Very early this morning, Sen. John McCain joined two Republican colleagues in voting "no" on the so-called "skinny repeal" of the Affordable Care Act--effectively killing Sen. Majority Leader Mitch McConnell's last resort on the effort.
What Happens Now?
House Republicans met this morning in what was supposed to be a post-vote conference committee planning meeting on strategies for merging the two repeal bills that passed out of the House and Senate. But...the Senate bill didn't pass, so this meeting will likely focus more on next steps and messaging the latest turn of events.
Meanwhile, Democrats and some Republicans--including McCain--have expressed interest in moving forward with bipartisan efforts on Cost Sharing Reduction funding and a short-term market stabilization package. Senate health committee chairman Lamar Alexander has already prepped for hearings on repairing the individual market. Of course, the divisions in the Senate remain with some conservatives are vehemently opposed to fixing Obamacare. So, getting to a majority would still be a challenge. In addition, the Senate's fall schedule is packed with debt ceiling debates, nominations, the National Defense Authorization Act, appropriations bills, and the budget for fiscal year 2018.
Are Repeal Efforts Dead?
Repealing Obamacare has been a major effort and key promise of the Republican Party for the past 7 years, so it is very unlikely they will abandon the idea. Though, the fact is that the Senate is seemingly irreparably divided on this issue. It's not just about politics or policy; it's an ideological divide over whether government's role in the American healthcare is an intrusion, safety net, watchdog, or protector of what should be a basic right.
What Should Advocates Do Now?
First, thank your legislators who voted against the "skinny" repeal. It has been a very long road for them. But, they stayed strong and their vote means that millions of American families can keep their health coverage for the foreseeable future. Don't forget to thank your fellow advocates and give yourselves big pats on the back!
Next, stay vigilant. Repeal efforts are likely not going to disappear in Congress. State-side, we need to watch for waiver attempts that will exempt the state from Obamacare requirements and result in less access to coverage and a lower quality of care.
Finally, now is the time to offer congressional members and state legislators your ideas for improving healthcare coverage and access. This report from Georgetown University's Center for Children and Families on The Future of Children's Health Coverage is a great place to start.