With the latest Republican-only Affordable Care Act change repeal proposal hanging by a thread, President Donald Trump took to his favorite bully pulpit on Saturday to chide lawmakers who've announced their opposition or are on the fence.
Trump directed tweets at Sens. Rand Paul of Kentucky and John McCain of Arizona. Both have said they'll oppose the bill, meaning one more committed "no" will sink the legislation. "I know Rand Paul and I think he may find a way to get there for the good of the Party!" Trump told his 39 million followers.
He also targeted Lisa Murkowski of Alaska, who hasn't committed to a position so far but voted no on a previous replacement measure. "Alaska had a 200% plus increase in premiums under ObamaCare, worst in the country. Deductibles high, people angry!" Trump said, adding inscrutably, "Lisa M comes through."
The president saved the most animus for McCain, who provided the third "no" vote to doom the previous Affordable Care Act repeal bill in July, in a dramatic return to the Senate floor after being diagnosed with an aggressive form of brain cancer.
"John McCain never had any intention of voting for this Bill, which his Governor loves," Trump tweeted. "He campaigned on Repeal & Replace. Let Arizona down!"
On Friday, McCain said in a statement that he "cannot in good conscience vote for the Graham-Cassidy proposal." Republicans and Democrats could do better by working together "and have not yet really tried," McCain said.
McCain was the second Republican to oppose the measure, joining Paul. Sen. Susan Collins said Friday she's leaning against it, according to a newspaper in her home state of Maine. Senate Republicans can afford to lose no more than two members of their 52-48 majority and pass the bill.
The health bill under discussion was introduced by Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina. Graham is a close friend of McCain — a element of the drama that Trump didn't leave untouched: "McCain let his best friend L. G. down!"
Graham wrote on Twitter Friday, "My friendship with @SenJohnMcCain is not based on how he votes but respect for how he's lived his life and the person he is."
In contrast to the senators' friendship, the president and McCain have been at odds since then-candidate Trump insulted the former Vietnam War prisoner during a campaign event in 2015: "McCain is a war hero because he was captured, and I prefer people who weren't captured, okay?"
The Republican drive to gut the Affordable Care Act is using a dramatically shortened legislative process that seeks to transform the act using a bill introduced just two weeks ago.
Hospital and health insurance stocks moved upward after McCain's announcement. The S&P 500 Managed Health Care Index of insurers pared earlier losses and closed down about 0.5%. A Bloomberg Intelligence index of hospital stocks gained 1.1%.
Senate Majority Leader Mitch McConnell has said he intended to hold a Senate vote next week before a Sept. 30 deadline to use a fast-track budget reconciliation procedure that lets some budget measures get through the Senate with a simple majority vote, rather than the 60 votes usually required. David Popp, a spokesman for McConnell, didn't immediately respond to a request for comment about McCain's decision.
Trump warned on Twitter on Friday that "Rand Paul, or whoever votes against Hcare Bill, will forever (future political campaigns) be known as 'the Republican who saved ObamaCare.'" The president is working the phone on the issue and is "open to having face-to-face meetings," adviser Kellyanne Conway said on Fox News. "The president is leaning in all the way."
The White House "just wants a legislative victory, they're not as concerned with the policy" in the bill, Paul told the Associated Press after Trump's tweet.
The Brookings Institution estimated Friday that the Graham-Cassidy plan would reduce the number of people with health coverage by about 21 million a year from 2020 through 2026. The number may be larger, it said, because of difficulties in setting up state health systems by 2020 and possible market turmoil in the final years. "What is clear, however, is that the legislation would result in very large reductions in insurance coverage," Brookings said.