In a closed-door lunch meeting on Tuesday, Senate Majority Leader Mitch McConnell told Republicans that he will not hold a vote on the Graham-Cassidy bill, the last Affordable Care Act repeal legislation left standing, CNN and the Washington Post report.
McConnell's decision follows Senator Susan Collins' (R-Maine) announcement last night that she would oppose Graham-Cassidy on account of a Congressional Budget Office score that predicted "millions" fewer Americans would have insurance coverage under the bill than under the ACA. Collins' announcement, which followed opposition from John McCain (R-Arizona) and Rand Paul (R-Kentucky), doomed Graham-Cassidy's prospects.
It's unclear if McConnell's decision spells the end of the GOP's efforts to repeal Obamacare entirely. The GOP was facing a September 30th deadline on its ability to use the fiscal year 2017 budget resolution instructions to repeal the ACA via reconciliation (a procedure that allows legislation to pass with only 50 votes in the Senate). The GOP could, however, attempt to use the 2018 budget resolution instructions for both ACA repeal and tax reform, a strategy for which Lindsey Graham (R-South Carolina) has advocated. But others in the party are concerned such an approach could jeopardize the GOP's ability to execute tax reform.
Also unclear is the fate of the bipartisan legislation aimed at stabilizing the ACA's non-group marketplaces that Senators Lamar Alexander (R-Tennessee) and Patty Murray (D-Washington) were working on before the Graham-Cassidy proposal gained momentum. Reporting from the Post indicates that Republicans don't intend to return to those efforts, believing that instability in the non-group market will help their efforts to repeal the ACA. Insurers have until Wednesday to sign contracts to participate in the ACA's exchanges, and had said that premium increases would be smaller if the law's cost-sharing reductions were guaranteed and no longer subject to political jockeying by the Trump administration.