{"slug":"trump-aca-repeal-mccain-thumbs-down","title":"ACA Repeal Failure: Skinny Repeal Defeated, 23 Million Would Have Lost Coverage","date":"2017-07-28","lastUpdated":"2017-07-28","description":"The Trump administration's effort to repeal the Affordable Care Act — conducted without committee hearings, without a formal bill text until the night before the vote, and without a score from the Congressional Budget Office showing its impact — failed at 1:30 AM on July 28, 2017, when Republican Senators John McCain, Susan Collins, and Lisa Murkowski voted against the 'skinny repeal' bill. The CBO had estimated the bill would cause 15 million Americans to lose health insurance in the first year and 22 million by 2026. Trump had promised during the campaign that no one would lose coverage.","summary":"The Republican-led repeal effort over seven months produced several bills that the CBO estimated would cause tens of millions of Americans to lose health insurance. The final attempt — 'skinny repeal' — was a bill so limited in scope that even its Republican proponents did not want it to become law; its stated purpose was to pass something into conference. John McCain, who had returned from brain cancer treatment to cast the deciding vote, gave a thumbs-down at 1:30 AM to defeat the bill 51-49. Trump's response was to blame Republicans and to threaten to withhold the cost-sharing reduction payments that stabilized the ACA market, causing premiums to rise.","category":"rule-of-law","severity":"major","ongoing":false,"sources":[{"url":"https://www.nytimes.com/2017/07/27/us/politics/obamacare-partial-repeal-senate-vote.html","title":"John McCain Casts Decisive Vote Against 'Skinny Repeal'","publisher":"The New York Times"},{"url":"https://www.washingtonpost.com/news/powerpost/wp/2017/07/28/the-senate-failed-to-pass-the-skinny-obamacare-repeal-bill/","title":"The Senate failed to pass the 'skinny' Obamacare repeal bill","publisher":"The Washington Post"},{"url":"https://www.cbo.gov/publication/52978","title":"CBO Cost Estimate — Better Care Reconciliation Act","publisher":"Congressional Budget Office"},{"url":"https://apnews.com/article/mccain-obamacare-vote-skinny-repeal-trump","title":"Senate GOP fails to pass 'skinny repeal' of Obamacare","publisher":"The Associated Press"}],"draft":false,"status":"published","tags":["ACA","healthcare","McCain","repeal","first-term","rule-of-law","CSR"],"relatedEntries":[],"timeline":[{"date":"2017-01-20","title":"Trump signs executive order directing agencies to undermine ACA","summary":"On his first day, Trump signs an executive order directing agencies to waive, defer, and delay ACA provisions 'to the maximum extent permitted by law.' The order is a signal of intent to undermine the law while legislative repeal is pursued."},{"date":"2017-06-26","title":"Senate ACA repeal bill — CBO: 22 million would lose coverage","summary":"The CBO scores the Better Care Reconciliation Act, finding it would cause 22 million people to lose insurance by 2026. The bill fails to attract enough Republican support to proceed to a vote."},{"date":"2017-07-25","title":"McCain returns from cancer treatment to vote","summary":"McCain, who had been diagnosed with glioblastoma brain cancer days earlier, returns to the Senate to vote on the procedural motion to proceed with ACA debate. He votes to proceed while delivering a speech calling for regular order and bipartisan process."},{"date":"2017-07-28","title":"Skinny repeal fails 49-51 — McCain's thumbs down","summary":"At approximately 1:30 AM, McCain walks to the front of the chamber and gives a thumbs-down, casting the 51st vote against the skinny repeal. The vote is 49-51. The repeal effort ends."},{"date":"2017-10-12","title":"Trump terminates cost-sharing reduction payments","summary":"Trump signs an executive order terminating the CSR payments that helped lower-income ACA enrollees afford their plans. Premiums rise; insurers exit markets. Federal courts find the termination illegal but the damage to market stability is already underway."}],"location":{"name":"Washington, D.C.","lat":38.9072,"lng":-77.0369},"custom":{"era":"first-term","posture":"reported","warCrimeClassification":"enabling","internationalLaw":[],"iccRelevance":false,"victims":"Approximately 22 million Americans who would have lost health insurance under the full repeal bill per CBO; Americans with pre-existing conditions who would have faced coverage exclusions; millions whose premiums increased after Trump ended cost-sharing reduction payments","structuredPerpetrators":[{"name":"Donald Trump","role":"President; pushed for ACA repeal without replacement; later sabotaged ACA through cost-sharing reduction payment termination","institution":"White House"}],"updateLog":[{"date":"2017-10-12","summary":"Updated with CSR payment termination."}]}}