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McCain says ‘no’ to health care bill, putting outcome in doubt

Updated September 22, 2017 - 6:01 pm

WASHINGTON — A Republican bill to repeal Obamacare appeared in doubt Friday when Sen. John McCain announced he would vote against the legislation because it lacked bipartisan consensus and because of the unknown consequences on families.

“I believe we could do better working together, Republicans and Democrats, and have not yet really tried,” McCain, R-Ariz., said in a statement.

With McCain and Sen. Rand Paul, R-Ky., officially against the bill, one other Republican defection would doom its chances in the Senate where the GOP holds a razor-thin majority. Republican Sen. Susan Collins told a Maine newspaper Friday that she was leaning against the bill.

McCain’s announcement was a blow to President Donald Trump, seeking his first major legislative victory, but was praised by those who oppose the latest GOP bill because of cuts in Medicaid funding.

The GOP bill would repeal the individual and employer mandates in Obamacare, and redistribute funds for private insurance subsidies and Medicaid expansion in block grants to states. Supporters say that would give states flexibility to waive other regulations so that legislators could craft tailored health care plans.

Nevada Gov. Brian Sandoval this week joined a bipartisan group of governors who urged Senate leaders to shelve the bill and seek a bipartisan solution to health care reform. He reiterated his opposition in a statement late Thursday.

“Flexibility with reduced funding is a false choice,” Sandoval said.

Sandoval said he would not “pit seniors, children, families, the mentally ill, the critically ill, hospitals, care providers or any other Nevadan against each other because of cuts.”

Heller co-sponsors bill

Sandoval’s position puts him at odds with the state’s senior senator, Dean Heller, a Republican co-sponsor of the bill along with Sen. Lindsey Graham, R-.S.C., Sen. Bill Cassidy, R-La., and Sen. Ron Johnson, R-Wis.

Heller stood with Sandoval at a Las Vegas news conference this summer and announced his opposition to repeal plans that cut Medicaid spending.

But he co-sponsored the most recent bill, which also cuts Medicaid. Heller argues the flexibility afforded states and a redistribution of Obamacare funds through block grants would increase spending in Nevada — a claim disputed by independent analysis.

On his split with Sandoval, Heller said, “we respectfully disagree.”

About McCain’s decision and the future of the bill, Heller said: “Obamacare is collapsing, and I remain confident that the Graham-Cassidy-Heller-Johnson plan is the best path forward so we’re going to keep working on this.

“Doing nothing is not an option,” he said.

Senate Majority Leader Mitch McConnell, R-Ky., has told the bill’s backers he will not bring the bill to the floor unless there were 50 votes to pass it.

Paul has said he will vote against bill because it does not fully repeal the Affordable Care Act, commonly known as Obamacare.

That drew Trump’s ire Friday. He took aim at Paul on social media and sought to sway other undecided GOP lawmakers.

“Rand Paul, or whoever votes against Hcare Bill, will forever (future political campaigns) be known as ‘the Republican who saved ObamaCare,’ ” Trump said on Twitter.

Paul shot back: “I won’t be bribed or bullied.”

Hours later, McCain said: “I cannot in good conscience vote for the Graham-Cassidy proposal.”

Outcome in doubt

The Arizona senator’s decision leaves the bill’s outcome in doubt.

Republicans hold a slim 52-48 majority in the Senate and need 50 votes, with Pence casting a tie-breaking vote, to pass the bill under budget reconciliation rules that expire Sept. 30.

After the rule expires, Republicans would need 60 votes to overcome a filibuster.

McCain, who cast the vote that tanked an earlier repeal bill in July, said Republicans should not ram through a partisan bill without hearings. He criticized Democrats for passing Obamacare along straight-party votes in 2010.

His decision could give political cover to other undecided lawmakers, like Sen. Lisa Murkowski, R-Alaska.

Alaska Gov. Bill Walker, an independent, joined Sandoval and eight other Republican and Democratic governors urging the Senate to reject the legislation. Fifteen governors support it.

Sandoval led the expansion of Medicaid in Nevada, enrolling roughly 300,000 residents and providing insurance to 90,000 more through the Silver State Health Insurance Exchange.

An analysis by the left-leaning Center for American Progress out this week estimated 243,000 Nevadans could lose insurance under the Senate bill.

Nevada officials also dispute claims by Senate bill supporters that Nevada would see a growth in block grant funding from approximately $1.4 billion in base year funding to more than $1.9 billion in 2026.

Two analyses of the bill released this week by the Kaiser Family Foundation and Avalere Health projected Nevada would lose between $600 million and $2 billion from 2020 to 2026.

“Healthcare reform is working in Nevada,” Sandoval said. “Improvement is needed and planned but we are making great progress.”

Contact Gary Martin at 202-662-7390 or gmartin@reviewjournal.com. Follow @garymartindc on Twitter. Contact Sean Whaley at swhaley@reviewjournal.com or 775-461-3820. Follow @seanw801 on Twitter.

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