Perhaps the two “no” votes from Sens. Susan Collins, R-Maine, and Rand Paul, R-Ky., would have been enough to sink the GOP health-care effort. Senate Republicans and virtually all political watchers have been cultivating a sense of suspense – who would be the third “no” vote? – when in fact there are likely, according to Collins, many more “no” votes (eight to 10, she said in TV interviews Sunday).

Then a very public and simple barrier to passage emerged – Sen. John McCain’s, R-Ariz., undetermined recuperation time. With two “no” votes already clinched, Senate GOP leaders could not even pretend to have sufficient support without McCain (who actually might be a “no” vote in the end).

Now comes perhaps the death knell for Trumpcare: Sens. Mike Lee, R-Utah, and Jerry Moran, R-Kan., both announced their opposition Monday night.

To be clear, the Better Care Reconciliation Act was already at death’s door before McCain took ill and before Lee and Moran’s announcement. A handful of moderates continue to refuse to stomach huge Medicaid cuts. In an act of exceptional duplicity, McConnell reportedly told moderates not to worry about Medicaid cuts (presumably because Congress will never have the nerve to go through with them), which understandably angered conservatives.

Republican Sen. Ron Johnson told a Wisconsin paper, “I am concerned about Leader McConnell’s comments to apparently some of my Republican colleagues – ‘Don’t worry about some of the Medicaid reforms, those are scheduled so far in the future they’ll never take effect.’ I’ve got to confirm those comments. … I think those comments are going to really put the motion to proceed in jeopardy, whether it’s on my part or others.”

He continued: “Many of us, one of the main reasons we are willing to support a bill that doesn’t even come close to repealing Obamacare . . . was because at least we were devolving the management back to the states, and putting some level of sustainability into an unsustainable entitlement program. If our leader is basically saying don’t worry about it, we’ve designed it so that those reforms will never take effect, first of all, that’s a pretty significant breach of trust, and why support the bill then?”


Additional time has never been an asset for the administration. The more time that passes, the more anger Team Trump seems to induce in wavering members.

CNN reported:

“Vice President Pence and top Medicare and Medicaid administrator Seema Verma were deployed to Rhode Island over the weekend to meet with skeptical governors at the National Governors Association’s summer meeting. In private meetings, Pence and Verma tried to convince governors that the GOP’s health care bill would give them greater flexibility to design Medicaid programs that were better tailored to their needs.

“But the weekend didn’t go especially well for the administration. After a speech in which Pence claimed 60,000 disabled Ohioans were waiting to get care, a spokesman for Ohio Republican Gov. John Kasich dismissed the claim as false on Twitter.

“Connecticut Democratic Gov. Dan Malloy described Pence’s private meeting with the governors Saturday as “pretty atrocious” as Pence encouraged governors to dismiss an unfavorable score from the Congressional Budget Office that showed 15 million Americans would lose Medicaid coverage over the next decade.”

And of course the Congressional Budget Office’s scoring on the newest version of the bill has yet to come out. Each time the CBO has produced a score, decried as fake by the White House, a spasm of concern has gripped the Republican caucus. Republicans get cold(er) feet with each reminder of how many people will lose insurance, be cut off from Medicaid and/or have to pay more for coverage. On the floor of the Senate, Minority Leader Charles Schumer, D-N.Y., needled Republicans, imploring them to use the time to secure a CBO score and to hold hearings on the bill. (He told Republicans they should “use this extra week, or extra weeks, to do what Republicans should have done a long time ago: hold public hearings. Allow the stakeholders to come in and express their concerns.” That idea likely sends shivers down the spines of most Republicans as they contemplate the parade of doctors, patients, insurers, advocates for the elderly and other witnesses who would come forward.)

In sum, given the choice between holding up the Senate until McCain returns and changing at least two of the declared “no” votes, or moving on so as to avoid the agony of extended dismal coverage and the humiliation of a losing vote on the floor, wouldn’t Republicans rather proceed to the debt limit, the budget and tax reform? Let’s be candid: McConnell knows that forcing some of his members (especially Dean Heller of Nevada) to vote in support of a grossly unpopular bill would be a political death sentence. He cannot in his heart of hearts be thrilled with the prospect of a vote, especially one he will now almost certainly lose; all he need to do is show he tried everything possible.

Initially, McConnell may have figured a ridiculously early deadline for a vote in July could have cleared the decks (win or lose), but now he has a ready-made excuse for ditching the whole exercise. Sure, they can come back to the bill – sometime. Gosh, if only McCain hadn’t gotten ill. Well, now we’ve got four “no” votes. Let a hundred excuses bloom.

Jennifer Rubin is a columnist for The Washington Post.

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