The Republicans' signature campaign promise to repeal and replace Obamacare came to a screeching halt Monday night after Sens. Mike Lee of Utah and Jerry Moran of Kansas came together, shocked Capitol Hill and vowed to vote against the latest draft of the GOP's health care bill.
"We should not put our stamp of approval on bad policy," Moran said in a bold statement that derailed Majority Leader Mitch McConnell's bid to overhaul the Affordable Care Act. McConnell could only lose two senators and still pass the bill, and Maine's Susan Collins and Kentucky's Rand Paul had already defected.
Across town, over rosemary-grilled rib eye and summer vegetable succotash at the White House, President Donald Trump and GOP leaders were attempting to convince a group of reliably conservative rank-and-filers to join with them and vote for the health care bill. But as they dined on lemon ricotta agnolotti with heirloom tomato ragout and the "farm stand peach cobbler," the Senate rebellion against the health care bill was well underway.
That's because Lee and Moran were working all day Monday on how they could announce their opposition together.
The goal was to avoid being the notorious and definitive third "no" vote, aides told CNN. If they announced together, Moran and Lee could share the heat. But also implicit in their joint opposition was a clear fact: They represented different, significant concerns with the bill. Their joint opposition served to provide cover for other on-the-fence colleagues who may soon join them in publicly opposing the GOP's effort at finally making good on its cornerstone campaign promise of the past seven years.
A Senate GOP aide with direct knowledge of the ongoing upheaval told CNN that Lee and Moran are likely just the first of many to announce publicly they oppose the bill.
"More senators are ready to jump," the aide said. "This wasn't done without that knowledge."
The developments ended any hope that McConnell, with his Republican Senate majority, can pass the current version of the health care bill he's been crafting for months. He announced a plan to set up a vote on a straight repeal of Obamacare, a move that could let some Republican senators save face but likely wouldn't pass given lawmakers are skittish about repealing Obamacare without a replacement.
"Regretfully," McConnell said in a statement late Monday, "it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful."
Pressure behind the scenes
In recent days, aides said there had been several exchanges among wary senators about how and when to announce opposition to the bill. Going into the weekend, two Republican senators -- Collins and Paul -- were already publicly opposed to it. It only took one more lawmaker to stop the health care bill in its tracks.
Of course, the weekend provided an unexpected turn of events. While Republicans were scheduled to vote on health care this week, Sen. John McCain underwent surgery for a blood clot, an unforseen medical episode that required the senior senator from Arizona to stay at home and rest. McConnell announced Saturday night the bill would be delayed. Without McCain in town, McConnell had no chance of passing health care.
Behind the scenes, leadership applied pressure. They asked Republican rank-and-filers to keep their powder dry and come quietly to them with any problems they had with the bill rather than battling it out in the press. The goal for leaders was to continue working through the week and lobby members privately, with the idea being to set up the vote once McCain came back to Washington.
"At this point, every day without another 'no' is a small victory," a senior GOP aide told CNN Monday morning.
A Lee aide told CNN that Lee did not inform McConnell or his office directly about his statement. And, the aide said that the closest that the Utah senator ever got to supporting the bill was "at most undecided." The simplest explanation for his public opposition: In Lee's opinion, Texas Sen. Ted Cruz's amendment -- which gave insurers more flexibility to offer skimpier plans in the health care market -- didn't go far enough to reduce premiums.
"In addition to not repealing all of the Obamacare taxes, it doesn't go far enough in lowering premiums for middle class families; nor does it create enough free space from the most costly Obamacare regulations," Lee said in a statement.
As soon as the news was out Monday night that the bill was sunk, Republicans from Trump to the recovering McCain had advice on the best path forward.
"The Congress must now return to regular order, hold hearings, receive input from members of both parties, and heed the recommendations of our nation's governors so that we can produce a bill that finally provides Americans with access to quality and affordable health care," McCain said in a statement.
Trump tweeted Monday night that Republicans should come together to pass a full repeal and worry about crafting a replacement with Democrats later.
"Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in!" he tweeted.
McConnell then said that he'd move forward with a procedural motion and make as the first amendment a 2015 repeal bill -- which was ultimately vetoed by President Barack Obama that had earned support two years ago even from senators who are wavering today.
That legislation was meant to be a messaging exercise and when leadership briefly considered bringing it back up again earlier this year, there was widespread distaste for the idea. The plan would repeal Obamacare, but delay the repeal for two years.
So much has changed in a week
Republican leaders unveiled their overhauled health care bill less than a week ago. GOP leadership aides were upbeat following a lengthy meeting last Thursday afternoon in McConnell's office when Centers for Medicare and Medicaid Services Administrator Seema Verma worked with McConnell and his top aides to convince four Republicans from states that had expanded Medicaid under Obamacare that the bill would work for their constituents.
After the meeting, the aides thought the votes were trending in their direction and that Rob Portman of Ohio, Lisa Murkowski of Alaska, Shelley Moore Capito of West Virginia, and Dean Heller of Nevada would come around.
They were so relieved that soon after the meeting several of McConnell and Senate Majority Whip John Cornyn's top leadership and health care aides joyfully bolted from their offices in the Capitol -- with supermarket-baked cookies and cakes in hand -- to celebrate the birthday of Eric Ueland, the bow-tied and cheerful staff director of the Senate Budget Committee who, like them, was deeply enmeshed in the intense and uncertain negotiations. It was a brief and welcomed sugary relief from the unrelenting pressure they had been under for months.
Then came the weekend.
In an attempt to win over a handful of skittish Republican governors, Vice President Mike Pence and Verma were dispatched to Rhode Island to the National Governors Association's summer meeting.
But things went off the rails there. Connecticut Gov. Dan Malloy, a Democrat, described Pence's outreach as "pretty atrocious" as the vice president tried to make the case to governors that the nonpartisan Congressional Budget Office was wrong about its estimate that 15 million people would lose health care over the next decade.
Republicans weren't happy either. After a speech in which Pence claimed 60,000 disabled Ohioans were waiting to get health care, Ohio Gov. John Kasich's office openly dismissed the VP's numbers. It was unclear by the end of the meeting if Pence had done anything to convince Republican Brian Sandoval of Nevada to support the bill. Without Sandoval's blessing there were real questions as to whether Heller could back the plan.
On Monday evening, things devolved even more. Wisconsin Republican Sen. Ron Johnson, who had told reporters he'd vote "yes" to advance the GOP's health care bill last week, suddenly told reporters he was undecided.
Johnson told reporters he'd come to question leadership after a report in The Washington Post cited an anonymous lobbyist saying that McConnell had been telling moderates that a change in the growth rate for Medicaid wouldn't actually go into effect. Johnson admitted he no longer was sure if he could support the motion to proceed to the health care bill.
"You know I was strongly in favor of doing that last week before I read the comments by Sen. McConnell," Johnson said. "I've confirmed those from senators that those comments were made too so I find those comments very troubling, and I think that really does put in jeopardy the motion to proceed vote."
Johnson called the comments "a real breach of trust."
Of course, nothing in Washington is ever truly dead. One needs only to look back to March, when House Republicans pulled their health care bill from what would have been a failing vote, only to rebound and pass it two months later.
On the triumphant day of passage, Trump hosted GOP congressmen at the White House for a victory celebration on a picture-perfect May afternoon --- that now looks premature given the Senate bill was felled by dissension among several factions of the Senate Republican caucus.
"We've developed a bond," Trump said at the time. "This has really brought the Republican Party together."