Not even 24 hours after John McCain dramatically tanked a Republican effort to repeal Obamacare in late July, his best friend, Lindsey Graham, started working feverishly in private to try again.

Graham — who’s never shown much interest in health care policy — quietly trekked to the White House with Sen. Bill Cassidy to try and sell President Donald Trump on their latest proposal that would transform Obamacare into a block grant program for states.


It seemed like an afterthought at the time; Obamacare repeal was all but left for dead. But momentum behind the so-called Graham-Cassidy plan snowballed this month. The unexpected passage of a fiscal deal well ahead of schedule freed up valuable floor time. And McCain’s stated openness to the bill — combined with his friendship with Graham — raised hopes within the GOP.

Ultimately, his friendship with Graham mattered less than McCain's grievances with the lack of scrutiny and lack of bipartisanship surrounding the bill.

“I’ve never known John on something he believes strongly to defer to a friend,” said Charlie Black, a longtime adviser who speaks to McCain regularly. The GOP leadership’s view that McCain would buckle under new pressure or reverse course because Graham was involved “didn’t make sense to me,” Black added.

McCain’s announcement Friday to reject the latest iteration of repeal wasn’t as dramatic as the shocking thumbs-down he motioned to deliver the death blow the last time. But his lengthy statement on Friday was probably just as consequential, dealing most likely a fatal blow to the Senate GOP’s last, best attempt to repeal Obamacare.

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Sen. Rand Paul (R-Ky.) has been adamant in his opposition, detailing his reasons to anyone who'll listen. Sen. Susan Collins (R-Maine) was against previous versions of Obamacare repeal because of their dramatic changes to Medicaid, so GOP leaders counted her as a firm “no” from the start.

But momentum in Graham-Cassidy’s favor began to turn earlier this week, when the unlikely duo seemed to be picking up votes and leadership signaled that the plan could actually get to the floor. In a meeting with his top deputies on Monday evening, Senate Majority Leader Mitch McConnell (R-Ky.) said that holding a vote would help Republicans to get to “yes." But he also recognized the risk of setting up the GOP for failure, according to one person in attendance. Ultimately, McConnell’s office issued a statement that it was his “intention” to hold a vote.

Adding to the bullishness, it was McCain himself who seemed to welcome the push for Graham-Cassidy to begin with. After returning to the Capitol from the four-week August recess and treatment for brain cancer, McCain held court with reporters and swung the door wide open for another try at the health care bill.

Asked whether he was supportive of the bill, McCain answered with a grin: “Yes. You think I wouldn’t be?”

“If it’s not through regular order, then it’s a mistake. Doesn’t mean I wouldn’t vote for it,” McCain said. Pressed on whether he could support the plan if it did not go through committee, he replied: “Yeah. but it’s wrong. Doesn’t make it right to do that.”

McCain seemed to be strongly leaning in favor of the bill then, an explosive development given that he was the surprise “no” this summer. His office then put out a statement saying he preferred a bipartisan approach and needed to study the bill further.

The perceived openness from McCain accelerated Graham and Cassidy’s plans. And while Republicans were shifting toward tax repeal, others wanted to simultaneously continue work on health care.

“There’s an old saying in Louisiana: Good things come to those who work their ass off,” quipped Sen. John Kennedy (R-La.) in mid-September, as the GOP was paralyzed with indecision.

Graham and Cassidy had much work to do: Finishing the bill, rolling it out, persuading governors to back it, getting the White House fully on board and then prodding McConnell to consider it. Arizona GOP Gov. Doug Ducey eventually backed it, a development that had many Republicans confident McCain would get on board.

But McCain grew less committal as time passed and the specter of Graham-Cassidy passing the Senate became a reality.

“We need to go to regular order,” McCain told reporters after meeting with McConnell on Monday. “I am not supportive of the bill yet.”

Still, Senate Republicans privately believed McCain's vote was gettable. Republicans said on Friday that while many outside the Capitol assumed McCain was a “no,” the rest of the caucus hadn’t given up, particularly Graham.

“Graham has felt he could win him over,” one source familiar with the conversations said. “We all knew it was up in the air.”

But McCain appeared to grow increasingly entrenched in his position as the week unfolded.

After Graham indicated to a White House pool reporter on Tuesday that he feels “very good” about McCain’s stance after hearing positively from Ducey, the normally talkative McCain grew far less loquacious.

“I have nothing to say,” he growled when asked about Graham’s sentiments. A day later, after McConnell’s office indicated a vote would come up, McCain was on message — and still grumpy.

Adding to the bullishness of his decision, it was Sen. John McCain (left) himself who seemed to welcome the push for the bill from Sens. Lindsey Graham (right) and Bill Cassidy to begin with. | Chip Somodevilla/Getty Images

“Nothing has changed,” McCain told POLITICO as he hopped off the train connecting the Capitol to the Senate office buildings. When asked whether that made him a “no” vote, he repeatedly said: “I want the regular order.”

That seemed to signal heavily that McCain would end up opposing Graham’s bill. And he made it official Friday, prompting Graham to stress that his work to repeal Obamacare would nonetheless continue and that “my friendship with John McCain is not based on how he votes but respect for how he’s lived his life and the person he is.”

What puzzled McCain’s friends is the idea that a Hail Mary on Obamacare as the clock wound down would ever persuade the sixth-term senator to overcome his convictions. McCain had long railed against the law, but the idea of legislating on the fly to uphold a campaign promise always seemed anathema to the longtime committee chairman.

“Here’s the thing. John has always believed that the Senate ought to operate by regular order, through committees on a bipartisan basis. And he’s always done that,” Black said. “He’s a man you can take at his word in his career. And people should have.”