarian ruled that the window for Republicans to use reconciliation to pass health care reform would end on September 30th, once that window was closed the GOP would need sixty votes to pass any form of health care reform before the end of this year. As the article above indicates, there was a half-hearted attempt to revive ‘repeal and replace’ earlier this week with a new proposal that even managed to get an initially positive response from Senator McCain, although the reports that he had endorsed the plan turn out to have been inaccurate. In any event, given the mountain of other issues on the Senate’s plate this month and the limited number of days that they would actually be in session, it was clear that there was simply no way they could get even fifty votes corralled for a vote before the end of the month.

All of this means, of course, that the PPACA is here to stay for the foreseeable future. There’s basically no chance that Republicans can come up with a ‘repeal and replace bill that would get enough Democratic support to withstand an inevitable filibuster. It’s also unlikely that they’ll be able to come up with legislation that can pass both chambers of Congress next year while legislators are counting down the days to primary elections and a General Election where, based on history alone, Republicans in both the House and the Senate are likely to be vulnerable. in the midterms to begin with. Given that, it’s unlikely they’ll seek to increase that vulnerability by trying to step on the third rail of health care reform in an election year, especially when polling still indicates that the public does not support any of the Republican alternatives to the PPACA that have been offered and that support for the PPACA itself has increased with each Republican attempt to repeal it.

It’s never advisable to say that anything is officially “dead” on Capitol Hill, of course. There’s always a chance that Republicans could seek to revive the effort to repeal the PPACA at some point in the future, perhaps next year when the Senate can try to take advantage of the reconciliation process yet again. If they were going to succeed in that effort, though, their best chance to do it was this year, and that’s simply not going to happen. For now, the PPACA will remain the law of the land, and as long as that continues to be the case the odds that it will ever be fully repealed become smaller and smaller.


FILED UNDER: Congress, Healthcare Policy, US Politics, , , , , , , , , , , , , , , , , ,
Doug Mataconis
About Doug Mataconis
Doug Mataconis held a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010 and contributed a staggering 16,483 posts before his retirement in January 2020. He passed far too young in July 2021.


  1. teve tory says:

    ETA: oopsie wrong thread

  2. Daryl's other brother Darryl says:

    Repeal and replace is dead…but efforts to sabotage Obamacare are ongoing.

  3. OzarkHillbilly says:

    So much winning!