In a dramatic and unexpected turn of events, Sen. John McCain, R-Ariz., cast the decisive vote against the Senate health care bill after midnight Thursday, telling reporters to “watch the show” to see where he stood on the bill. His vivid thumbs-down as he intoned his no overshadowed two of his Republican colleagues, Sen. Susan Collins of Maine and Sen. Lisa Murkowski of Alaska, who had consistently opposed the Obamacare repeal in the face of pressure from the Trump administration and a (presumably jocular) threat of a duel from a congressman from Texas.

The three were joined by every Senate Democrat to sink the “skinny repeal,” the Republicans’ last-ditch effort to undo the Affordable Care Act. One Republican had to join Collins and Murkowski to avoid a tie that would have been broken with a yes from Vice President Pence. In the normal course, McCain would have voted before Murkowski, making hers the decisive third no, but when his name was called, the Arizonan was absent from the chamber. When he reappeared on the Senate floor, he strode directly to the clerk with his arm raised before casting the vote that elicited gasps from Republicans and applause from Democrats.

McCain, 80, recovering from surgery after being diagnosed with brain cancer, had returned to Washington at the beginning of the week and cast an equally decisive vote in the other direction, allowing a version of the Republican bill to proceed, before delivering a stirring speech calling for an end to the hyperpartisan and irregular manner in which the bill had been fashioned.

Collins and Murkowski have more quietly and more consistently opposed the various iterations of health care reform put forward by Senate Majority Leader Mitch McConnell and have been targeted as a result.

Sen. Susan Collins, Sen. John McCain and Sen. Lisa Murkowski. (Photos: Getty Images)

Last week, Rep. Blake Farenthold, R-Texas, said in an interview, “Listen, the fact that the Senate does not have the courage to do some of the things that every Republican in the Senate promised to do is just absolutely repugnant to me.”

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“Some of the people that are opposed to this — there are some female senators from the Northeast — if it was a guy from South Texas, I might ask him to step outside and settle this Aaron Burr-style,” he continued, apparently challenging Collins while referencing the 1804 shootout in which Aaron Burr killed Alexander Hamilton. Collins said Farenthold later apologized.

Murkowski was called out by President Trump directly, on the commander in chief’s favorite platform. After she voted no on the motion to proceed Tuesday, Trump tweeted she had “really let the Republicans, and our country, down.”

Senator @lisamurkowski of the Great State of Alaska really let the Republicans, and our country, down yesterday. Too bad! — Donald J. Trump (@realDonaldTrump) July 26, 2017





In the canon of Trump criticism, the tweet was mild. However, another member of the administration went further. Alaska Dispatch News reported that Interior Secretary Ryan Zinke threatened to punish Murkowski’s state over her rejection of health care reform.

When Rep. Buddy Carter, R-Ga., was asked about Trump singling out Murkowski, he said it was “perfectly fair,” before advocating a different approach to the matter.

“Somebody needs to go over there to that Senate and snatch a knot in their ass,” Carter said. The regional term “snatch a knot in” means “hit.”

Still, Collins and Murkowski broke with the majority of their party and with McCain defeated “skinny repeal,” ending — for now — the GOP’s effort to dismantle the Affordable Care Act. McCain’s vote received outsize attention partly because it was unexpected, but it still led many to argue the Republican women were being overlooked.

Giving McCain the credit for defeating this repeal when female Senators Murkowski & Collins were early NOs is EVERY WORK MEETING EVER. — Jenny Yang (@jennyyangtv) July 28, 2017





Collins, Murkowski, and McCain have all released statements on health care reform, advocating for a more transparent and bipartisan process in addressing Obamacare’s flaws.

After the vote, Senate Minority Leader Chuck Schumer was visibly emotional while speaking about McCain on the floor of the chambers. Later, he told reporters, “Given his stature, his remarks at the beginning when he came in, moved everybody and I think that helped. He’s a hero. He’s a hero of mine.”

At a press conference this morning, he reiterated McCain was on “the top of the list” of people he credited with beating back Obamacare repeal, before referring to the less showy, but equally important, votes cast by Collins and Murkowski: “Certainly not to be forgotten, of equal praise, are Susan Collins and Lisa Murkowski. They were amazing and women are in so many instances stronger than men. They brag less about it, but they are. And last night sort of proved that.”

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