The GOP’s latest Obamacare repeal bill is dead

Republican leaders have decided not to vote on Obamacare repeal legislation this week, effectively ending the party’s latest effort to wipe away the 2010 health care law.

When, and whether, they will try again remains to be seen. But at least for the moment, the GOP’s seven-year crusade to undo the Affordable Care Act lies in shambles ― and insurance for the millions of Americans who depend on the law remains intact.

The decision to shelve repeal legislation came during a weekly caucus meeting on Capitol Hill, as leaders acknowledged that the the latest proposal, from Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.), lacked the support it required to pass.

“We don’t have the votes,” Cassidy said afterwards.

Sen. Susan Collins (R-Maine) had announced her intention to vote against the measure on Monday, joining two of her colleagues, Sens. John McCain (R-Ariz.) and Rand Paul (R-Ky.). That left Republicans with just 49 votes, one short of the 50 they needed.

And the clock was ticking, because special authority allowing Republicans to pass repeal with a simple majority, rather than the 60 votes it takes to overcome a filibuster, ends on Sept. 30.

“We basically ran out of time,” said Sen. Ron Johnson (R-Wis.), a co-sponsor of the repeal bill.

As Graham and Cassidy have promoted their bill in the last two weeks, and GOP leaders got behind it, it appeared for a while that repeal legislation, a version of which had come within one vote of passing in July, might finally get through the Senate ― putting it on track for quick approval in the House and then signature by the president.

Even on Tuesday, Republicans were vowing not to give up.

Many in the party already have their eyes on a new push for repeal, using the same special legislative authority, once they are done working on an upcoming bill to cut taxes.

“There’s plenty of fight left in us,” Graham vowed on Tuesday.

“We haven’t given up on trying to change the American health care system,” added Senate Majority Leader Mitch McConnell (R-Ky.).

But the failure of the Graham-Cassidy legislation, following the collapse of the July effort, has made clear that Republicans still do not agree among themselves on how to replace the ACA, and have no policy plans living up to promises ― from Trump and other party leaders ― that they can deliver better, cheaper health care to more people.

The Affordable Care Act has helped millions to get health coverage, bringing the number of people without insurance to historic lows and improving both access to care and financial security. But because people at higher incomes don’t qualify for the law’s tax credits, many of them face high premiums and high out-of-pocket costs ― in some cases, more than they paid previously and, in the worst instances, more than they can realistically afford.

Those higher costs are largely a function of the law’s new requirements on insurers ― to cover everybody, regardless of pre-existing conditions, and to provide comprehensive benefits with each policy. Republicans have decried these effects, but every plan they proposed would have left many millions without insurance and gutted protections for pre-existing conditions.