Senator John McCain has voted during the last two days to consider—not approve—a practically empty vessel which Republicans will try filling with legislative cargo; to waive Senate rules restricting an amendment as-written; against adopting one of those amendments as working language for a bill; and against sending the health insurance reform process to committees under one Democratic-favored condition.
I specify “McCain” because the commentariat has anointed him as this legislative melodrama’s main character: either “a f—ing disgrace” or “our greatest American,” depending on whether you side with the Sharks or the Vet.
Since he returned to his office on Tuesday afternoon, the Arizona senator has preached like a statesman and voted like a mainstream Republican, a familiar combination since President Obama’s second term. With that, here is the evolution of health insurance reform this week (so far) told through the votes of John McCain.
Tuesday
(1) A vote on the motion to proceed to H.R. 1628, the American Health Care Act of 2017.
McCain: Yea.
The House-approved health insurance reform package, the American Health Care Act, always stood zero chance of passing the upper chamber. However, the fact that bill made it out the House at all is of use to Senate Republicans trying to advance the legislative process. If they take it up, amend it, and approve it, it would return to the House, which could alter it further, or initiate a negotiation of differences with the Senate in a conference committee.
McCain voted in the affirmative with 49 of his colleagues on Tuesday afternoon for the “take it up” portion of the program. Had he or another GOP lawmaker cast a nay, the current deliberations never would have begun. McCain inveighed against the way his party has overseen health insurance reform: bypassing committees, which draw up legislation and report it to the full chamber. But the current circumstances notwithstanding, he supported furthering the Senate’s work. “It’s a shell of a bill right now. We all know that,” he said in well-received remarks after the vote. “I have changes urged by my state’s governor that will have to be included to earn my support for final passage of any bill.”
(2) A vote on the motion to waive all applicable budgetary discipline re: amdt. no. 270.
McCain: Yea.
Senator Patty Murray, ranking member of the budget committee, objected Tuesday evening to an amendment containing the updated text of the Senate’s Better Care Reconciliation Act for violating requirements governing the legislative process. This amendment contained a provision from Sen. Ted Cruz allowing insurers offering Obamacare-compliant insurance to also sell non-compliant plans—stay with me, if you can—as well as an extra $100 billion proposed by Sen. Rob Portman to assist low-income individuals on the market.
Murray’s complaint was that the Congressional Budget Office had not evaluated these ideas before the Senate voted on them, in violation of budget rules. Overcoming her “point of order” would have required 60 yea votes. Republicans were only able to muster 43, including McCain. (Although this was a technical vote, it also could have been a test of how senators would have approved or disapproved of the amendment. In any event, it would not have concluded the amendment process.)
Wednesday
(1) A vote on the adoption of partial repeal of the Affordable Care Act with a two-year delay.
McCain: Nay.
The Senate passed a measure similar to this one two years ago, when President Obama could be counted on to veto it.
Among other changes, this amendment would have eliminated several of the law’s taxes and repealed Obamacare’s individual mandate, but left its regulations—including those pertaining to people with pre-existing health conditions—in place.
It is widely acknowledged that this combination would doom the individual insurance market. Senator Rand Paul’s contention was that the economic and political realities of repealing much of Obamacare a couple of years from now would give legislators the necessary urgency to work on a replacement.
McCain voted nay, and the proposal failed 45-55. (Again, the amendment process would not have ended had the result been different.)
(2) A vote on the motion to commit H.R. 1628 to relevant committees with instructions to strip the legislation of its Medicaid language.
McCain: Nay.
This proposal is relatively straightforward—and given McCain’s Tuesday complaint that the Senate had deviated from “regular order,” a proposal that seems to approach his wishes.
“Let the Health, Education, Labor, and Pensions Committee under Chairman [Lamar] Alexander and Ranking Member Murray hold hearings,” he said, “try to report a bill out of committee with contributions from both sides, then bring it to the floor for amendment and debate, and see if we can pass something that will be imperfect, full of compromises, and not very pleasing to implacable partisans on either side, but that might provide workable solutions to problems Americans are struggling with today.”
Yet McCain voted no on party lines, resulting in a 48-52 tally.
(3) The coming votes . . .
The Senate is expected to continue debate and participate in a “vote-a-rama” of amendments through Thursday. McCain has proposed three Medicaid-related amendments himself: one that he says would protect Arizona’s decision to expand eligibility in 2000, prior to Obamacare; another that would phase out the law’s Medicaid expansion over a decade (the most generous Republican offering of its kind); and an additional one that would tie Medicaid’s growth rate to a more generous measure of inflation than one advocated by his more conservative peers.
The most-watched vote on the horizon is a “skinny repeal” of Obamacare, which would eliminate the law’s individual and employer mandates and taxes on medical device companies—but leave its core regulations and subsidies, as well as Medicaid, untouched.
Such a limited bill could be unobjectionable enough to the GOP’s rightward and centrist flanks to earn the bare 50 yeas needed for passage, with the idea that the House and Senate would then select conferees to hammer out major differences between the two chambers.
While this might not be a long way off on the calendar, it’s million years away in the sequence of votes on health insurance reform. The process is only in its nascent stages.
A previous version of this post mistakenly listed McCain as a “yea” on the Paul amendment.
