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The GOP repeal failed. What happens to Obamacare now?

July 28, 2017 at 6:45 PM EDT
Senate Republican efforts to repeal Obamacare suffered a stunning defeat overnight, prompting renewed calls for bipartisanship in the aftermath. The historic drama unfolded as Sen. John McCain cast a decisive vote against the "skinny" bill unveiled just hours earlier. Lisa Desjardins offers a recap, then joins Judy Woodruff and Sarah Kliff of Vox to look at what happens now.
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JUDY WOODRUFF: And now to the day’s other big story, and that is the collapse of Senate Republican efforts to pass a health care bill.

A last-ditch effort for a partial repeal of Obamacare failed by a single vote early today, frustrating Republican leaders and the president.

Lisa Desjardins begins our coverage.

LISA DESJARDINS: President Trump today showed no sign of backing down, despite the stunning Senate defeat.

PRESIDENT DONALD TRUMP: They should have approved health care last night, but you can’t have everything. Boy, oh, boy. They have been working on that one for seven years. Can you believe that? The swamp.

But we will get it done. We’re going get it done.

LISA DESJARDINS: At an event for police officers in Ronkonkoma, New York, he was blunt.

PRESIDENT DONALD TRUMP: You know, I said from the beginning, let Obamacare implode, and then do it. I turned out to be right. Let Obamacare implode.

(CHEERING AND APPLAUSE)

LISA DESJARDINS: All this after the Senate’s overnight drama. Outside the Capitol stood a crowd of protesters. Inside, around 10:00 p.m. Last night, Republicans had just released their bill, and Democrats like Chris Murphy were irate that the vote on it was in just two hours.

SEN. CHRIS MURPHY, D-Conn.: This is nuclear-grade bonkers, what is happening here tonight.

LISA DESJARDINS: Hawaii Democrat Mazie Hirono, now being treated for kidney cancer, added a personal dimension.

SEN. MAZIE HIRONO, D-Hawaii: I lost a sister to pneumonia when she was only 2 years old in Japan. She died at home, so I know how important health care is. What I don’t get is why every single senator doesn’t know that know that.

LISA DESJARDINS: A frustrated Senator Mike Enzi, Republican of Wyoming, said Democrats offered only complaints.

SEN. MICHAEL B. ENZI, R-Wyo.: And I started hearing, it’s not perfect. It’s not perfect. Well, where are the suggestions for making it as near perfect as possible?

LISA DESJARDINS: And so, shortly after midnight, a first vote began, with Democrats somber and in their seats. On the opposite side, slowly arriving Republicans were more social.

But something notable, Alaska Senator Lisa Murkowski walked over to Arizona’s John McCain, and he signaled a thumbs down. Murkowski, along with Susan Collins of Maine, were two expected no votes.

Soon, Vice President Mike Pence stepped over, shook hands and then spent a long 20 minutes apparently trying to win McCain’s vote. Minutes later, another signal. McCain walked over to Democrats. A large group surrounded him. Nearby, GOP Leader Mitch McConnell walked the other way, just as McCain was embraced by California’s Dianne Feinstein.

The final vote resembled a great sporting event, Democrats on their feet as McCain walked up to vote. Some, like Massachusetts’ Elizabeth Warren, leaned to watch him. And he signaled his vote with a simple thumbs down.

(APPLAUSE)

LISA DESJARDINS: Democrats gasped and clapped, before their leader waved them off and stopped the applause.

Outside, protesters did not hold back. It all marked a seismic shift in momentum and emotions.

SEN. MITCH MCCONNELL, R-Ky., Majority Leader: This is, you know, clearly a disappointing moment.

LISA DESJARDINS: Republican Leader McConnell thanked his side and slammed Democrats.

SEN. MITCH MCCONNELL: Now, I imagine many of our colleagues on the other side are celebrating. I think the American people are going to regret that we couldn’t find a better way forward. And, as I said, we look forward to our colleagues on the other side suggesting what they have in mind.

LISA DESJARDINS: As the night turned to day, bipartisan calls grew louder. Democratic Minority Leader Chuck Schumer said his party is ready.

SEN. CHUCK SCHUMER, D-N.Y., Minority Leader: I hope we can work together to make the system better in a bipartisan way. And I’m optimistic that that can happen. Nobody has said Obamacare is perfect. Nobody has said our health care system doesn’t need fixing.

LISA DESJARDINS: So, where does that begin? Likely with a return to the traditional committee process.

JUDY WOODRUFF: And Lisa joins me now for more, along with Sarah Kliff. She’s a senior policy correspondent for the Web site Vox, and she covers health care.

And you were with us last night. And we wanted to have you both with us again tonight.

So, Lisa, what a lot of drama. You were up most of the night covering that. Where do things stand? Where do they go from here?

LISA DESJARDINS: It seems like the idea is that perhaps they can get help from the Health Committee, which is the Health, Labor and Pensions Committee in the Senate.

One reason for that, Judy, not just because its covers health care, but because of its leaders. Senator Lamar Alexander of Tennessee is the Republican chairman, and the ranking Democrat is Patty Murray, both of them senior members of their party who thought are of very highly and who have done bipartisan deals before.

Senator Alexander is planning hearings. And they’re hoping that something comes of this in the way of legislation. Also, Judy, there were conversations on and off the floor last night. Senator Perdue told me already Republicans and Democrats speaking with each other.

But they all have one problem still. Unclear what could pass. It seemed like last night’s vote was very close, but the truth is, Judy, is that McCain was expressing something a lot of Republicans felt. This bill was far short of a number of people who really wanted it to become law.

