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ACA survives; Capito votes to repeal, Manchin votes to keep

Sens. Shelley Moore Capito and Joe Manchin

The U.S. Senate voted down a “skinny repeal” of the Affordable Care Act early Friday, with Sen. Shelley Moore Capito, R-W.Va., voting in the minority.

A narrow 51-49 vote at roughly 2 a.m. knocked the proposal out of contention after a long day of debates, and a final bill going public just after 10 p.m. Thursday.

Sen. Joe Manchin, D-W.Va., voted against the repeal, known as the Health Care Freedom Act.

The legislation would have repealed certain provisions of the ACA, also known as “Obamacare.”

Along with Manchin, all 47 other Senate Democrats, along with Republican Sens. Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona, voted against repeal.

When asked for a reaction after the vote, Manchin said now is the time to carry momentum forward with repairs to Obamacare.

“First reaction is, we have a chance to really fix it,” he said. “If everybody gets their minds right — there’s nobody gloating, there’s nobody celebrating, I can assure you. What we know is we have a lot of work ahead of us in trying to save this thing and making sure people have a stabilized market.”

Capito had said in the past that she would not vote for a repeal of the ACA unless she were confident in its replacement. When asked about this statement in reference to Friday’s vote, Ashley Berrang, a spokeswoman for Capito, said it all comes back to Medicaid and subsidies under the ACA.

“Senator Capito didn’t want to repeal the provisions in Obamacare that provide West Virginians with access to health care coverage, specifically the Medicaid expansion and premium subsidies, without a clear replacement that would allow individuals on Medicaid expansion or the exchange to access affordable coverage,” Berrang said. “The Health Care Freedom Act did not touch the Medicaid expansion or the premium subsidies, which is why she was able to support it.”

Berrang also provided an emailed statement on behalf of the senator.

“I voted on Tuesday for a measure to repeal and replace Obamacare; however, it failed to pass,” she said. “The failure to pass legislation to repeal and replace Obamacare does not change the need to fix our broken health care system. As we go forward, I stand ready to work with my colleagues on bipartisan solutions that result in affordable coverage and expanded options for West Virginians.”

McCain’s vote proved to be the knockout punch for the bill. Manchin said McCain showed courage, given Vice President Mike Pence’s efforts to convince him to vote for repeal on the floor, and what Manchin suspects was a phone call between McCain and President Donald Trump.

“God bless John McCain. I mean, I’ve seen profiles in courage, up close and personal,” he said. “If you have the vice president on the floor working on him for 15 minutes to a half an hour, and then they take him to the back and put him on the phone with the president. I can only imagine the pressure put upon that gentleman. He truly is a patriot.”

Not long after the bill passed, Trump offered his two cents via Twitter.

“3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let ObamaCare implode, then deal. Watch!” he wrote.

According to analysis by the Congressional Budget Office, the Health Care Freedom Act would have removed the individual and employer mandates from the ACA. Additionally, it would have eliminated the Prevention and Public Health Fund starting in 2019, delay the implementation of the medical device tax, increase contribution caps for Health Savings Accounts, defund Planned Parenthood and increase the Community Health Center Fund.

The bill also would have made it easier for states to waive requirements that they cover certain essential health care benefits.

The CBO estimated that 16 million more people would be uninsured under the Health Care Freedom Act than under existing law by 2026. It also estimated that premiums would increase by 20 percent in the same period.

Before roll call on the bill, Capito also voted against a motion to send the bill to committee, which failed on a 52-48 vote.

Reach Jake Zuckerman at, 304-348-4814 or follow @jake_zuckerman on Twitter.

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