Focus on Plan O Fully

Sen. John McCain.

Sen. John McCain.

During a 78-minute stretch early Friday morning, the U.S. Senate rejected a last-chance health care bill known as skinny repeal 51-49.

The vote, spurred by Majority Leader Mitch McConnell, broke the Republican Party’s seven-year promise to repeal the Affordable Care Act — Obamacare.

Three Republicans joined with Democrats. The vote pronounced that all Americans deserve health care.

Worry about administrative or legislative trickery taking away the protections of Obamacare will linger.

Directly after the vote, President Donald Trump took to Twitter. He wrote: “As I said from the beginning, let Obamacare implode, then deal. Watch!”

Trump and those in his administration charged with operating Plan O must do the opposite. Their legal charge is to follow the requirements of the Affordable Care Act.

As the president wrote on Twitter later Friday, “We will always ENFORCE our laws.” Obamacare counts.

The same applies to Republicans in Congress who might be equally eager to ensure failure through nonfeasance.

The government must enforce legal mandates for employers to provide health insurance and for individuals to obtain health insurance. Also, it must fund cost-sharing agreements. All are needed to keep the cost of coverage down.


Meetings of the U.S. Senate are not the most physical gatherings.

Nonetheless, three physical properties of Sen. John McCain made impressions during the Tuesday-through-Friday effort to eliminate Obamacare.

McCain, R-Ariz., walked onto the Senate floor Tuesday to deliver a speech upon his return after surgery July 14 for a blood clot behind his skull and above his left eye. Stitches above his eye and bruises beneath marked the medical work.

McCain’s raised-and-spread right hand, and his right thumb, would complete the visual memories by which many people will remember the week’s erratic effort to govern.

In his speech, McCain said the Senate was not accomplishing anything and all of its members would have to work together if they hoped to succeed.

McConnell countered cooperation by dishing out soggy bowls of his health care Alpha-Bits. Never mind that the senators had not supported Plan A, Plan B or Plan C the previous week.

McConnell should have heeded McCain’s message.

After all, five days after surgery, the Mayo Clinic said tests found that McCain has an aggressive type of brain cancer. If any senator was thinking deeply about health care, it was the 80-year-old Arizonan.

“Our deliberations,” McCain said in his speech, “can be sincere and principled. But they are more partisan, more tribal more of the time than any other time I remember.” He added, “Right now, they aren’t producing much for the American people.”

Both sides are to blame for the partisan rift, including individuals such as himself, McCain said. “Sometimes, I’ve let my passion rule my reason. Sometimes, I made it harder to find common ground because of something harsh I said to a colleague. Sometimes, I wanted to win more for the sake of winning.”

The Senate is “getting nothing done,” McCain said. “Our health care insurance system is a mess,” he said. “We Republicans have looked for a way to end it and replace it with something else without paying a terrible political price. We haven't found it yet, and I’m not sure we will.”

With McConnell’s ABCs piling up, he switched to descriptive names Tuesday. The Senate voted down a new variation of the Republican bill, known as repeal and replace, 57-43. The bill included an amendment from Sen. Ted Cruz, R-Texas, to allow low-coverage, low-cost insurance plans that do not meet Obamacare standards.

Wednesday, the Senate voted down partial repeal 55-45. The proposal would have removed the bulk of Obamacare after two years, allowing the Senate to write a new plan in the meantime. The same proposal was called Plan C the previous week. It would eliminate health insurance for 17 million people in 2018, compared to present, 27 million in 2020 and 32 million in 2026, estimated the nonpartisan Congressional Budget Office on June 19.


Just after midnight on Friday, McConnell placed one more plan, known as skinny repeal, before the Senate.

Skinny repeal would have removed the mandate for most people to have health insurance and it would have cut several lesser requirements. It would eliminate health insurance for 15 million people in 2018, compared to present, 15 million in 2020 and 16 million in 2026, estimated the CBO on Wednesday.

Then McCain acts on his convictions.

At 12:34 a.m., “McCain is in his seat and Alaska Sen. Lisa Murkowski, one of two Republicans expected to vote no, starts to talk. McCain makes a thumbs-down motion to Murkowski, but few notice it,” wrote Lisa Desjardins for the PBS NewsHour.

At 1:16 a.m., after a series of discussions with senators of both parties, as well as Vice President Mike Pence, McCain leaves to take a phone call.

At 1:28 a.m., McCain re-enters through a tall pair of wooden doors at the rear.

He walks to a clerical desk on the Senate floor, stands straight, sticks his right arm out rigidly and opens his right hand wide to signal readiness to vote.

McCain receives a nod of recognition. He turns his thumb down and says one sharp word, “No.”

His act shifts the balance and leads to the defeat of skinny repeal, the final effort to kill Obamacare.

Trump could have learned about leadership and cooperation by paying attention to McCain.

While McCain criticizes Obamacare for its problems, he recognizes that it has provided health insurance for more than 20 million Americans. Any change or replacement must be an improvement.

In a statement Friday, McCain said skinny repeal “offered no replacement to actually reform our health care system and deliver affordable, quality health care to our citizens.”

Now, Democrats and Republicans in the House of Representatives and Senate, as well as the president, should focus on Plan O fully.


The people understand.

In a Kaiser Health poll released July 14, respondents said congressional Republicans should work with Democrats to improve Obamacare, not repeal the law, 71 percent to 23 percent.

In a Washington Post-ABC News poll released July 16, respondents preferred Obamacare over the Republican approach 50 percent to 24 percent.

Health insurance should cover pre-existing conditions. Health insurance should cover young-adult children on parental plans. Health insurance should cover preventive tests and lab work to detect problems when small and curable. Health insurance should cover emergencies to take substantial cases directly from an emergency room to a hospital room. Health insurance should cover mental care equally with medical care. Health insurance should cover maternity care for mother and child. Health insurance should continue to provide coverage, regardless of total payout, to enable care in cases that are difficult or require long-term treatment.

The only plan that provides such meaningful coverage is the Affordable Care Act — Obamacare.

Protect and bolster the superior treatment made possible by Plan O. Focus on changes that improve health care for Americans. Ensure that everyone is covered fully.

Adapted from “Path Back to Plan O.”

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