The Senate early Friday rejected a new, scaled-down Republican plan to repeal parts of the Affordable Care Act, seemingly derailing the Republicans’ seven-year campaign to dismantle the health care law.

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WASHINGTON — The Senate early Friday rejected a new, scaled-down Republican plan to repeal parts of the Affordable Care Act, seemingly derailing the Republicans’ seven-year campaign to dismantle the health care law.

Sen. John McCain, R-Ariz., cast the decisive vote to defeat the proposal, joining two other Republicans, Susan Collins of Maine and Lisa Murkowski of Alaska, in opposing it.

The vote was a huge setback for the majority leader, Mitch McConnell of Kentucky, who has spent the past three months trying to devise a repeal bill that could win support from members of his caucus.

The truncated Republican plan was far less than what Republicans once envisioned. Republican leaders, unable to overcome complaints from both moderate and conservative members of their caucus, said the skeletal plan was just a vehicle to permit negotiations with the House, which passed a much more ambitious repeal bill in early May.

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The so-called “skinny” repeal bill, as it became known at the Capitol this week, would still have broad effects on health care. The bill would increase the number of people who are uninsured by 15 million next year compared with current law, according to the nonpartisan Congressional Budget Office. Premiums for people buying insurance on their own would increase by roughly 20 percent, the budget office said.

The new, eight-page Senate bill, called the Health Care Freedom Act, was unveiled just hours before the vote. It would end the requirement that most people have health coverage, known as the individual mandate, but it would not put in place other incentives for people to obtain coverage — a situation that insurers say would leave them with a pool of sicker, costlier customers. It would also end the requirement that large employers offer coverage to their workers.

The “skinny repeal” would delay a tax on medical devices. It would also cut off federal funds for Planned Parenthood for one year and increase federal grants to community health centers. And it would increase the limit on contributions to tax-favored health savings accounts.

In addition, the bill would make it much easier for states to waive federal requirements that health insurance plans provide consumers with a minimum set of benefits like maternity care and prescription drugs. It would also eliminate funds provided by the Affordable Care Act for a wide range of prevention and public health programs.

Before rolling out the new legislation, Senate leaders had to deal with a rebellion from Republican senators who demanded assurances that the legislation would never become law.

On Thursday night, Ryan tried to reassure senators as he goaded them to act. “If moving forward requires a conference committee, that is something the House is willing to do,” he said in a statement. “The reality, however, is that repealing and replacing Obamacare still ultimately requires the Senate to produce 51 votes for an actual plan.”

That was an unusual pitch, considering that in normal House-Senate conferences each chamber advocates its version of a bill.

“The skinny plan manages to anger everyone — conservatives who know it’s a surrender and know it doesn’t come close to the full repeal they promised, and moderates who know it will be terrible for their constituents,” said the Senate Democratic leader, Chuck Schumer of New York.