Senator John McCain has said he will not support a new Republican proposal to repeal and replace Obamacare, potentially scuppering his party’s hope of agreeing a last-minute healthcare plan next week.
Two months after the Arizona senator deprived Senate Republicans of a majority in a dramatic late-night healthcare vote in the Senate, Mr McCain said he could not support the so-called Graham-Cassidy Bill in its current form.
The new proposal – named after senators Lindsey Graham and Bill Cassidy, who proposed the Bill – has been gathering support in Congress in recent days, giving Republicans renewed hope that a replacement Bill for Obamacare could be agreed.
The new proposal would dismantle the Affordable Care Act, the legislation known as Obamacare, and instead offer individual states block grants to be used to fund a healthcare programme.
Most controversially it would cut Medicaid, the healthcare programme for low-income Americans, a move that has prompted fierce criticism from Democrats. In particular, states that chose to dramatically expand Medicaid coverage under Obamacare would be likely to lose federal funding under the new plan, while states such as Texas, which did not, would be likely to gain.
The proposal would also remove the requirement for all people to have health insurance, a requirement introduced by Obamacare. It is unclear whether people with pre-existing conditions would be protected under the proposal, which was still being debated by senators privately on Friday.
‘We could be better’
Mr Mc Cain, who is continuing to work and vote in the Senate despite being diagnosed with a brain tumour during the summer, said that he could not "in good conscience" support the Bill.
“I believe we could do better working together, Republicans and Democrats, and have not yet really tried,” he said. “Nor could I support it without knowing how much it will cost, how it will affect insurance premiums, and how many people will be helped or hurt by it.”
Other senators who have yet to support the proposal include Senator Rand Paul from Kentucky, Susan Collins of Maine and Alaskan senator Lisa Murkowski, who opposed the last attempt to repeal and replace Obamacare.
US president Donald Trump has urged Republicans to back the deal, while vice-president Mike Pence left the UN General Assembly earlier this week to fly to Washington to chair talks in a bid to hammer out a deal.
“I hope Republican senators will vote for Graham-Cassidy and fulfil their promise to Repeal & Replace ObamaCare. Money direct to States!” Mr Trump tweeted this week. He also warned Rand Paul and other Republicans who don’t support the deal that they will be ever known as “the Republican who saved Obamacare”.
Legislative failure
With Republicans having little in the way of legislative victories to show since the inauguration of Mr Trump, senior figures in the party are keen to move forward with their promise to repeal and replace Obamacare, a key campaign promise of many.
The party is also trying to get consensus on tax reform, with an announcement on a new tax code expected imminently.
Meanwhile, Mr Trump was due to travel to Alabama on Friday evening to rally support for senator Luther Strange ahead of a Republican run-off next week to fill the seat vacated by the state's former long-time senator Jeff Sessions, who was appointed attorney general by Mr Trump.
Mr Trump has inserted himself into the tight race between two Republicans – Mr Strange and Roy Moore, a former judge – in a race that has thrown up tensions between two wings of the Republican Party. Mr Strange has stressed his close relationship with the US president during the campaign.
Mr Trump tweeted on Friday before his departure: “Will be in Alabama tonight. Luther Strange has gained mightily since my endorsement, but will be very close. He loves Alabama, and so do I!”