Senior Republicans have finally conceded defeat in their troubled campaign to repeal and replace the Affordable Care Act. On Tuesday, Senate Majority Leader, Mitch McConnell, announced that the Graham-Cassidy bill would not come to a vote, as it was unlikely to receive the necessary support. The measure stood as the last legitimate hope for an ACA ‘repeal and replacement.’

“We haven’t given up on changing the American health care system. We are not going to be able to do that this week […] But it still lies ahead of us, and we haven’t given up on that,” McConnell said.

The bill would have distributed ACA funds to states as block grants, and would slowly draw down federal healthcare funding to states over a period of several years. It would do away with the employer and individual mandates, and would provide the opportunity for state waivers allowing price discrimination on the basis of pre-existing conditions for insurance providers.

For a little while, it seemed like Graham-Cassidy was doing well. Fundamentally, however, one could make a convincing argument that this was a result of the approaching September 30 deadline and the further off 2018 midterm elections.

Congressional Republicans must still do something about healthcare. At the very least, they cannot afford to do nothing and expect to occupy a sound position come election time.

Senator Lindsey Graham said Tuesday that, “Today to me, it’s not a matter of if, it’s now when […] Because this idea makes sense. Let’s say we fail. Let’s say we continue to fail. You’ve seen the damage done to the party, donors, people upset. The good news is I see enthusiasm for the first time among Republicans about an alternative to Obamacare.”

Senator Susan Collins was highly critical of Graham-Cassidy, which she called, “deeply flawed.” On Monday, she joined Republican Senators John McCain and Rand Paul in opposition to it.

The Congressional Budget Office is likely a significant source of Collins’ and others’ disapproval. It estimates that, “if this legislation was enacted, millions of additional people would be uninsured compared with CBO’s baseline projections each year over the 2018–2026 period. ” The report also estimates that federal Medicaid spending, “would be reduced by about $1 trillion,” under Graham-Cassidy over the same period.

Insurance stocks have rallied modestly since the announcement. This comes as no surprise when one considers the destabilizing effect that the bill would have on insurance markets, and on individual consumers in general.

Republicans hold a 52-48 majority in the Senate. For the measure to pass before the end of the month it would have required a simple majority, making the three ‘no’ votes of Senators Collins, McCain, and Paul deadly (assuming absolutely no votes from Senate Democrats).

Some of the most entertaining reactions from the left came from Senator Chris Murphy (D-Conn.). On Monday, Murphy tweeted, calling Graham-Cassidy, “an intellectual and moral garbage truck fire,” also saying on CNN that, “it essentially is the equivalent of health care arson.”

The Affordable Care Act remains safe and it appears that Republican eyes turned elsewhere several weeks ago, sensing imminent failure. Problematic is the damage that this quest has dealt to Republican cohesion.

It appears that Republican leaders are having a difficult time uniting their party toward accomplishing their goals. Even worse is the fact that ‘repeal and replace’ has drowned out most bipartisan voices in Congress, crippling efforts at recognizable and up-building legislation.

Had the effort to repeal and replace started slow and simple, things might have looked different than they do now. As things currently stand, each new move to pass influential legislation has been plagued with the same problems as its predecessors.

Tax reform may, indeed, yield a more positive result for themselves. At present, the Republican leadership has cut its losses in the battle for further healthcare reform, but it will have to come back to the issue before midterm elections next year. If congressional Republicans are unable to succeed, they risk convincing the electorate of their own incompetence.

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