Senate Majority Leader Mitch McConnell of Ky., joined by, from left, Sen. John Barrasso, R-Wyo., Sen. John Thune, R-S.D., and Senate Majority Whip John Cornyn of Texas, speaks with reporters on Capitol Hill in Washington, Tuesday, July 25, 2017, after Vice President Mike Pence broke a 50-50 tie to start debating Republican legislation to tear down much of the Obama health care law. (AP Photo/J. Scott Applewhite)
Senate Republicans on Wednesday tried and failed to pass a partial repeal of Obamacare that would end Medicaid expansion and all subsidies to buy insurance, as the caucus continues to struggle to bridge the gap between its right and centrist members.
The repeal without a set replacement proposal received 45 votes, as seven Republicans rejected the measure during its second day of debate to craft an Obamacare repeal that can garner at least a simple majority vote. Three Republican senators rejected both approaches — Maine's Susan Collins, Alaska's Lisa Murkowski and Nevada's Dean Heller .
The Senate passed a nearly identical bill to the one that died Wednesday, when Republicans knew President Barack Obama would veto the proposal. Wednesday's bill has been called repeal-and-delay, as it would give lawmakers two years to come up with a plan to improve the individual insurance market.
An expected future repeal-and-replace proposal is what's been called a "skinny repeal"— ending the individual and employer mandates, but keeping most taxes in the Affordable Care Act and continuing premium subsidies and funding for the Medicaid expansion.
The Congressional Budget Office projected 15 million people would stop being covered by an insurance without the individual mandate, either because they wouldn't try to sign up, and therefore wouldn't learn they could get Medicaid, or because they would decide not to buy.
Even if the Senate passes a skinny repeal, it will go to a conference committee for a compromise to be hammered out with the House's American Health Care Act.
The AHCA included cuts to federal Medicaid funding for all populations, not just the Medicaid expansion.
"Skinny repeal is full repeal. It's a Trojan horse," Senate Minority Leader Chuck Schumer (D-N.Y.) said on the floor Wednesday. "It's clear that House and Senate Republicans are miles apart. What would be the point of a conference?"
Although moderates like Heller, Murkowski, Collins and Rob Portman (R-Ohio) have complained about caps on Medicaid matches to states and the end of enhanced funding for the Medicaid expansion, no Republican joined a Democratic amendment that suggested that changes to Medicaid be stripped from any Obamacare replacement. That amendment failed on a straight party-line vote.