There was something for everyone to dislike in the legislation. Promptly, a bloc of conservatives voiced their opposition, followed by a chorus of centrist Republicans. The bill was going nowhere fast. Having originally scheduled a vote before the July Fourth recess, without any committee hearings or extended floor debate, McConnell was forced to postpone any such action into July due to schisms in his party.
Things didn’t get any easier after the recess. Republicans spent the first three weeks of July bickering over changes to the bill, only to discover that any alteration that gained two votes was costing them three. The balancing act appeared impossible. At one point, McConnell threw up his hands and declared the “replace” part of their mission dead, announcing that Senate Republicans would vote on a repeal-only bill. (For a man touted as the canniest governmental operator since Pericles, it was something of a reputation-deflating summer.)
McConnell’s decision only fanned the internal angst. His colleagues trashed the notion of giving up—or of stripping coverage from millions of Americans without offering a substitute. The GOP leadership went back to the drawing board, soliciting final suggestions for a modified bill. Finally, on July 25, McConnell directed the Senate to begin debate on legislation to repeal and replace the Affordable Care Act.
Enter the Hollywood scriptwriters.
Earlier in the month, John McCain, who’d been missing from the Senate due to what his office described as eye surgery, announced that he had cancer. It was glioblastoma, the same lethal brain tumor that had killed his friend Ted Kennedy. Washington was shaken by the news. There was no spinning what it meant. McCain, the man who seemed immortal after surviving five and half brutal years as a prisoner of war in Vietnam, was going to die soon.
Returning to the Capitol for the first time since his diagnosis, McCain stormed the Senate floor with the last major speech of his distinguished career.
“Our responsibilities are important, vitally important, to the continued success of our Republic. And our arcane rules and customs are deliberately intended to require broad cooperation to function well at all,” McCain said. “The most revered members of this institution accepted the necessity of compromise in order to make incremental progress on solving America’s problems and to defend her from her adversaries.”
He went on: “That principled mind-set, and the service of our predecessors who possessed it, come to mind when I hear the Senate referred to as ‘The world’s greatest deliberative body.’ I’m not sure we can claim that distinction with a straight face today.”
The crux of his complaint, with McConnell and the health care push, was that the GOP had abandoned “regular order,” the process of writing bills in committees, debating them, allowing amendments to be offered, and then subjecting them to scrutiny on the floor of the Senate. McCain had spent three decades in the upper chamber advocating this practice of transparency. He was not going to forsake it in the twilight of his life. The Arizona senator announced that he would vote against the bill, and urged McConnell to start from scratch, working with Senate Democrats on a bipartisan solution.
McConnell did not heed this advice. After failing to advance the repeal-and-replace bill on July 25, and failing to pass a repeal-only bill on July 26, the Senate majority leader brought forth a new piece of legislation on July 27. (To be clear, the procedural hypocrisy here was gobsmacking: McConnell and other Republicans had spent the previous eight years accusing Democrats of shoving ill-considered legislation down the public’s throat, only to spend their first year in charge of Washington crafting laws in the dead of night and voting on them without hearings, markups, debates, polling, or input from constituents.)
Nicknamed “skinny repeal,” the newest legislation from McConnell represented a scaled-down version of the Senate’s earlier efforts. The contents were unimportant at this point: McConnell told Senate Republicans they simply needed to pass a health care bill, any health care bill, so that they could enter into conference committee negotiations with the House. At that point, they would worry about the final details.
Buying into this strategy, 49 of the 52 Republicans were in favor. Two were opposed: Alaska’s Lisa Murkowski and Maine’s Susan Collins. The deciding vote belonged to McCain. If he backed the effort, Pence, the constitutional tie-breaker, would approve passage of the bill. A conference committee would be created. Ryan and McConnell would craft a final product and have Trump throw the full weight of his presidency behind it. Obamacare repeal would be on the one-yard line, and Republicans, facing the fury of their voters, wouldn’t dare refuse to push it over the plane.
The senator from Arizona was nowhere to be found. He had disappeared from the chamber. As senators murmured of his whereabouts, McCain was on the phone with Ryan. He respected the young Speaker and wanted his commitment—his word—that the conference committee bill would be negotiated in the open and debated in the daylight, unlike the current bill before the Senate, which had been scraped together in a matter of hours and tossed onto the floor. Ryan promised him that it would be so. McCain, in turn, told Ryan he planned to vote yes.
It was midnight. Ryan called McConnell to confirm McCain’s support. “He’s good,” Ryan said. Thinking it was a done deal, the Speaker went to sleep.
A short while later, McCain walked onto the Senate floor. He chatted with Pence. He walked over to the Democrats’ side and held court. Then, after the final vote was called, McCain disappeared again. With all of Washington holding its collective breath, the Arizona senator reemerged, walked toward the clerk’s desk, and raised his hand flat in the air. He held it steady for several moments, then gave an emphatic thumbs-down.
Gasps filled the room as the aging senator turned and ambled to his desk. The Republican drive to repeal Obamacare was dead. McCain had preserved the legacy-defining achievement of the very man who had defeated him for the presidency.
THERE WAS PLENTY OF BLAME TO GO AROUND FOR REPUBLICANS’ FAILURE to deliver on the promise that had animated the party since the spring of 2010. Ryan had botched the rollout of the original bill. McConnell had been unprepared to act when the House passed its later version. Conservatives and moderates alike had failed to pressure their leadership to bring the process out of the shadows, fueling charges of hypocrisy from the left. And of course, McCain, a favorite scourge of the conservative base, had dealt the fatal blow to the repeal-and-replace crusade.
The one politician seemingly spared of all culpability in the eyes of Republican voters was Trump, whose approval rating with the base didn’t budge. Polling showed GOP voters blaming Congress, far more than the president, for the failure to repeal Obamacare.2 Reported vignettes from across the land revealed a grace period for a president who was predated by dysfunction in his party. “I really don’t think people are trying to help Trump,” Melinda James, a supporter from Broadview Heights, Ohio, told PBS after the failed House effort in March. “We need to unify. We need to give him a chance.”3
Trump had tilled the field for this. Having spent the past two years railing against do-nothing politicians who never follow through on their promises, the president walked into a win-win. If Republicans delivered, he would be hailed as the redeemer of the party; if Republicans fell short, he would be excused as a sympathetic figure, another victim of an undrainable swamp.