Here's why the GOP health reform bill collapsed
The GOP health reform bill ultimately failed because it got stuck between a rock and a hard place.
The rock — in the form of conservative senators including Rand Paul of Kentucky, Mike Lee of Utah and Jerry Moran of Kansas — represented the view that the compromise bill didn't go far enough to wipe out the Affordable Care Act that provided health coverage to tens of millions of Americans.
"The current system is terrible," Paul told Fox News on Sunday. "I don't think Republicans should put their name on this (bill)."
But moderate Republicans — including Susan Collins of Maine and a handful of other "undecided" GOP senators — found themselves in a hard place facing the millions of voters who would see coverage evaporate or insurance premiums soar, according to multiple analyses of the bill's impact.
Many of those voters are among the 70 million recipients of Medicaid, the federally subsidized, state-administered program that was expanded under Obamacare. The bill, known as the Better Care Reconciliation Act, would have reversed that expansion over three years, from 2021 to 2024, and then make deeper cuts in 2025.
"We should not be making fundamental changes in a vital safety-net program that's been on the books for 50 years — the Medicaid program — without having a single hearing to evaluate what the consequences are going to be," Collins said.
The latest version of the bill collapsed late Monday when Lee and Moran joined Collins and Paul in promising to vote "no." Those defections doomed the measure in the Senate, where Republicans enjoy a slim 52-48 margin. Democrats remain unified in their opposition to the GOP reform measure.
The demise of the act left President Donald Trump fuming and GOP leadership scrambling to find a new strategy to show progress on an issue that was one of the party's signature campaign issues in the 2016 election. Senate Majority Leader Mitch McConnell of Kentucky was reported to be maneuvering to call a vote on a full repeal of Obamacare, effectively starting over on a compromise plan to replace the nation's public health insurance system.
That would leave moderates like Collins still stuck in the hard place of facing voters worried about losing coverage. Though Maine is not among the 32 states that chose to expand Medicaid coverage under Obamacare, it is one of the country's most rural states, which tend to have older populations and higher health care costs, according to the Center for Budget Policies and Priorities.