Return to Transcripts main page


Obamacare Repeal Fails in Senate; Senator McCain Voted "No" on Skinny Repeal Bill; 3 Republicans Joins Democrats to Defeat Obamacare Repeal. Aired 2-3a ET

Aired July 28, 2017 - 02:00   ET



MARGARET HOOVER, REPUBLICAN STRATEGIST: Now you have, this week, has been really a cleaving point, you have had the failure of health care to pass after promises for eight years. You have signs in the Senate and in -- on Washington that there is a real crack in the pillar of support for Donald Trump with Jeff Sessions losing support from -- or gaining support from Senate, being this cleaving point between the Congress and the president.

And all these people coming out, Republican, elected, coming out against the president's position for the trans military service and voting uniformly for sanctions against Russia.

You are starting to see fissures between Republicans and Donald Trump and now, with the unraveling and the failure of this health care bill, it is going to be very, very interesting. And I frankly think this might be the beginning of an unraveling of Republican support of Donald Trump.


DON LEMON, CNN ANCHOR: I need everybody to stand by and I promise -- Alice Stewart has joined the panel -- Alice, you'll get in. But it's the top of the hour and I just need to reset for our viewers.

This is CNN TONIGHT. I'm Don Lemon. Our breaking news right now, the Republicans' ObamaCare repealed failed in the Senate tonight. The vote, 49-51. And one of those who voted no was Senator John McCain.






LEMON (voice-over): So that was John McCain that you saw on your screen there, just voting no, putting his finger down, Senator John McCain, of course, just returned to the Senate this week after having brain surgery. So I want to get, before we get to our panel, let's get to Ryan Nobles. Ryan has been covering this all evening for us. He is on Capitol Hill.

Ryan, what a dramatic turn of events tonight.

RYAN NOBLES, CNN CORRESPONDENT: No question about that, Don. And we should point out that we had no idea the way this vote was going to go throughout the entire night.

And, in fact, we tried to run John McCain down several times throughout the day to see how he was going to vote. He was coy at each and every turn, including when he made his final walk to the chamber before casting that ballot to -- that ultimately led to this bill being turned down.

And it wasn't just John McCain. There were two other Republicans that voted this down, Lisa -- sorry, Lisa Murkowski from Alaska and Susan Collins of Maine. It took three Republican senators to vote it down. And that's exactly what happened here tonight.

So the big question, Don, is what do Republicans do next?

You heard the Senate majority leader Mitch McConnell say that it is time for them to move on. In what form or fashion they decide to move on remains to be seen.

But I think an important point to make here tonight, Don, is that while both sides talk about bipartisanship and that they want to find ways to work together, there is still a major problem with them working together. And that is Republicans still want to repeal ObamaCare in some form or fashion and Democrats do not.

That, right there, shuts off any opportunity for cooperation because, as soon as you begin that discussion, that's where things break down.

So they are talking a good game here tonight. Senator Chuck Schumer, the minority leader, said in his speech, to close out the night, that he wants the opportunity to work with his fellow Republicans.

That is the speech that John McCain gave a couple of days ago, when he returned to the Senate floor. They want to return to regular order and have both Republicans and Democrats involved.

But the reality of the situation is, Don, despite what happened here tonight, they are still a long way away from anything like that happening.

LEMON: All right, Ryan Nobles on Capitol Hill. Ryan, thank you very much.

Back with my panel. Margaret Hoover; Dana Bash, of course our chief political correspondent; Scott Jennings, Jason Kander is with us as well, Karine Jean-Pierre and also Alice Stewart joins us.

Alice, this stunning defeat. Did you hear Margaret say that this will cause fissures in the Republican support for Donald Trump.

Do you believe that?

ALICE STEWART, CNN POLITICAL COMMENTATOR: Look, we've all been on the presidential campaign trail the last two cycles, 2012 and 2016.

