STEVE INSKEEP, HOST:
It takes a moment to get your brain around what the United States Senate did last night. Republicans in the Senate were desperately trying to find some version of repealing the Affordable Care Act. They settled on a very limited version of repeal, slicing out a few pieces of the law. Republican Senator Lindsey Graham called the so-called skinny repeal a, quote, "disaster" and "a fraud" in terms of policy, also terrible politics, he said. And that he said he would vote yes, hoping the House and Senate would agree on something better at a later date. Several Republicans, in fact, said they would vote for this bill only if guaranteed that it would never, ever, ever become law. And then they voted on the legislation that many considered terrible and were devastated by its defeat. Senate Majority Leader Mitch McConnell was visibly upset.
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MITCH MCCONNELL: I want to thank all of our colleagues on this side of the aisle for everything they did to try to keep that commitment. What we tried to accomplish for the American people was the right thing for the country. And our only regret tonight is that we didn't achieve what we had hoped to accomplish.
INSKEEP: Not enough Republicans went along. Lisa Murkowski of Alaska, Susan Collins of Maine said no. And then John McCain of Arizona voted no, leaving Republicans one vote short. NPR's Tamara Keith has been covering this amazing story.
Hi, Tam.
TAMARA KEITH, BYLINE: Hi.
INSKEEP: What does this mean for the repeal effort?
KEITH: So as you say, this piece of legislation, this thing that they were voting on, the so-called skinny repeal - many of them thought it was terrible and didn't want it to become law. But it was like a Hail Mary pass. This was the vehicle. This was the thing to sort of keep the effort going to repeal...
INSKEEP: Get something through the Senate, I guess.
KEITH: Get something through the Senate, get a small win, keep the fight going to try to repeal and replace the Affordable Care Act. Now it's not clear what happens. Senator Mitch McConnell said that he regrets that their efforts were not enough this time. He also said it's time to move on. Now, it's not clear whether he was talking about, like, we're done - we're not going to deal with this anymore - or whether he was literally saying, let's move on to another bill.
INSKEEP: OK. Well, we'll find out what he meant in the coming days...
KEITH: Absolutely.
INSKEEP: ...As the legislation - the legislative calendar reshapes itself. One response for the moment, though, came from Senator Ted Cruz, a Republican, outside the Capitol.
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TED CRUZ: If you stand up and campaign and say, we're going to repeal Obamacare and you vote for Obamacare, those are not consistent. And the American people are entirely justified in saying any politician who told me that and voted the other way didn't tell me the truth. They lied.
INSKEEP: OK. Ted Cruz sounds disappointed. But are Republicans really that disappointed?
KEITH: Yes.
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INSKEEP: OK. Just thought I'd check because so many of them said it was a bad bill. But go on.
KEITH: Yes. But this was the vehicle. And there is a real political concern here - that they promised, for seven years, to repeal and sometimes replace - repeal and replace, repeal and replace the Affordable Care Act. And there is a concern that if they don't do that, that they have nothing to show for it - that they have a Republican president and a Republican House and a Republican Senate and they couldn't do it, that there are going to be political consequences, that Republican base voters are going to be disappointed and depressed.
President Trump tweeted very early in the morning, after the vote happened, here, I'm going to read it...
INSKEEP: All right.
KEITH: ...Quote, "three Republicans and 48 Democrats let the American people down. As I said from the beginning, let Obamacare implode, then deal - watch, exclamation point."
So you know, the president has also been making this argument that Republicans are going to be in trouble if they can't do this thing.
INSKEEP: And also predicting that Democrats will, at some point, be desperate because he's predicting that health care costs will go up so much. There is, of course, a lot of disagreement about whether Obamacare is really on its way to imploding.
But in any event, John McCain, the guy who was seen as the swing vote, the one vote that Republicans needed and did not get, also spoke last night about a different way to approach this situation. Let's listen to some of that.
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JOHN MCCAIN: When we passed Obamacare in 2009, it split us. It split us dramatically, and it split us for years. It's time we sat down together and came up with a piece of legislation that addresses this issue.
INSKEEP: I guess we should define us. When he says it split us, I think he means it split us - not as a party, not Republicans - it split us as a country. And he's made a number of statements suggesting that after a failure such as this, it would be a proper time to negotiate with Democrats and make health care law better. Any chance of that?
KEITH: And he's not the only Republican who's saying that. There are a lot of people who, in their statements last night, said, we need a bipartisan solution here. And it wasn't only Democrats saying that. The question is whether it's really possible to do a big, sweeping piece of legislation. And that seems kind of unlikely. It's more likely - but we're not in the prediction business - that, you know, they would make small, incremental changes that would improve the Affordable Care Act around the edges and embed them in larger pieces of legislation and, you know, do it that way.
INSKEEP: I guess Republicans have never wanted to make small incremental changes to Obamacare...
KEITH: No.
INSKEEP: ...Because that would be seen, they fear, as implicitly approving the idea of the law itself.
KEITH: And for a long time, Democrats resisted it because they thought that that would, you know, allow Republicans to say, look, it was a failure.
INSKEEP: Tamara, thanks very much. Really appreciate it.
KEITH: You're welcome.
INSKEEP: That's NPR's Tamara Keith. Transcript provided by NPR, Copyright NPR.
