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John McCain opposes Graham-Cassidy, in possible death blow to Obamacare repeal

Arizona senator wants bipartisan agreement and regular order.

John McCain Wakil Kohsar/AFP/Getty Images
Dylan Scott covers health care for Vox. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo and STAT before joining Vox in 2017.

Sen. John McCain (R-AZ) announced Friday he would oppose the latest Obamacare repeal bill, a potential death blow to the GOP’s last hope of undoing much of the 2010 health care law.

McCain said in a statement he “cannot in good conscience” support the bill from Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA), which would turn much of Obamacare’s funding into a block grant for the states starting in 2020.

The Arizona senator said, much as did when he voted down Obamacare repeal in late July, that Republicans should instead work with Democrats on a health care bill and that any legislation should go through the regular order of committee hearings and markups.

“I believe we could do better working together, Republicans and Democrats, and have not yet really tried,” McCain said. “Nor can I support it without knowing how much it will cost, how it will effect insurance premiums, and how many people will be helped or hurt by it.”

McCain’s vote was crucial to killing the last GOP attempt to repeal Obamacare in late July. Now his opposition could spell doom for Graham-Cassidy, which outside estimates have projected would lead to 21 million fewer Americans having health coverage versus Obamacare. Fifty of the 52 Senate Republicans must support any repeal plan for it to pass the Senate, and the legislation appears to be short.

Sen. Rand Paul (R-KY) has consistently said he opposes the plan, arguing that it keeps too much of Obamacare for his support. Sen. Susan Collins (R-ME) has not taken a definitive position, but she has raised concerns about how the bill affects people with preexisting conditions and its Medicaid cuts. She is widely considered a “no” vote.

There are a few others, most notably Sen. Lisa Murkowski (R-AK), who haven’t yet said whether they support or oppose the bill, but whose support is thought to be in doubt.

McCain’s opposition comes with the clock ticking down for Senate Republicans to repeal Obamacare. The special privileges they are using to pass a bill with only 51 votes and avoid a Democratic filibuster expire on September 30. After that, they would need to start the process over by passing a budget resolution.

Senate leaders had said that they intended to bring Graham-Cassidy up for a vote next week, though it’s not clear if they would still hold the vote knowing that the bill would fail.

Here is McCain’s statement in full:

“As I have repeatedly stressed, health care reform legislation ought to be the product of regular order in the Senate. Committees of jurisdiction should mark up legislation with input from all committee members, and send their bill to the floor for debate and amendment. That is the only way we might achieve bipartisan consensus on lasting reform, without which a policy that affects one-fifth of our economy and every single American family will be subject to reversal with every change of administration and congressional majority.

“I would consider supporting legislation similar to that offered by my friends Senators Graham and Cassidy were it the product of extensive hearings, debate and amendment. But that has not been the case. Instead, the specter of September 30th budget reconciliation deadline has hung over this entire process.

“We should not be content to pass health care legislation on a party-line basis, as Democrats did when they rammed Obamacare through Congress in 2009. If we do so, our success could be as short-lived as theirs when the political winds shift, as they regularly do. The issue is too important, and too many lives are at risk, for us to leave the American people guessing from one election to the next whether and how they will acquire health insurance. A bill of this impact requires a bipartisan approach.

“Senators Alexander and Murray have been negotiating in good faith to fix some of the problems with Obamacare. But I fear that the prospect of one last attempt at a strictly Republican bill has left the impression that their efforts cannot succeed. I hope they will resume their work should this last attempt at a partisan solution fail.

“I cannot in good conscience vote for the Graham-Cassidy proposal. I believe we could do better working together, Republicans and Democrats, and have not yet really tried. Nor could I support it without knowing how much it will cost, how it will effect insurance premiums, and how many people will be helped or hurt by it. Without a full CBO score, which won’t be available by the end of the month, we won’t have reliable answers to any of those questions.

“I take no pleasure in announcing my opposition. Far from it. The bill’s authors are my dear friends, and I think the world of them. I know they are acting consistently with their beliefs and sense of what is best for the country. So am I.

“I hope that in the months ahead, we can join with colleagues on both sides of the aisle to arrive at a compromise solution that is acceptable to most of us, and serves the interests of Americans as best we can.”

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