Three Republicans dealt what appears to be a final, fatal blow to their party’s ObamaCare repeal effort on Friday morning after a yearslong odyssey that now leaves the GOP in the wilderness.
Here are five takeaways from this morning’s drama and the monthslong Senate repeal fight.
Leadership is ready to move on
Sen. Ted Cruz (R-Texas) and Rep. Mark Meadows (R-N.C.), the chairman of the House Freedom Caucus, were among the conservatives urging their colleagues to keep fighting after the dramatic defeat in the Senate.
“I believe ObamaCare will be repealed,” Cruz told reporters after leaving the Senate chamber following Friday morning’s 49-51 vote.
“On the merits, I think we are quite close. I think there are 45 or 46 votes, and I think we’re a few votes away,” he said.
Meadows said a new effort is underway to write a bill that would include proposals offered by Sens. Lindsey Graham (R-S.C.), Bill Cassidy (R-La.), Rob Portman (R-Ohio.) and Cruz.
“I just think that we’ve got to regroup and continue to stay involved and find something that has 51 votes in the Senate that we can make work,” Meadows told reporters Friday.
ObamaCare repeal has repeatedly come back from the dead this year, and the “skinny” repeal bill defeated on Friday was just a vote away from passage.
The White House and congressional Republican leaders, however, look ready to move on.
Senate Majority Leader Mitch McConnell (R-Ky.) in a floor speech said it was time to switch focus, while Speaker Paul Ryan (R-Wis.) signaled a pivot to tax reform.
“We have so much work still to do, and the House will continue to focus on issues that are important to the American people,” Ryan said. “At the top of that list is cutting taxes for middle class families and fixing our broken tax code. I’m glad that members will now take time to hear directly from those they represent and make the case for historic tax reform that we intend to pursue in the fall.”
Trump in a tweet said ObamaCare would “implode,” which might bring Democrats to the bargaining table. He did not urge a tireless new effort.
Sen. Roy Blunt (R-Mo.), a member of leadership, acknowledged the political reality.
“I think this ends this discussion for a little while,” he said.
Closed process haunts McConnell
Senate Republicans received flack from the beginning of their effort for closing the process to Democrats and keeping their work behind closed doors.
In May, McConnell convened a working group of 13 senators for twice-a-week meetings to discuss a reform plan. No female senators were initially included, and the group leaned toward conservatives and McConnell allies.
Democrats skewered the closed-door process, noting Republicans had criticized their party over the issue when ObamaCare was approved in 2010 — after months of open Senate hearings at which the party pleaded for centrist GOP support.
Worse for McConnell was that the criticism was echoed by Republicans, including two women — Sens. Lisa Murkowski (Alaska) and Susan Collins (Maine) — who voted against the final bill.
The third senator to vote no on Friday morning, Sen. John McCain (R-Ariz.), had urged a return to regular order just days before his return to the Senate after a brain cancer diagnosis.
“We’ve been spinning our wheels on too many important issues because we keep trying to find a way to win without help from across the aisle,” McCain said.
Dems win by staying united
Democrats face a difficult political map in next year’s midterm elections, when they will be defending 25 seats, including two Independents who caucus with Democrats, compared to eight for Republicans.
That should have given the GOP an opportunity to divide the minority party by making Democratic senators in red states up for reelection feel pressure to back a reform bill.
Instead, it was Republicans who wavered.
Sen. Dean Heller (Nev.), considered the most vulnerable GOP senator up for reelection, faced pressure to oppose the bill from Nevada Gov. Brian Sandoval (R). So did Sen. Rob Portman (R-Ohio), who faced opposition from his state’s Republican governor, John Kasich.
While Heller and Portman voted in favor of the final bill, their early opposition to various repeal-and-replace measures delayed McConnell’s efforts.
President Trump’s low approval ratings and the unpopularity of the GOP measures helped Democrats. So did the rising popularity in polls of ObamaCare.
The results were a victory for Senate Minority Leader Charles Schumer (D-N.Y.), who throughout the process preached Democratic unity.
As McCain cast his vote to kill the legislation, Schumer could be seen on camera waving his arm, urging his members not to cheer. The moment highlighted his control over the caucus.
“Our caucus was so united. Everyone from Bernie Sanders to Joe Manchin was on the same page,” he said Friday morning.
Senate Republican divisions run deep.
Centrist and conservative Republicans were never on the same page, and McConnell’s efforts to win over one side repeatedly cost him votes from the other.
Medicaid quickly emerged as one of the thorniest issues. The Senate GOP bill included deep cuts to Medicaid and a three-year transition to end extra federal funds for Medicaid expansion.
The 20 GOP senators who represent states that expanded Medicaid worried about thousands of their constituents losing coverage. Kasich and Sandoval were loud, politically powerful voices on the issue.
GOP centrists ultimately won that battle, in that the skinny repeal bill included no Medicaid cuts. Conservatives were willing to back the skinny bill with the hope it could be improved in a conference with the Senate.
Yet it was hard to see how something could emerge from that conference that would serve both sides of the debate.
In the end, Republicans couldn’t get the 51 votes necessary to try, as three Republican senators wouldn’t support the skinny bill.
Trump threats backfire
Trump tried to up the pressure on Murkowski after she voted against three critical healthcare votes in one week.
“Senator @lisamurkowski of the Great State of Alaska really let the Republicans, and our country, down yesterday. Too bad!”
Interior Secretary Ryan Zinke called Murkowski and Sen. Dan Sullivan (R-Alaska) on Wednesday and threatened to withhold federal support for key economic development projects in the state if Murkowski didn’t line up to support the GOP’s healthcare plans.
The threats backfired badly.
Murkowski didn’t change her vote, and she was reportedly furious about the Zinke call. As the chairwoman of the Senate Energy and Natural Resources Committee, she has power over the Interior Department’s budget, and it’s possible the pressure could have long-term negative effects for Zinke and Trump.