What Ducey told McCain ahead of his big vote to kill GOP 'repeal' bill

Throughout U.S. Senate deliberations over a proposed repeal of the Affordable Care Act, Sen. John McCain repeatedly invoked the name of Gov. Doug Ducey, saying he wanted to ensure any new law didn't punish their home state of Arizona.

"My position on this proposal will be largely guided by Governor Ducey's analysis of how it would impact the people of our state," McCain, R-Ariz., said Thursday during a news conference hours before the late night vote in which he would give a thumbs down to the Senate GOP's so-called "skinny repeal" bill.

"My friends, this is legislation that directly affects the people of my state," he continued. "I trust my governor. I trust his people and he is looking carefully at this."

But despite eventually getting the go-ahead from Ducey, McCain, who turns 81 on Aug. 29 and starts treatment Monday for brain cancer, voted against the "skinny" legislation, killing it and stopping the current Republican push to undo the Affordable Care Act.

The day before, McCain had filed three amendments drafted in consultation with Ducey, who like McCain has long emphasized the need to get rid of the Affordable Care Act — which critics refer to as "Obamacare". Those amendments aimed to shield the Arizona Health Care Cost Containment System, the state's Medicaid program, from any financial hit from the Republican-backed repeal proposal.

However, the amendments became moot after GOP leaders settled on the "skinny repeal" bill. The measure didn't change Medicaid funding, which was at the heart of what had troubled Ducey and AHCCCS officials. It would instead have left the Affordable Care Act largely in place, ending only its individual and employer mandates and repealing, for three years, a medical-device tax, among other changes.

On Thursday afternoon, Ducey tweeted that he agreed with McCain "that the bill on the table clearly isn’t the right approach for Arizona."

But ahead of the early Friday vote — and after talking to Vice President Mike Pence — Ducey spoke by speaker phone to McCain and Sen. Jeff Flake, R-Ariz., in the Senate's GOP cloakroom. During the conversation, Ducey gave his blessing to their voting for the "skinny repeal."

A Republican aide familiar with conversations between the governor and the senators told The Arizona Republic the governor "was OK with this moving forward if it meant it was going to be a vehicle for a better bill."

There were fears that the House GOP might send a Senate-passed "skinny repeal" to President Donald Trump for his signature. Because of such fears, McCain had demanded earlier Thursday that House Republicans agree to a joint House-Senate conference committee to work out a final bill drawing from the two versions passed by each chamber.

Ducey didn't necessarily believe the "skinny" bill was the best policy outcome, the aide said, but he was not opposed to McCain and Flake moving it forward if they thought it could be improved upon and had assurances from leadership.

Ultimately, the governor didn't want to see the GOP-driven effort to repeal the ACA die. McCain, who preferred to start over using them in a more bipartisan fashion, came to a different conclusion.

The repeal of Obamcare is a top priority for Trump, who said on Twitter Saturday that Republicans should not give up on the goal.

A Ducey aide also confirmed that the governor got a call Thursday from Pence, who was among those lobbying McCain to vote for the bill.

Another Republican aide briefed on the conversation said Ducey and Pence had two conversations in the hours before the final vote. At least one of those discussions centered on how McCain would vote, the aide said, requesting anonymity so he could speak freely about the exchanges that had not been publicly disclosed.

McCain's office on Sunday declined to comment on any private discussions McCain may have had with Ducey.

Flake, who is up for re-election in 2018, voted in favor of the "skinny" bill, officially known as the Health Care Freedom Act.

"Too many Arizonans go without health coverage because Obamacare premiums are unaffordable, and too many Arizonans who have health coverage can't afford to utilize it because of exorbitant deductibles," Flake said in a written statement provided to The Republic. "I supported the bill because it kept the possibility of reform alive for those who have to purchase insurance on the individual market."

With all Democrats in opposition, the 52-member Republican Senate majority could only afford two GOP defections. Republican Sens. Susan Collins of Maine and Lisa Murkowski had already staked out ground as "no" votes. Other senators audibly gasped and clapped when McCain delivered the death blow.

The vote should not have come as a total surprise to anyone who followed McCain's comments since the original GOP plan, the failed Better Care Reconciliation Act, first emerged from behind closed doors.

He gave multiple signals along the way that he had serious misgivings.

Besides oft-repeated worries about the bill's impact on Arizona, McCain decried the secretive process in which the proposals were written. He predicted the GOP effort would fail, and urged Republicans to reach out to Democrats in hopes of finding a sustainable healthcare solution.

And in a dramatic Tuesday floor speech, McCain put Trump on notice that senators "are not the president's subordinates," but are his equal.

"From the beginning, I have believed that Obamacare should be repealed and replaced with a solution that increases competition, lowers costs, and improves care for the American people," McCain said in a written statement issued after the vote. "The so-called ‘skinny repeal’ amendment the Senate voted on today would not accomplish those goals.

"While the amendment would have repealed some of Obamacare’s most burdensome regulations, it offered no replacement to actually reform our health care system and deliver affordable, quality health care to our citizens."

By stopping the unpopular legislation, McCain "actually may have saved the (Republican) Party in the long term," said Jennifer Duffy, a national political analyst who handicaps Senate races for the influential and non-partisan Cook Political Report in Washington, D.C.

Ducey's role advising the senators also was not a surprise to those who closely follow his administration.

He frequently references discussions with the senators. And while he has long called Obamacare a "monumental failure and rolling disaster," he has said a replacement should not be rushed through Congress. Ducey is running for re-election in 2018.

READ MORE:

Sen. John McCain torpedoes Republican health-care effort, kills 'skinny repeal' bill

Sen. John McCain returning to Arizona to start cancer treatment on Monday

Obamacare repeal is dead for now. What could that mean for you?