healthHealth and Medicine

22 Million Americans Retain Healthcare As All Three Senate Repeal Attempts Fail


Robin Andrews

Science & Policy Writer

Senator McCain seen walking into the Senate, ready to cast the vote that killed off Obamacare repeal once and for all. Mark Wilson/Getty Images

Game over. All three attempts to repeal the Affordable Care Act (ACA) have failed. Obamacare lives, which means hundreds of thousands of Americans get to as well.

No matter what you think about Republicans or Democrats, the facts were clear: Millions of Americans would lose health coverage if any of Obamacare was repealed, and around 220,000 would die by 2026 because of this. Healthcare should be improved, not taken away. There’s no point in living in a country that leads the world on biomedical research if huge numbers of Americans don’t have access to it.


Fortunately, despite the Republicans having a majority in the Senate and the House, this future will never come to pass. Choking up on the Senate floor after the final repeal effort was shot down, Majority Leader Mitch McConnell said: “It’s time to move on.”


First, on Tuesday, the Senate’s replacement for the ACA – the Better Care and Reconciliation Act (BCRA) – was rejected by a margin of 57 to 43. Among other things, this would have left 22 million people without health coverage and would have decimated Medicaid, the social health program that ensures low-income and disadvantaged Americans receive care, including for drug abuse and mental health problems.

Then, on Wednesday, the effort to repeal the ACA without a replacement – something which would have left 32 million without health coverage – was defeated too, 55-to-45. This left the Republicans with only one option: skinny repeal, something which would have seen 15-16 million lose health insurance.

As we’ve explained in a previous article, amendments designed to stop Medicaid expansion and take out the individual mandate – the requirement for all to get health insurance or suffer a penalty – were being targeted in this skinny bill.


It was one that Republicans were most likely to pass, as it appealed more to moderates, as well as conservatives that were left with no other choice and were desperate to say they repealed something, anything of the former President’s legacy.

Two holdout GOP Senators – Susan Collins (Maine) and Lisa Murkowski (Alaska) – voted No on skinny repeal, but this still meant that the bill could pass, with VP Mike Pence casting the tie-breaking vote. However, Arizona’s John McCain then approached the clerks and declared that he’d also vote No on the bill, dubbed the Health Freedom Act (HFA).

McCain’s voting intentions were unclear for several hours, but after a heated talk with Pence, he cast his vote, and Senate Democrats gasped and applauded; as news of the bill’s death trickled outside, waiting crowds cheered and applauded.


This was political theatre, but in the end, this was about life-saving access to cutting-edge biomedical science for millions. Along with the Democrats, these three rebellious Republicans are the reason that this still remains a reality.


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