JUDY WOODRUFF: So, what are the roadblocks? Is it figuring out the policy? Because I have had people say to me, well, if you could just put folks in a room and not worry about politics, you could get it done.

But you’re suggesting it’s not that simple.

LISA DESJARDINS: It’s complicated because Republicans have tried to put a lot of together different ideas together here.

For one, Planned Parenthood, defunding Planned Parenthood has been part of that. That’s something that Susan Collins and Lisa Murkowski haven’t liked.

There is an idea that, if they pared it down and focused on fixing the Affordable Care Act, that perhaps, perhaps they can come up with some ideas they share. But this is just less than 24 hours after things fell apart. But that is the hope right now.

JUDY WOODRUFF: Well, let’s talk about what’s at stake as they figure this out, Sarah Kliff, because, until there is new legislation, the Affordable Care Act is in effect.

It’s out there. What’s going to happen to it?

SARAH KLIFF, Vox: That is a fantastic question, and you’re right. There are millions of people who get coverage through the Affordable Care Act, particularly through the marketplaces. These are people who buy private insurance, often with tax subsidies,.

And we are expecting some pretty significant premium increases unless we have some kind of changes in policy from the Trump administration. They have done some things to increase uncertainty. And when insurance companies sense uncertainty, they react by raising prices. And that’s what we’re seeing in the marketplaces right now.

JUDY WOODRUFF: What are insurance companies — I know it’s only been not even 24 hours since this happened, but what’s your understanding, from having reported on this for a long time, that insurance companies need to have?

What are they looking for as Congress works its way through at this point?

SARAH KLIFF: They’re going to be looking for two things. They want to know that the individual mandate, the requirement to carry health insurance, that will be enforced by the Trump administration.

Even though the Trump administration has been negative on that provision, they want to know that they will tell people, if you don’t buy insurance, there is a fine because they think that gets healthy people to sign up for coverage.

They also want a guarantee from President Trump that he will continue paying threat cost-sharing reduction subsidies. It’s this $8 million — or $8 billion — excuse me — fund that helps offset co-pays for low-income Americans. They don’t know if they’re going to get that money. And they want a guarantee on that.

JUDY WOODRUFF: And, meantime, Lisa, what the president has said — in fact, he said it — was tweeting this morning and last night — let Obamacare implode, which sounds like he’s not going to be putting any money out there.

LISA DESJARDINS: Right, nor does it sound like he necessarily wants to enforce the individual or employer mandates.

So that’s a real question for Congress now. Does Congress take action to force, for example, those cost-sharing reductions, that $8 billion, I think it’s $10 billion next year? Does Congress fund that on its own?

There are many Republicans would like to do that, but they know that anything right now in Congress like that is a heavy lift, but it is in the conversation.

JUDY WOODRUFF: Is there — Sarah, as you talk to folks out there in the health care world, whether it’s insurance companies, hospitals, and the others, are they coming up with another approach at all this? Are they standing back with their fingers crossed? How do they look at this right now?

SARAH KLIFF: The insurance companies in particular have been quite vocal, really less vocal in the repeal fight, and much more vocal on stabilization.

They keep talking about the cost-sharing reduction subsidies, about the individual mandate. Even just today, after we saw repeal fail, we saw this flurry of letters from insurance companies saying, we need stabilization right now. And we are getting close to the deadline.

Insurance companies have to decide in about September if they’re going to sell on healthcare.gov or not. And these are assurances they are asking before they sign those contract letters.

JUDY WOODRUFF: So, if they’re on that kind of timeline, Lisa, it takes Congress a while to get things done. They did have at least some recess coming in August. What does the timeline look like there and what about House members? They have had an even more conservative position on this than in the Senate.

LISA DESJARDINS: The Senate is in session two more weeks. That’s part of the August recess that they rolled back.

So, I don’t expect major action, but perhaps conversations can tart happening that give us an idea of whether something tangible is possible in September.

As for the House, Speaker Ryan put out a statement saying he was disappointed and frustrated. But I think the real feelings of House members were expressed better by Diane Black of the Budget Committee, who lashed out at the Senate, said it was a slap in the face of what the House had done.

And it seems like that is going to be a real problem in the two chambers trusting each other in the future. There is some hope that they could do something by September, but I’m not sure what that’s based on, to be honest.

JUDY WOODRUFF: Yes, I think people — a lot of people, it seems to me, Sarah, are standing back saying, can the two parties work together now, when clearly the Republicans, acting on their own, it didn’t happen?

SARAH KLIFF: And lot of it, honestly, rests with the Trump administration at this point. They are creating a lot of the uncertainty.

And it’s been interesting to watch their Health and Human Services Department, which has kind of acted as an attack shop on the Affordable Care Act. They send press releases every time an insurance company quits the marketplace or raises its rates and they send these and say, look, this is why we need repeal.

I am watching to see if they change their tactics now that the repeal bill seems to be dead and say, yes, we won’t repeal, but, in the meantime, we kind of — we run healthcare.gov right now, and we want to make it work as well as we can.

We don’t know if we’re going to see that shift. And if we do, it would really be a 180 from how they have treated the Affordable Care Act so far.

JUDY WOODRUFF: So much of the ball is in the administration’s court, the Trump administration’s court, as we wait to see what Congress does.

Thank you both, an extraordinary story to follow.

Sarah Kliff, our own Lisa Desjardins, thank you.

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