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Latest Republican Attempt To Repeal Obamacare Dies In The Senate

STEVE INSKEEP: Here's the thing that finally killed a Senate health care bill - two more Republican senators finally said what a lot of them were reportedly thinking. They weren't even interested in debating the proposal to replace the Affordable Care Act. The statements by Senators Mike Lee and Jerry Moran meant that Republicans no longer had the votes to move forward, which is fine for some Republicans who really did not want to take steps like rolling back Medicaid. It's also fine for Democrats, who know that Obamacare is as popular as it's ever been. But it is not at all the end of the story, which our colleague Scott Horsley is going to help us tell. Hi, Scott.

SCOTT HORSLEY, BYLINE: Good to be with you, Steve.

INSKEEP: So what's not to like about the Senate bill?

HORSLEY: Well, there was plenty. There was opposition from all sides. The fatal blow came from the right. Senators Jerry Moran of Kansas and Mike Lee of Utah objected that this bill didn't go far enough in unwinding Obamacare. And it was sort of politically clever of them to come out simultaneously against it. It's like giving a blank to one member of the firing squad. No senator has to take responsibility for being the vote that killed the repeal.

INSKEEP: Oh. They went to - they went one vote beyond what they needed to go since two of them came out at the same time.

HORSLEY: Exactly. So everyone can sort of point to the other and say, well, his was the one that did it in. Now that it's dead though, we may see sort of a rush to the exits because there was opposition from moderate senators, as well, who thought this bill went too far.

INSKEEP: And, of course, different reasons from different senators for objecting to it. But there are also different options available to Senate leaders, and Senator Moran offered one of them. He said in this statement - in rejecting the bill, he said, let's start fresh with an open legislative process. Which sounds like doing things like committee hearings and actually discussing legislation in public and involving Democrats. Is that what the Senate majority leader, Mitch McConnell, wants to do?

HORSLEY: No, at least not yet. His next play is to bring back the straight up Obamacare repeal that the Senate passed back in 2015 and say, we'll repeal first and replace later or maybe never. That was McConnell's original plan at the beginning of this year. But it was then - it was President Trump who said, no, no. We have to do replacement at the same time. And that's what they've been struggling with. Trump is now on board though with the repeal-first-replace-later plan. He tweeted last night that that's a way to get a clean slate. And he suggested that Democrats would join in that effort.

INSKEEP: Haven't there been a lot of insurance companies and other people in the health care industry warning that that could be - well, that could lead to chaos because you'd repeal it without any certainty about what comes next?

HORSLEY: Yeah. It's a recipe for disaster. The Congressional Budget Office at the beginning of the year looked at what repeal only would mean. And it would not only, of course, unwind the Medicaid expansion and throw millions of people off Medicaid, but it would really undermine the individual insurance market even more so than is the case now because it leaves in place the requirement for insurance companies to cover everyone but takes away the mandate that everyone buy insurance. So it's really a problematic proposal.

INSKEEP: Although it would certainly be politically awkward for Republicans to be presented with this vote to just straight up repeal Obamacare since so many of them campaigned on repealing Obamacare. And many of them actually voted to repeal Obamacare back when it wasn't possible to do, since President Obama was president.

HORSLEY: Right. That's McConnell's argument that, look, this is a plan we have already approved. The Senate did pass this bill back in 2015 when Obama was president and vetoed it. What they have discovered, of course - it was a lot easier to cast symbolic votes against Obamacare when they didn't really have responsibility. Now they own all three branches of government, and they have to take responsibility for the lives at stake.

INSKEEP: So Robert Costa of The Washington Post put some reporting on Twitter last night, a thread of tweets. And several of them were quite interesting, including this one. And this is based on his reporting. This is his understanding of what some Republicans in Congress think.

(Reading) Most elected Republicans do not fear a primary challenge if they buck repeal. They see their political base as focused on grievances and fake news and not obsessed with the Affordable Care Act.

Does that sound right to you, Scott, that there might not be any political price to pay for walking away from repeal?

HORSLEY: Well, Robert Costa is a smart political reporter, smarter than I. But it's a very interesting perspective because, you know, the Republican argument here has been it's better to pass a bad bill than no bill at all, that they can't simply walk away. If Costa's right, then maybe they can walk away from a bad bill and not pay a political price.

They've also been arguing that Obamacare is in such dire straits that they have to do something. In fact, a lot of health care experts say Obamacare appears to be stabilizing. There are certainly steps that lawmakers could take to shore it up, but it may not be the disaster that forces the Senate to consider an even worse proposal.

INSKEEP: Scott, always a pleasure talking with you. Thanks very much.

HORSLEY: My pleasure, Steve.

INSKEEP: That's NPR's Scott Horsley. Transcript provided by NPR, Copyright NPR.

Scott Horsley is NPR's Chief Economics Correspondent. He reports on ups and downs in the national economy as well as fault lines between booming and busting communities.