After supporting a failed Affordable Care Act replacement Tuesday night, Sen. Shelley Moore Capito, R-W.Va., voted Wednesday against repealing the law without a working bill to take its place.
The Senate voted 55-45 Wednesday afternoon not to repeal the law, also known as Obamacare, and defund Planned Parenthood. Both Capito and Sen. Joe Manchin, D-W.Va., opposed that bill, as did every other Senate Democrat and six other Senate Republicans.
Other votes to repeal parts of the ACA were expected later Wednesday.
Capito had said she would not vote to repeal the ACA without a replacement plan in place. However, Tuesday afternoon, she voted to proceed with debate on repeal and replacement; that motion would not have succeeded without her vote. And Tuesday night, she voted in favor of the Better Care Reconciliation Act, despite stating her opposition to some of the bill’s key provisions over the past two months.
Just before 9:30 p.m. Tuesday, the Senate took up an amended version of the bill that would have repealed major provisions of the ACA and left 22 million fewer Americans insured by 2026 than under existing law, according to analysis by the Congressional Budget Office.
Despite Capito’s backing, the Senate defeated the bill on a 57-43 vote. Hours before the action, Capito said she probably would not support any bill estimated to knock millions of people from coverage within a decade.
“I doubt it, but I don’t know until I see it,” she said before the vote. “I’m hoping I don’t have that option, because I don’t think it’s in the best interests of the country to add to the uninsured by 22 million people. That’s not my goal.”
However, Capito said in the same interview that she wanted to see more funds in the bill to help people transfer from Medicaid to private health insurance, which was included in the proposal.
Tuesday night’s replacement bill also included a provision backed by Sen. Ted Cruz, R-Texas, that would allow insurance providers to sell plans that do not meet minimum coverage requirements under the ACA, so long as they also sell compliant plans.
In an interview earlier this month, Capito said she opposed Cruz’s amendment, saying it takes the bill in the wrong direction.
“I think that reopens an issue that I can’t support, that it would make it too difficult for people with pre-existing conditions to get coverage,” she said at the time.
Capito spokeswoman Ashley Berrang said Tuesday night’s bill contained language that addressed Capito’s key concerns, such as increased funding to help people covered by Medicaid move to private providers and an added $45 billion to cover substance abuse treatment. Berrang said these changes in concert outweighed her opposition to the Cruz amendment.
According to analysis from the CBO, Tuesday night’s bill would have cut Medicaid funding by $756 billion by 2026.
Experts have reported that a $45 billion fund to combat the snowballing opioid epidemic is insufficient, noting that many people with substance abuse disorders would lose their Medicaid and that the epidemic continues to worsen.
Senators added that $45 billion in substance abuse treatment grants for states, based on the research of Richard Frank, a health economist at Harvard Medical School, and Sherry Glied, dean of New York University’s School of Public Service. Frank has noted that grants for opioid addiction wouldn’t pay for other health problems, such as hepatitis C, and that the problem is rapidly growing. He said the federal government likely would need to spend $183 billion over 10 years, instead.
Along with Manchin, every other Senate Democrat and nine Republicans voted down the BCRA on Tuesday night.
Staff writer Erin Beck contributed to this report.
Reach Jake Zuckerman at firstname.lastname@example.org, 304-348-4814 or follow @jake_zuckerman on Twitter.