How many times have we heard let's get together and repeal ObamaCare? We won the House and the Senate and the presidency on repealing ObamaCare. Yes, there are skyrocketing costs, yes, there are plummeting choices, yes, in some parts of the country they only have one choice for health care. That still remains the fact.

All of these senators that voted yes for this, they can campaign and they can say I did what I could and I tried and I fought. I have a yes vote for moving forward and trying to repeal and replace ObamaCare.

The one person that doesn't have something to hang their hat on is President Trump. He campaigned on this as well. He was not able to get people together. And unfortunately, he is the one that is going to have to try to explain this to the people.

All this week, he has been saying, you Republicans, you Republicans, you need to get together. But it's also part of his responsibility to corral them.


STEWART: Absolutely. He campaigned on this just as much as everyone else did. And I think Mike Pence was a great advocate for him to help bring people together. But he has just as much to gain or lose from the --


HOOVER: He's going to lose the House of Representatives in 2018. He could very likely --


DANA BASH, CNN SR. U.S. CONGRESSIONAL CORRESPONDENT: -- smart Republicans about that. Because the president was involved in a big way in the House. It didn't go so well and my understanding is that Mitch McConnell was like thank you so much, Mr. President, for your support but we will take some help from Mike Pence here.

And so is it -- is it that part of it?

I don't know.


UNIDENTIFIED MALE: I think the president was involved with the people that he could help with. But look at the three people who voted no: Murkowski, his administration is fighting with Murkowski this week; Collins, not a fan; John McCain, he has been fighting with John McCain for two solid years.


UNIDENTIFIED MALE: How could Donald Trump help with those three votes?

LEMON: Lisa Murkowski, by the way, remember when he did this?

He said, "Senator Lisa Murkowski of the great state of Alaska really let the Republicans and our country down yesterday. Too bad."

SCOTT JENNINGS, CNN POLITICAL COMMENTATOR: But let me take the contrarian view on the fissures of support for Trump. You are right. The Republicans still support the president in the mid-80s. And I think that's unlikely to change because of something you said.

This is the benefit of having a roll call vote. He has people to blame. If you are a Trump supporter and you believe in the president, he will tell you -- I'm guessing tomorrow -- here are the three people that sunk what we were trying to do.

So the president's been very good at putting blame for things not happening on others and keeping it off of himself and that's a big reason the Republicans in his base have stuck with him.

LEMON: Karine and Jason, you're not in the room but if you want to jump in at any time, we don't want to forget about you. Just jump in and --


LEMON: -- yes, go ahead.

JASON KANDER, CNN CORRESPONDENT: Well, look, let me -- Scott and I don't agree all that often. So maybe I should jump at the opportunity to say that --

JENNINGS: Don't kill my street cred.


KANDER: I agree with him on something and that is that if there is one thing that Donald Trump is real good at, it's blaming other people. And I bet that's exactly what he is going to do. And I figure he is rolling around right now maybe having trouble sleeping but he'll wake up. His alarm will go off, telling him he's got a tweet to blame somebody. That may be what it says on his phone, I'm not sure.

But that's what he is going to do. You know what, whatever. That's fine. He can do that. Right now, there are a whole lot of people around this country who they didn't -- they are not thinking about whether they're going to losing an election or anything.

They're breathing a sigh of relief that they are not going to lose their health insurance. And so that's fine. He can blame whoever he wants. But right now, a whole lot of good people are not going to lose their health insurance. And now it's time to move forward and actually try and make create something or try and make improvements that are going to make a positive difference in those folks' lives.

LEMON: The question is --


LEMON: -- go ahead, Karine. Go ahead.

JEAN-PIERRE: -- no, I was going to say I think that's right. I think at the end of the day, these bills were unpopular. Constituents stood up and said they didn't want this. This was not better. This was worse.

And they did not want to lose their health care. And that is really the crux of this. They didn't put anything that was better. It was unpopular. It did not make people's lives better at all.

