John McCain’s absence from the Senate as he recovers from surgery has led Republican leadership to postpone consideration of the troubled healthcare bill. Surgeons in Phoenix removed a blood clot from above 80-year-old McCain’s left eye on Friday.

“While John is recovering,” Senate majority leader Mitch McConnell said in a statement late on Saturday, “the Senate will continue our work on legislative items and nominations, and will defer consideration of the Better Care Act.”

John Cornyn of Texas, the No2 Senate Republican, told NBC’s Meet the Press on Sunday there should be a vote once a “full contingent of senators” was available.

McCain predicted last week that the bill would fail when senators back in their home states for the summer recess – which McConnell delayed by three weeks – heard strong opposition from voters.

On Sunday, a Washington Post/ABC News poll put public support for Barack Obama’s Affordable Care Act (ACA), popularly known as Obamacare, over its possible Republican replacement at 50% to 24%, or two to one.

With a 52-48 majority, Republicans can afford to lose only two of their own party. One conservative, Rand Paul of Kentucky, and a moderate, Susan Collins of Maine, have said they will vote against the measure.

The White House has put its weight behind the bill, with Donald Trump seeking to influence wavering senators, of whom Collins said on Sunday there remained “eight to 10” with “serious concerns”. Collins said she had been contacted by Trump’s chief of staff, Reince Priebus.



In addition to its effects on access to health insurance, the Senate bill mandates huge cuts to Medicaid, which is relied upon by many old or low-income Americans.

Addressing a meeting of state governors in Rhode Island this weekend, vice-president Mike Pence said: “President Trump and I believe the Senate healthcare bill strengthens and secures Medicaid for the neediest in our society. And this bill puts this vital American program on a pathway to long-term sustainability.”



On CNN’s State of the Union on Sunday, Collins said she would “respectfully disagree with the vice-president’s analysis”.

“This bill would impose fundamental, sweeping changes in the Medicaid program and those include very deep cuts,” she said.

“Those would affect some of the most vulnerable people in society including disabled children and poor seniors. It would affect the rural hospitals, nursing homes. They would have a very difficult time even staying in existence, serving vulnerable populations. So no, I see it very differently.

“You can’t take more than $700bn out of the Medicaid program and not think it’s going to have some kind of effect.”

On CBS’s Face the Nation, Paul said he was against the Senate bill because “it’s not repeal”. “Everybody’s going to discover that it keeps the fundamental flaw of Obamacare,” he said. “It keeps the insurance mandates that cause the prices to rise.”

On Saturday, two insurance industry giants said in an open letter to McConnell that a provision authored by the Texas conservative Ted Cruz was “unworkable in any form” as it would “undermine protections for those with pre-existing medical conditions”, increase premiums and lead to “widespread terminations of coverage”.



The Cruz provision would allow insurers to sell basic, “bare bones” plans as well as the comprehensive coverage mandated under the ACA. The open letter was issued by America’s Health Care Plans and the BlueCross BlueShield Association.

On Sunday, Collins said the Cruz provision was “not the answer”. Paul said that though Cruz and another hardliner, Mike Lee of Utah, were “trying to do what’s right”, their amendment was compromised by having been “done in the context of keeping all of the overall regulatory scheme of Obamacare”.

The nonpartisan Congressional Budget Office (CBO) score for the first version of the Senate bill said it would cause 22 million people to lose access to health insurance in 10 years. A House bill, passed in May to great fanfare from Trump, scored worse. The White House responded by criticising CBO methodology and accuracy.

A new CBO score and a procedural Senate vote had been been expected in the coming days, the vote cast as a showdown over the replacement of the ACA, which Republicans have tried to achieve for seven years. In 2013 such efforts in the Senate, led by Cruz, led to a government shutdown.

McConnell and other Republican leaders have been urging senators to at least vote in favour of opening debate, which would allow amendments to be offered. In recent days GOP leaders expressed optimism that they were getting closer to a version that could pass the Senate.

On Thursday, speaking to reporters on Air Force One, Trump said healthcare reform was “the only thing more difficult than peace between Israel and the Palestinians”.

