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On Wednesday, Sen. John McCain (R-AZ) breathed life into Republican hopes and dreams of taking health insurance away from millions of people by repealing the Affordable Care Act and destroying Medicaid. Since McCain was the third and deciding vote—joining Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK)—that prevented Republicans from achieving that goal in July, this is a big deal, and a cause for concern.
Popular vote loser Donald Trump is still pushing for repeal, and he's doing it by propping up this effort from Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA), the one McCain said he supported. He's also been agitating with House Republicans to get them behind it. But, critically, he's not working with Republican leadership. Also critical, the window that Republicans have to repeal Obamacare with just 51 votes closes at the end of the month, a very, very busy month. That's one reason why bipartisan hearings on stabilizing Obamacare are happening this week in the Senate—that's the track that leadership decided to follow when it comes to the healthcare law.
So it seems like McCain realized moments after he made his off the cuff statement that he of course supported whatever Graham wanted to do that he was potentially really complicating this already challenging month by making Obamacare repeal theoretically possible once again. So he walked it back with a statement emphasizing that he is "committed" to working with his governor, and that while he was supporting the "concept" of Graham-Cassidy, "I want to see the final legislation and understand its impact on the state of Arizona before taking a position." And then this:
"As I have said all along, any effort to replace Obamacare must be done through the regular order of committee hearings, open debate, and amendments from both sides of the aisle."
Now, it is McCain. He's perfectly capable of demanding regular order on all this, and then just going along with whatever leadership decides to do. But this is a credible threat because he has killed one repeal effort because it didn't follow regular order—not because it would be a disaster for the health of American people, but because of procedure. There just isn't time to meet McCain's demand of regular order on this by the end of the month, and it's pretty darned unlikely that his leadership would be willing to call his bluff, to put all the effort it would have to in another repeal effort—in the handful of days they have available to them this month—and have him torpedo it.
Add to that the debt limit meeting Wednesday, in which Trump totally blew off the Republicans to give Democrats everything they wanted. It also seems darned unlikely that leadership is going to want to have this massive repeal fight all over again just to make Trump happy after that performance.
So it seems that, for now, repeal is still mostly dead. Mostly dead isn't totally dead and we're going to have to remain vigilant, but at this point Trump's active sabotage is a much greater threat to the survival of Obamacare than Congress.