LEMON: The interesting thing you said, that the president is sleeping; I just have to -- the former communications director of the White House, Dan Pfeiffer, tweeted, said, "Trump is going to be shocked when he wakes up and turns on his DVR and watches tonight's episode of Don Lemon."



LEMON: Ted Cruz is speaking right now. Let's --

UNIDENTIFIED MALE: He has got a really old --


UNIDENTIFIED MALE: -- DVR and I'm sure he's going to watch --

SEN. TED CRUZ (R), TEXAS: -- hours a week. Millions of American who've had their health insurance canceled, who've lost their doctors, who've seen the premiums skyrocket, the 6.5 million Americans each year who are fined by the IRS because they don't make enough money to afford health insurance.

And so not only do they not get health insurance but they get a fine from the IRS and 80 percent of them are earning $50,000 a year or less. Nearly half are earning $25,000 a year or less.

It's the single moms, it's the truck drivers, it's the steelworkers, it's the working men and women who were left behind tonight. That's unfortunate. And you know, there will be a great many Americans who tonight feel a sense of betrayal, feel a sense of betrayal that politicians stood up and made a promise.

I'll tell you this, if you stand up and campaign and say we are going repeal ObamaCare and you vote for ObamaCare, those are not consistent. The American people are entirely justified in saying any politician told me that and voted the other way didn't tell me the truth. They lied to me.

But I will say also the democratic process is a long process. The next 24 hours and the next week, Democrats will crow exultantly and claim total victory for a collapsing and failing law that is ObamaCare.

And the media will write story after story after story about how ObamaCare will remain even though it is failing and hurting millions of Americans. But after all of the chest-beating, after all of the proud --


CRUZ: -- victory laps on the Left, I believe this Congress will come back and in time, we will honor our promises.

You know, senators are going to go home the next few weeks. They're going to go home to their states. And they're going to face their constituents. They're going to have hard questions of people who look them in the eyes and say, 'Why did you lie to me?'

And by the way, it's not just the Senators who voted no. The Senators who voted yes are going to be asked, 'Why did you lie to me?' Because the voters are not going to distinguish. They will say, you guys promised to do this and you failed.

I understand the frustration and anger of the American people. And I think the frustration and anger will be heard by members of the Senate.

I believe we'll come back after all of the victory laps by the Democrats, all of the media exultations, I believe we will come back and we will honor our promise.

And here's how we'll do it. The way we get to 50, the way we get a majority and honor our promise is we focus on lowering premiums. And the key to lowering premiums is the consumer freedom amendment, give you, the consumer, more freedom, more choice, more competition.

The Health and Human Services agency projected that the consumer freedom amendment that I introduced would reduce health insurance premiums by $7,000 each year on average.

So I would ask people at home, would a $7,000 decrease in your health insurance premiums make a difference?

All the Democrats who are really happy are saying, you know what, you don't need 7 grand a year. They're happy to overcharge you. And, by the way, when you premiums go up next year, the Democrats are happy for to you pay more year after year after year when you are struggling to provide --

LEMON: Senator Ted Cruz at the Capitol tonight, saying something I think is very important. He's saying that, when they go home, people are going to say, the constituents, what happened?

You promised to do this and you didn't. And that's really the important thing.

And but critically, I just want to get to something else and then we'll talk about this. But I wonder what lawmakers are thinking right now. And we have on that, Dana, we're going to talk to.

BASH: It's Senator Ed Markey from Massachusetts, of course, on the Democratic side of this, Senator, thank you so much for joining us -- I would say tonight. But this morning since it is almost 2:15 in the morning on the East Coast.

So now that this is -- appears to be dead, this whole notion of repeal of ObamaCare, at least in the short term and maybe forever, we will see, my question for you is, Democrats say over and over, well, we know ObamaCare is not perfect. We have to fix it.

Now it's time for you guys to figure out a way to step up and find Republicans who are willing to work with you and figure that out.

