The Republican efforts to repeal or replace Obamacare have fallen apart, and at this time there is no clear path ahead.
On July 17, conservative senators Mike Lee (R-Utah) and Jerry Moran (R-Kan.) each announced they would not support the Better Care Reconciliation Act (BCRA), a Senate bill drafted in two versions, released on June 22 and July 14, to reform the Affordable Care Act (ACA), also known as Obamacare.
Since Republican senators Rand Paul (R-Ky.) and Susan Collins (R-Maine) had previously announced their opposition to the bill, this doomed its chances of even coming to a vote. To do so would require votes from 50 senators, plus the tie-breaking vote of Vice President Mike Pence, and the Republicans only have a total of 52 senators. With Lee and Moran joining Paul and Collins in opposition, reaching 50 votes was impossible.
In fact, the opposition to the BCRA may be greater than this suggests, as several moderate senators had not committed to voting for it.
Late at night on July 17, in response to the failure of the BCRA, Senate Majority Leader Mitch McConnell announced he would offer a bill, which was passed in December 2015 by the Republican-controlled Congress but vetoed by President Barack Obama, that repealed the taxes and subsidies of Obamacare. The repeal would be delayed for two years, allowing Congress to put in place a plan to replace it.
On the morning of July 18, three Republican senators—Collins, West Virginia’s Shelly Moore Capito, and Alaska’s Lisa Murkowski—announced they would not vote to repeal Obamacare, killing McConnell’s initiative less than 24 hours after he announced it.
The failure of the Republican efforts has to do with a caucus at odds with itself, with different views on how to handle Medicaid and subsidies for insurance, and unable to get its message out.
Conservatives Versus Moderates
The two senators who first announced their opposition to the BCRA did so for nearly opposite reasons, illustrating the difficulty Republicans face in wrestling with health insurance policy.
In a July 14 opinion piece, Paul defended his intention to vote against the BCRA in defense of capitalism in the United States. He wrote that Senate Republicans supporting BCRA “will be voting to keep the main premise of Obamacare and all its attendant distortions and market disruptions.” Only a repeal of Obamacare would be consistent with Republican principles and promises.
