Since the Senate released its second version of its health care bill last week, it had been stuck on two Republican "no" votes, Maine Sen. Susan Collins and Kentucky Sen. Rand Paul. It would have been quite hard for any Republican senator to be the third to go, since that would kill the bill. That's changed Monday night, as a third and fourth senator, Utah Sen. Mike Lee and Kansas Sen. Jerry Moran, have come out jointly to oppose the motion to proceed. And it’s Moran’s statement that’s the bigger problem—one that might put this process to bed.
Lee had withheld his support because the version of the deregulatory “Consumer Freedom Amendment” that he and Texas Sen. Ted Cruz asked for—which was added to the most recent version of the bill—didn’t go far enough. Lee explained in a post that he wants a certain Obamacare provision eliminated before he can vote to proceed to debate. “The full, original version of the Consumer Freedom Amendment is the best chance we can give them,” Lee wrote in explaining his opposition.
Moran, though, is not asking for one little policy tweak. From his statement (emphasis mine):
We should not put our stamp of approval on bad policy. Furthermore, if we leave the federal government in control of everyday healthcare decisions, it is more likely that our healthcare system will devolve into a single-payer system, which would require a massive federal spending increase. We must now start fresh with an open legislative process to develop innovative solutions that provide greater personal choice, protections for pre-existing conditions, increased access and lower overall costs for Kansans.
Even if Lee was given what he wanted, there would still be three hard noes who seem fed up with the fundamental structure of and process behind Trumpcare. (And now that this version is dead, the floodgates are open for all other senators with concerns to jump ship.) It is unclear how Senate Majority Leader Mitch McConnell gets around that. If this is the end of Trumpcare—and let's not write off McConnell just yet—then Jerry Moran, a typically reliable vote, will go down as a legend.
Update, 10:53 p.m.: The votes are not there for the Better Care Reconciliation Act. But that doesn't mean there won't be any votes! McConnell released the following statement tonight:
The "first amendment" McConnell is referring to is the "test run" bill that the House and Senate each passed in 2015 to see how much of Obamacare they could eliminate under reconciliation. (Coincidentally, while the test run bill eliminates as much of Obamacare's taxes and spending as possible, it does not touch any of the market regulations that so arouse conservatives' ire.)
That bill, though, was passed when House and Senate Republicans knew that President Obama would veto it, and they wouldn't have to live with its consequences. When the Congressional Budget Office, at Democrats' request, rescored the 2015 legislation earlier this year, they found that it would increase the uninsured ranks by 32 million and double premiums over 10 years. It will be... quite difficult to pass that. McConnell may just be offering a sacrifice to conservatives (and the president).
The process may never get that far. The Senate will have to vote first to take up the House bill with a procedural vote that could very well fail.