Do you think that's doable?

SEN. ED MARKEY (D), MASSACHUSETTS: I hope it's doable. The leader, Schumer, tonight called for that. We do want to work with Republicans. We know that the Affordable Care Act has to be improved and it needs more competition. We can lower premiums and we can lower costs.

But we have to do it in a bipartisan basis. Hopefully, those millions of Americans, who can sleep easier knowing that their health care has not been ripped away from them, can now look to Democrats and Republicans finally coming together to make this health care system work better.

And hopefully President Trump can hear this message as well and put aside partisanship in a way that I think will help all Americans and not just repeat what we have gone through for the first six months. Hopefully now we can move on.

BASH: Look, a lot of the Republican arguments -- maybe not so much in your state of Massachusetts but in a lot of other states, where the notion of this kind of health care is new and, in many of these states, their governors didn't take federal dollars and federal help.

People are hurting for not just health insurance but coverage because the market has changed and insurance companies and others have pulled out of their states. So there are things that really do need to be fixed in the short term. And if they are not, ObamaCare is still the law of the land, a democratic policy.

MARKEY: Well, you are right. After we passed the Massachusetts law, which the Affordable Care Act is based on, 10 years ago, it was not perfect. And we have had to work very hard in Massachusetts to get to a point where we have 98 percent of all of our citizens who are now covered. But we are still struggling with the price of premiums. We're still working hard on that issue. But we've made tremendous progress.


MARKEY: And we need to make the same progress in every state in the country. And we can only do it but we can only do it if we work together because the solutions are there to be had. And we have to end this partisan bickering that has, unfortunately, characterized the health care debate now for a decade.

BASH: Talk about the shift in public opinion on ObamaCare. Even Republicans, John McCain, when he and others who gave their speeches at the beginning of the week, said that somehow Republicans have been able to do what Democrats haven't been able to do for seven years, which is make ObamaCare popular because of the threat of taking it away.

But the grassroots have been really -- on your side of the aisle have really been instrumental in this. And correct me if I'm wrong, but they seem to be kind of leading the way and you all, in elected official positions, are kind of following their lead.

MARKEY: Well, people don't feel hypothetical pain. And so for seven years, yes, the Affordable Care Act was there. It was expanding benefits to millions of Americans. But it was just taken for granted.

So beginning in January, when this effort began to repeal the Affordable Care Act, all of a sudden the pain became more real. The people came to realize that they were going to lose protections against preexisting conditions not being covered or that their cancer treatment or their Alzheimer's afflicted mother or father in a nursing home could lose their Medicaid coverage.

So all of it became very real, which it hadn't been. And I think that, to date, drove up the favorability amongst the American people, because they came to understand what was in the bill.

And so in many ways, it was the Republicans who activated the American people into protecting something, in the same way that they ultimately came to depend upon Medicare and Social Security. Well, Medicaid is now in the same category and that's the critical component part of the Affordable Care Act.

BASH: Senator Ed Markey, thank you so much for joining us. I appreciate it.


LEMON: Senator, before you go, may I ask you a question?

What do you say to Republicans right now, moving forward tomorrow?

What do you say to them?

MARKEY: Well, first, I say to John McCain and Susan Collins and Lisa Murkowski that your vote was courageous and I think that millions of American families will be forever grateful.

And to every other Republican -- and I've served in Congress for a long time -- we really do have to work together. We have to go back to a process, by which we are sitting there as the representatives of the American people but hearing them and trying to work out our differences and trying to pass legislation.

This has been one of the least productive legislative periods in the history of the United States of America. And I just think that the American people want that era to end and so do most of the members of the House and Senate.

And so I would say to every Republican that I have ever worked with, that it's time for us to go back to business as usual, the way we historically have worked together.

LEMON: Senator Ted Cruz said Democrats will be crowing that they won and -- is that so?

Are you going to be doing that?

