WASHINGTON -- Five hours of contentious debate, marked by protests and arrests, did little to enhance the likelihood of success for the latest "repeal and replace," as opposition to the bill reached a tipping point when Senator Susan Collins (R-Maine) announced her opposition.
Collins would be the third no vote and would leave the Republican majority short of the needed votes for success. Senators John McCain (R-Ariz.) and Rand Paul (R-Ky.) had earlier announced opposition, while Senator Ted Cruz (R-Texas) signalled that he, too, would vote no.
Committee chair told The Washington Post, "Everybody knows that's going to fail."
The situation wasn't improved by the release of the Congressional Budget Office's limited score of the bill, which estimated that millions would join the ranks of the uninsured if the Graham-Cassidy proposal becomes the law of the land.
The deadline for passing a bill via budget reconciliation, which requires only 50 votes instead of the usual 60, is Sept.30 -- per the Senate Parliamentarian's decision earlier this month.
Debate Continues
At the hearing, Democrats argued that the bill was being rammed through the Senate without substantive information regarding its impacts on coverage, premium rates, and the healthcare market, so that Republicans could fulfill a campaign pledge.
"Nobody has got to buy a lemon just because it's the last car on the lot," said Ranking Member Ron Wyden (D-Ore.) in his opening statement.
Instead of focusing on repeal, Democrats said the Senate should allow the Health, Education, Labor, and Pensions Committee to continue its work in crafting a bipartisan fix to stabilize the individual insurance market.
"What we should be doing is going upstairs to the HELP Committee ... Now is our opportunity to fix [the individual insurance market], instead of playing politics with the American healthcare system," said Sen. Michael Bennet (D-Colo.).
Sen. Tim Scott (R-S.C.) pushed back saying Democrats were "demonizing" any bill that wasn't Obamacare. He spoke of Obamacare "collapsing" in his states, between the dwindling insurers and the rise in premium rates.
"Thirty one percent of South Carolinians who signed up at the beginning of the year simply can't afford to continue coverage," he said.
Sen. Lindsey Graham (R-S.C.), who authored the bill with Sen. Bill Cassidy, MD, (R-La.), both of whom were witnesses, took another tack stressing the importance of the new legislation's redesign of Medicaid.
Medicaid's current spending is on an unsustainable path, he argued. By 2027 spending for Medicaid would eclipse even that of the military, he said.
Rick Santorum, a former Republican senator of Pennsylvania, who helped craft the bill and also served as a witness, described the reductions in spending as "modest."
And Cassidy, emphasized that states that accept the Medicaid dollars in the bill, would be able to continue the Medicaid expansion "as they are now."
Sen. Mark Warner (D-Va.) noted that none of the bills sponsors have ever been governors. In Virginia, governors have only a four-year term and the state will have a new governor in January, he said.
"The notion that a new governor with a fresh legislature could redesign a whole healthcare delivery model, submit it by March of 2019, and that this administration could somehow provide a host of waivers, between then and 2020 ... was put together by somebody who's never run a program or surely never run a state."
The hearing itself was attended by protesters, many of them disabled and in wheelchairs, delaying the start of the hearing.
More than a dozen people in the audience, shouting, "No cuts to Medicaid. Save our liberty," were removed from the room by Capitol Police during the first 15 minutes of the hearing.
Shouts of, "Shame. Shame. Fight. Fight. Healthcare is a human right," continued in the hallway throughout the nearly five-hour hearing, which grew quieter in the last 2 hours.