Republican bill to roll back health care law defeated

WASHINGTON — Senate Republicans suffered a significant setback Friday morning in their drive to fulfill a seven-year campaign promise to dismantle the Affordable Care Act when a plan to advance a scaled-back version of the bill went down to defeat.

The Republican measure was rejected 51-49 as three Republicans — Sens. John McCain of Arizona, Susan Collins of Maine, and Lisa Murkowski of Alaska — joined a unified Democratic caucus in opposition.

The bill, an eight-page plan called the Health Care Freedom Act, had been released by Senate Majority Leader Mitch McConnell just hours before the vote ended at about 1:40 a.m. EDT.

“Our only regret is that we didn’t achieve what we hoped to accomplish,” McConnell said after the failed vote. McConnell, in a dejected tone, pulled the entire legislation from consideration and set up votes on nominations.

From left, Sen. Lindsey Graham, R-S.C., Sen. Ron Johnson, R-Wis., Sen. Bill Cassidy, R-La., and Sen. John McCain, R-Ariz., speak to reporters at the Capitol as the Republican-controlled Senate unable to fulfill their political promise to repeal and replace "Obamacare" because of opposition and wavering within the GOP ranks, in Washington, Thursday, July 27, 2017. (AP Photo/J. Scott Applewhite) less From left, Sen. Lindsey Graham, R-S.C., Sen. Ron Johnson, R-Wis., Sen. Bill Cassidy, R-La., and Sen. John McCain, R-Ariz., speak to reporters at the Capitol as the Republican-controlled Senate unable to fulfill ... more Photo: J. Scott Applewhite, Associated Press Photo: J. Scott Applewhite, Associated Press Image 1 of / 3 Caption Close Republican bill to roll back health care law defeated 1 / 3 Back to Gallery

“It’s time to move on,” he said.

Senate Minority Leader Charles Schumer of New York offered a conciliatory note. “We are not celebrating,” he said. “We are relieved. It’s time to turn the page.”

The plan would have revoked the current law’s mandate on individuals to buy insurance and end the requirement on employers who have 50 or more workers to provide insurance coverage. It would also have reversed the Affordable Care Act’s tax on medical devices.

The measure would have eliminated funds for preventive health care provided under the 2010 law and prohibit Medicaid beneficiaries from being reimbursed for Planned Parenthood services for one year. Instead, the bill directed the federal funding that would have gone to Planned Parenthood to go to community health centers.

It had been created only as a vehicle for Senate passage by a deeply divided Republican caucus to get it to conference committee, where negotiations on a larger bill were expected to take place between leaders of the Senate and House, which passed its own version of an Affordable Care Act replacement in May.

The vote was expected to be close, and Vice President Mike Pence arrived at the Capitol at 11:30 p.m. in case he was needed to cast a tie-breaking vote. Republicans could afford to lose only two votes, but McCain announced Thursday afternoon he would oppose the bill unless he was assured that a larger health care plan would emerge in negotiations reconciling the Senate plan and a House bill approved in May.

He disclosed his intent amid rumors flying through the Capitol that the House might pass the same slimmed-down bill and send it to President Trump for his signature. In a report released Thursday, the nonpartisan Congressional Budget Office said such a bill would cause 16 million Americans to lose coverage and raise insurance premiums by roughly 20 percent a year.

House Speaker Paul Ryan, R-Wis., provided assurances that he was willing to use the Senate proposal as a basis for negotiating a broader rollback of the current law, and would not move to quickly approve the bill in its current form. But McCain said the assurance wasn’t strong enough.

In addition to the impacts outlined by the Congressional Budget Office, health policy analysts and insurers, along with Republican and Democratic governors, said such a repeal would quickly cause the collapse of exchange markets for individual insurance — including Covered California and its 1.4 million enrollees.

Uncertain of the outcome, House Majority Leader Kevin McCarthy, R-Bakersfield, issued a notice to members to “remain flexible in their travel plans over the next few days” to accommodate a potential House vote on the Senate’s legislation.

House Minority Leader Nancy Pelosi, D-San Francisco, alerted Democrats that House Republicans had invoked “martial law” to allow passage of the Senate bill, waiving rules requiring at least a day between announcement of legislation and a vote on it.

“We now expect Senate Republicans will seek to pass Trumpcare in the dead of night and House Republicans will use martial law to jam it through the House as early as tomorrow,” Pelosi warned. “If any Republican senators are counting on House Republicans to rescue them from the consequences of their votes, they and millions of hard-working Americans are in for a very rough time.”

Trump had made clear he would sign anything that comes out of Congress to “end the Obamacare nightmare.”

For now, what will happen next was unclear.

Sen. Kamala Harris, D-Calif., praised the Senate vote and voters who registered their opposition to their senators’ offices. “Tonight health care was saved for millions of Americans,” she tweeted. “This is your victory. Your calls, letters, and courage made this possible.”

The Washington Post and Chronicle wire services contributed to this report.

Carolyn Lochhead is The San Francisco Chronicle’s Washington correspondent. Email: CLochhead@sfchronicle.com