Delaware's senators bullish on future of health care debate
Delaware's U.S. senators are confident that debate over health care will turn to fixing the Affordable Care Act after the Senate early Friday morning defeated a proposal to repeal parts of the landmark law.
The early morning vote capped months of failed attempts by the Republican majority to dismantle the health care law. The effort had been a central campaign promise for Republicans.
"We tried working against each other. Now, let's work together," said Sen. Tom Carper, D-Del. "Start out by stabilizing the exchanges."
The future of the American health care system had been in question Thursday night as Senate Republican leadership seemed close to winning the necessary support to advance their long-pitched promise to at least repeal the Affordable Care Act.
Then, after hours of debate, senators voted 49-51, defeating the bill shortly before 2 a.m.
"That was a finish worthy of a movie," said Sen. Chris Coons, D-Del., after the vote.
Make no mistake, dodging the bullet of this disastrous bill is an important win for the American people and for our health care system," Coons added.
The vote was a major defeat for Republicans who for months have failed to produce a repeal bill that could win enough support from members of their own caucus.
Thursday's bill was a so-called "skinny" repeal, a scaled-back effort that would have removed the mandate that everyone purchase insurance and eliminate the requirement that large employers provide employees health insurance.
The nonpartisan Congressional Budget Office said the bill would cause 16 million Americans to lose medical coverage by 2026. It would also drive premiums higher, the CBO said.
As the Senate debated the legislation shortly before midnight Thursday, Coons described the so-called skinny bill as a "big, fat problem for the average American."
Some 43,000 would lose coverage between now and 2026 in Delaware, according to statistics cited by his office.
"(Republicans) haven't developed a credible policy alternative to the Affordable Care Act," Coons said.
As the clock ticked toward midnight, prominent Senate Republicans had panned their own legislation, pitching its passage as merely a vehicle for advancing the repeal effort to another rung of negotiation with House leadership.
Senate Republicans said they had received assurances that if they passed the bill, House Republicans would negotiate and not simply move it along to President Donald Trump.
It left Senate Republicans pushing a bill some openly hoped would never become law.
"Most of their members have absolutely no interest in being here on the floor to defend the bill," Coons said shortly before the vote.
He later added: "The process they followed here is not a model of what should have happened."
The late-night wrangling made for a long night of uncertainty over whether the Republican effort would fall short. Coons spoke against the skinny repeal earlier in the day.
He spent the final hours of the debate looking on from a nearby room and wandering the halls of the Capitol, keeping an eye on activity in the nearby office of Vice President Mike Pence — who was potentially a crucial tiebreaker vote.
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"I'm having a great time," Coons said wryly, in a phone conversation shortly before midnight. "I've been here, in either the cloakroom or the floor, for, jeez, six hours?"
Senate Republicans needed all but two members of their caucus to force the bill through. So as rumors about Republican holdouts trickled through Twitter, Democrats and Republicans were left waiting.
"I just walked into the Marble Room, which is right off the floor," Coons said before the vote. "There are four senators in there sleeping."
Ultimately, Sen. John McCain, R-Ariz., joined Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska, as the three Senate Republicans torpedoing the repeal effort.
Coons said he had spoken to McCain earlier Thursday evening, trying to convince him that the House may not negotiate. He cited special provisions passed earlier in the House allowing a vote on the Senate bill to be immediate and without the promised negotiation.
"There were a lot of senators working on if John was ready to vote no, that he understood the reasons and context and had the encouragement," Coons said.
McCain's position was the major question as the vote drew near. It was made more dramatic by his recent return to Senate work after being diagnosed with brain cancer last week.
As Coons made his way through the halls shortly before midnight, he paused mid-sentence as the vice president's entourage made its way past to the Senate floor. Coons could be heard inquiring about how McCain was holding up.
"Just checking on a Republican friend of mine who has had a long, hard night," Coons said after coming back to the call.
Both Carper and Coons thanked McCain after the vote.
"(McCain), as he has done many times before, put politics aside to do what he believed was right," Carper tweeted.
"I was still very surprised when he voted no," Coons said Friday morning.
It's unclear where the defeat leaves Republican efforts to repeal Obamacare, though leadership indicated Thursday's vote was different from several other failed efforts to strike down the law.
"The mood and the spirit was: ok, we tried this, tried in the house, it didn’t work. We tried it going alone with just Republicans in the Senate and it didn’t work. Now, let's try something that might work," Carper said.
Majority Leader Mitch McConnell, R-Ky., at about 2 a.m. said it was "time to move on." He challenged Democrats to bring solutions as premiums under Obamacare continue to rise.
"It was clear on the floor last night that the members of the Republican caucus were exhausted," Coons said. "It felt different. People talked about it differently. I'm hopeful Mitch McConnell will abandon trying to do this with one party. "
Both Carper and Coons emphasized they want to work with Republicans to fix Obamacare, which is reeling in Delaware.
In May, Aetna, one of two insurers offering coverage in Delaware's ACA market announced it was vacating. In June, Highmark, the only remaining insurer, said it is seeking a 33.6 percent insurance rate increase through the state's marketplace.
Coons said Congress needs to work to stabilize the market using input from providers, insurers and patient advocacy groups. He said the effort to repeal provisions of the act have only served to hurt the market.
"There is a consistent theme from businesses which is predictability, predictability, predictability," Coons said. "The Highmark CEO told me this year half their increases were due to instability due to the unpredictability of what will happen."
Carper said congressional Republicans and President Donald Trump have been trying to sabotage the ACA markets by spurring uncertainty. After the vote, Trump tweeted: "As I said from the beginning, let ObamaCare implode, then deal. Watch!"
Carper said if premiums continue to rise, Democrats need to make clear why that is happening.
"If (Trump) is going to continue to destabilize the exchanges and put them in some kind of death spiral, it is on him," Carper said. "He might think he can push the blame on someone else. It is not going to happen."
Coons said future changes should come from a more deliberative process, criticizing Republicans both publishing and seeking to vote on a bill late Thursday.
"It is hard to legislate through the regular committee process, but that is the only way I've seen something get done," Coons said.
He said structural changes with Obamacare had started to drive down the overall cost for medical care and those improvements that should be bolstered by mending the system so insurers can better calculate risk.
Those technicalities will be for a different day.
While the fate of health care was the major question of Thursday night, sleep was also on the agenda at some point for Coons, who said most nights he still commutes back to his Wilmington home.
"I have a little room that I rent from (Oregon Democratic Sen. Jeff) Merkley for those nights like tonight when I'm clearly not going home."
Contact Xerxes Wilson at (302) 324-2787 or xwilson@