Pivotal US healthcare votes swung by ailing Senators


It’s been a disastrous week for Donald Trump’s Presidency. I won’t the list the cataclysms because there are endless articles cataloguing them. This article does a very good job in summing up the situation.

What struck me was that a situation which led to the Affordable Care Act (ACA – “Obamacare”) becoming law was repeated as the Republican “Skinny Repeal” of the ACA failed in the US Senate early on Friday morning.

In the December 2009, the late Senator Robert Byrd, then 92 years-old with fragile health, was instrumental in passing the Affordable Care Act through several late night voting appearances in his wheelchair.

This week, 80 year-old John McCain, suffering from a brain tumour, made the 2,224 mile air trip from Arizona to Washington DC to be the crucial swing vote to kill off the ACA Skinny Repeal.

I’m not sure what this tells us about American democracy, but it is noticeable that these two pivotable moments were swung by Senators who had to make unusual efforts to get to the chamber.

We shouldn’t forget the role of Republican Senators Susan Collins and Lisa Murkowski, who also voted against the Skinny Repeal.

Given the circumstances, the most remarkable thing is that the bill nearly passed. Michael Grunwald sums it up very well:

Forty-nine Republican senators voted for legislation that many of them admitted was substantively flawed and procedurally absurd—legislation that only 17 percent of the public supported and every major medical interest group opposed; that had been shredded by a bipartisan coalition of governors, the Congressional Budget Office and their own hand-picked parliamentarian.

After Trump promised to expand coverage, lower costs and block any cuts to Medicaid, he almost got to sign a bill that the CBO warned would do exactly the opposite, leading to a massive expansion of the insured rolls, higher premiums and deductibles for the old and the sick, and hundreds of billions of dollars’ worth of Medicaid cuts.

After attacking Democrats for ramming Obamacare into law with only 60 votes after insufficient hearings, insufficient bipartisan outreach, and insufficient transparency, Republican senators nearly passed Trumpcare with only 50 votes after no hearings, no bipartisan outreach, and so little transparency that even most of them had no idea what would be in it until a few hours before their middle-of-the-night roll call.

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