John McCain
**FILE** Sen. John McCain, Arizona Republican (Courtesy photo)

Just as President Donald Trump and GOP lawmakers spoke with renewed optimism of finally dismantling Obamacare, Arizona Republican Sen. John McCain again threw a monkey wrench into their plans.

McCain announced Friday that he would oppose the latest proposal to repeal the Affordable Care Act, leaving Republican leaders with little hope of succeeding in their last-ditch attempt to dismantle the health law.

“I cannot in good conscience support the Graham-Cassidy bill” to repeal the law, said McCain, who continues to battle brain cancer. “Nor can I support it without knowing how much it will cost, how it will affect insurance premiums, and how many people will be helped or hurt by it.”

With two other Republican senators likely to vote no, McCain’s opposition could put an end to what had been viewed as a last chance to pass a plan to repeal former President Barack Obama’s signature legislation.

With Democrats united in opposition, Senate Republicans can afford to lose only two of their members.

Sen. Rand Paul, Kentucky Republican, said this week that he would not vote for the bill because it did not dismantle enough of the Affordable Care Act.

And fellow Republican Sen. Susan Collins of Maine has expressed broad concerns about the legislation, strongly suggesting that she, too, would vote against it, just as she voted no in July along with McCain and a third Republican senator, Lisa Murkowski of Alaska.

On Friday, the New York Times reported that Collins said she was leaning against the proposal.

For months, McCain has lamented a Senate legislative process that avoided hearings or formal bill-drafting procedures and excluded Democrats. On Friday, he said those tactics were intolerable.

“We should not be content to pass health care legislation on a party-line basis, as Democrats did when they rammed Obamacare through Congress in 2009,” McCain said. “If we do so, our success could be as short-lived as theirs when the political winds shift, as they regularly do.”

A bill of this magnitude “requires a bipartisan approach,” he said.

Those concerns were compounded by Republican leaders’ decision to press forward with a vote next week before the nonpartisan Congressional Budget Office could complete a full analysis of the legislation drafted by GOP Sens. Lindsey Graham and Bill Cassidy.

The budget office is expected to estimate the cost of the bill early next week, but it indicated that it would not be able to complete an analysis of the bill’s effects on health insurance coverage or premiums by Sept. 30, according to a Times report.

That date is critical because Republicans, who hold 52 seats in the Senate, have until the end of this month to make use of special budget rules that would allow them to pass a repeal bill in the Senate with only a simple majority, rather than 60 votes.

If Republicans could get 50 votes, Vice President Mike Pence would cast the tiebreaker vote.

The GOP had twice tried and failed this year to repeal and replace the health care law.

Its latest proposal would allow states to dismantle rules that prevent older, sicker people from being charged higher insurance premiums.

It would cap the federal outlay for traditional Medicaid, which could jeopardize coverage for the most vulnerable. And it would almost certainly lead to millions more Americans lacking insurance, health care policy experts said.

“They are one vote away,” Congressional Black Caucus Chair Cedric Richmond (D-Louisiana) said Thursday while backstage at the National Newspaper Publishers Association 2017 Leadership Awards in downtown D.C. “This latest bill is a travesty. Out of all the bills they’ve presented, this is the worst.”

The Century Foundation, a D.C. and New York City-based think tank, concluded that the Cassidy-Graham bill would increase the number of uninsured Americans, reduce patient protections and shift costs to states, as well as raise premiums.

“This latest scheme is the most offensive yet,” said Sen. Bob Casey, Pennsylvania Democrat. “These data show that every county in Pennsylvania could see costs rise if this bill becomes law. Many communities across the commonwealth could see premium increases over $1,000 per year.”

Topher Spiro, vice president of health policy at the Center for American Progress, said the bill is one of the most devastating proposals put forth by congressional Republican leaders yet.

“This proposal would eliminate protections that help millions of Americans obtain the care they need, repeal the Medicaid expansion, and place caps on the rest of Medicaid, leaving states on the hook for any and all unexpected costs from recessions, natural disasters, public health emergencies, or prescription drug price spikes,” Spiro said.

“At a time when our leaders should be focusing on a bipartisan solution to stabilize health care markets, as well as ensuring that millions devastated by natural disasters in the southern part of our country can rebuild, some congressional Republicans are instead trying to jeopardize Americans’ health and well-being,” he said.

The latest push by the GOP has also brought out a rare appearance by Obama to rebuke the effort.

“It is aggravating,” the former president said of watching yet another repeal effort. “And all of this being done without any … rationale, it frustrates. And it is certainly frustrating to have to mobilize every couple of months to prevent our leaders from imposing real human suffering on our constituents.”

The Sept. 30 expiration of the rule allowing Republicans to pass a bill without any Democratic support has “concentrated Republican minds,” Dean Clancy, a conservative health policy analyst who supports the plan, told Politico.

“This is their last chance to show they can govern on health care, and if they can’t govern on health care, what can they govern on?” Clancy said.

The substance really doesn’t matter, said Kathy Hempstead, who oversees coverage programs for the Robert Wood Johnson Foundation, likening it to frenzied efforts to kill a zombie in the movies.

“We’re not talking about killing a zombie, we’re talking about how we finance health care for 100 million people,” she said.

Stacy M. Brown is a senior writer for The Washington Informer and the senior national correspondent for the Black Press of America. Stacy has more than 25 years of journalism experience and has authored...

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