How John McCain became the pivotal vote that sent the GOP's healthcare efforts into disarray
McCain joined two other Republican senators, Susan Collins of Maine and Lisa Murkowski of Alaska, who voted against the bill and quashed Majority Leader Mitch McConnell's plan to upend the US healthcare system after 20 hours of debate. Ultimately, the vote was 49-51.
The senator from Arizona returned Monday to Washington, DC, less than a week after being diagnosed with an aggressive form of brain cancer and less than two weeks after he had brain surgery.
On Friday, a picture began to emerge of how McCain became the pivotal vote that sent the GOP's healthcare plan back to the drawing board.
Going into the debate period
Before the American Health Care Act passed the House, McCain had doubts. In March, he told reporters that he was concerned about how the bill would affect Arizona. The House bill cut hundreds of billions in Medicaid funding. Arizona, which had opted to expand Medicaid coverage under the ACA, would stand to lose a significant amount of funding.
Then came his surgery. On July 14, McCain had brain surgery above his left eye to remove a blood clot. The recovery period threw Senate Republicans' healthcare plans into jeopardy. McCain was expected to vote for the Better Care Reconciliation Act, even though he had concerns about that bill, as well.
On Tuesday, McCain returned to Washington, DC, shortly after doctors diagnosed him with glioblastoma, an aggressive form of brain cancer. He voted in favor of a motion to proceed to debate the healthcare bill, a move for which Democrats criticized him.
Following the vote, McCain delivered a speech in which he touched on his lingering concerns about the bill, working together with Democrats, and his plans to return to Arizona for cancer treatment.
"What have we to lose by trying to work together to find those solutions?" McCain said. "We're not getting much done apart. I don't think any of us feels very proud of our incapacity. Merely preventing your political opponents from doing what they want isn't the most inspiring work. There's greater satisfaction in respecting our differences, but not letting them prevent agreements that don't require abandonment of core principles, agreements made in good faith that help improve lives and protect the American people."
On Tuesday night, he voted "yes" on a version of the BCRA. The next day, however, he was one of seven Republican senators to vote against a repeal-without-replacement plan.
A shift to get 'skinny'
After two failed votes, the conversation Thursday started shifting more seriously to a plan for a "skinny repeal" bill, which would get rid of some of the main parts of the ACA, including the individual and employer insurance mandates. The idea was to pass the bill, then send it to the House. Then, the two chambers could conference on the bill and create a healthcare plan on which both could agree.
In short, the Senate would pass a bill many senators vehemently didn't want to become law, then hope Republicans came out of the conference with a better plan.
That afternoon, McCain was one of four Republicans who spoke out against the "skinny repeal" plan. At a press conference, McCain, along with Sens. Lindsey Graham, Ron Johnson, and Bill Cassidy, demanded that the House give assurances that the bill wouldn't become law if it passed in the Senate.
After, House Speaker Paul Ryan said he'd be "willing" to take the bill to conference. It was enough to get Graham, Johnson, and Cassidy on board.
The text of the "skinny" bill came out around 10 p.m. ET on Thursday. When asked an hour later whether he'd made up his mind on the bill, McCain told reporters that he had. As for which way he would vote, he wouldn't say.
"Watch the show," he told reporters as he walked into the chamber for the vote.
In a surreal scene on the Senate floor, McConnell and Vice President Mike Pence were seen before the vote speaking with McCain. The Senate left open a previous vote for more than 40 minutes as it appeared Republican leaders attempted to persuade McCain to change his vote. McCain had curious exchanges with Democratic senators, including a conversation with Minority Leader Chuck Schumer, who gave McCain an apparent fist pump.
McCain also took a phone call from President Donald Trump when McConnell and Pence's attempts to convince him failed, according to Politico. Trump's sell also failed.
The vote began, and McCain came to the Senate floor and put his right thumb down before walking off.
In a statement released Friday, McCain explained that he ultimately voted no because the Speaker's statement didn't go far enough, and the "skinny" bill didn't offer up a replacement plan. As he did earlier in the week, McCain urged both parties to work together.
"We should not make the mistakes of the past that has led to Obamacare's collapse, including in my home state of Arizona where premiums are skyrocketing and health care providers are fleeing the marketplace," he said. "We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of aisle, heed the recommendations of nation's governors, and produce a bill that finally delivers affordable health care for the American people. We must do the hard work our citizens expect of us and deserve."