How the GOP 'skinny repeal' bill tanked

— -- The replacement of the Affordable Care Act (ACA), which Senate Republicans had campaigned for years on and spent months crafting and revising, came crashing down in dramatic fashion in the wee hours of Friday morning with one veteran senator keeping most of his colleagues in suspense until he ultimately voted against the legislation.

Sen. John McCain’s thumbs down on the so-called “skinny repeal” bill that would have scrapped parts of the ACA, also known as Obamacare, was the final nail in the coffin of a measure most Republicans said they didn’t want to see become law anyway. McCain joined two Republican colleagues -- Sens. Susan Collins of Maine and Lisa Murkowski of Alaska -- in blocking leadership from reaching the 51-vote threshold needed to pass the measure.

McCain had signaled earlier to Democratic Leader Chuck Schumer that he would vote against the bill, but his Republican colleagues, including Majority Leader Mitch McConnell and Vice President Mike Pence, were seen on the Senate floor trying to cajole him up until the last seconds of the vote. A phone call even came from President Donald Trump to persuade the senator to vote the legislation through, according to CNN.

But it was no use: around 1:30 a.m. Friday morning, McCain -- back in Washington for health care votes after undergoing brain cancer surgery last week -- cast his “no” vote, and caused the bill to fail, 49-51, eliciting applause from Democrats before Schumer turned around and gestured for them to quiet down.

Spokespeople for McConnell did not respond to inquiries about if and when the leader knew McCain was going to vote no, but by the way the entire Senate stood silently to watch him as he voted, it appeared the senior Arizona senator had played his decision on how to vote close to the chest.

While the precise fate of the bill was unknown until the very final moments, Senate Republicans had been making it clear that the skinny repeal was nobody’s first choice. The bill would have scrapped the individual and employer health insurance mandate -- the crux of Obamacare -- but would have kept many regulations.

"The skinny bill as policy is a disaster. The skinny bill as a replacement for Obamacare is a fraud," Sen. Lindsey Graham of South Carolina said at a press conference hours before the vote, while flanked by McCain, Sen. Ron Johnson of Wisconsin and Sen. Bill Cassidy of Louisiana.

The problem for many senators with the skinny repeal was the scope, inherent in its nickname: after senators had tried, and failed, to pass more comprehensive repeal-and-replace plans, skinny repeal was considered the lowest common denominator around which at least 51 senators could coalesce to pass a health care bill in any form. While most senators supported all or most of the individual provisions in the skinny repeal, even those who voted for it balked at the prospect of passing something out of their chamber that they would not to see become law.

GOP moderates Collins and Murkowski, meanwhile, also had specific concerns with some of the bill's provisions, including those that would have ended federal funding for Planned Parenthood.

Graham and other senators said they wanted assurances that, if the Senate passed the bill, the House would work with the upper chamber to reconcile the differences between their two respective bills in a process known as a conference committee.

But even though House Speaker Paul Ryan responded in a statement by saying he would, in fact, bring the bare-bones skinny repeal into conference, McCain said it would not be enough of a guarantee for him.

“Not sufficient,” he told reporters as he headed to the floor Thursday night.

Earlier Friday morning, just before he cast the vote that audibly took the breath away from some of his colleagues, he reportedly gave journalists a hint of what was to come as they asked how he would break: “Watch the show.”