Or is this a time for, seriously, do you mean those words, that Democrats and Republicans should come together?

MARKEY: Well, I haven't been crowing for the last six or seven minutes on this show and I don't intend on crowing. And I really do feel this sense of relief, as Chuck Schumer said, that this law has been preserved.

But I do hope that it can signal a new era where we can work together on energy policy, environmental policy, health care policy, foreign policy in a way that bridges divides, that have been there for years.

The "National Journal" did a study of all senators and gave them credit for the number of bills that are now law that they could be credited with. And they gave me credit for 508 laws which are now on the books. But by definition, and every one of those laws, I worked with a Republican to put that law on the books.

And the only way this institution really works is if Democrats and Republicans ultimately find a way of bridging the gaps; no one wins 100 percent. But in those compromises comes the advance of the --


MARKEY: -- good for our country.

LEMON: Senator, thank you for joining us. I really appreciate it. Thank you for talking to me and to Dana as well. Thank you so much. I know it's late.

It's important because the senator, guys, brought up Susan Collins, he thanks -- Susan Collins. He thanked Lisa Murkowski and he thanked John McCain. There has been lots of focus on John McCain and I think rightfully so. But also I think we need to pay attention to the two women who have been against this from the very beginning.

They have been steadfast in wanting certain things in this bill. They were not brought into the all-male working committee. And one wonders, had they been, might their votes had been different, if that had happened?

BASH: I don't think their votes would have been different because of the people they represent. Lisa Murkowski represents -- and please tell me if you disagree -- but Lisa Murkowski represents a state that relies heavily on Medicaid expansion.

Lisa Murkowski -- and she said this to me -- represents a state where the women rely heavily on Planned Parenthood. She said she could never vote for anything that would do away with Planned Parenthood, even for a day, never mind a year, which is what this bill would have done.

And same goes for Susan Collins. They actually have similar constituencies when it comes to those who are the neediest and in the general population and the women who rely on Planned Parenthood, particularly in rural areas.

So I think at the end of the day, it would have been nice for them to be involved and certainly it would have made the process better. And I'm not just saying this because I'm a woman, just in my observations. But things tend to work better and get done more easily when the women are in the room because they tend to --


LEMON: Hey, now.

BASH: -- a little bit more of their ego --

LEMON: -- and, actually, I do agree with --

BASH: -- at the door. I mean, I'm just talking legislatively, not just -- not in general. But I'm not so sure if (INAUDIBLE) --


STEWART: Well, and I think -- excuse me -- it's also important to realize there are 50 different states that have different needs, what works for their state. And those that voted no, they needed certain things.

Dean Heller in Nevada, he certainly wanted -- and you've mentioned this many times -- he wanted to make sure that Medicaid funding for his state was protected. Governor Sandoval was really instrumental in speaking out on that when the governors got together.

And it's critical that all of these ideas and everything that these states need continues to be in the conversation. Clearly, Heller felt as though he was comfortable moving forward, that they would have a conversation and the Medicaid funding would be protected. Those that voted no certainly didn't agree that way.

And I think to Senator Markey's point, we need to work together. And that doesn't go just with Republicans and Democrats. But we had a real problem with Republicans working together this time. And I think moving forward, that would be helpful. LEMON: Yes, I just want to, before everyone else comes in, and Margaret, you go next, I just want to -- John McCain said -- was asked when he was leaving, said, why did you vote no, and he said because it was the right thing to do.

And why did you vote no, it was the right thing to do.

And then he made another comment, if I can find it here, where he asked -- and he said --

BASH: I'm not going to go into my thought --

LEMON: -- I'm not going to go into my thought process. And he said I wish reporters would ask --


JENNINGS: A word I have been sitting here, thinking about the last few minutes, is momentum. President Trump brought up this story about momentum to the Boy Scouts this week and everybody talked about it. But momentum changed tonight.

The Democrats, since Donald Trump got elected, have been looking for a point of momentum. They thought they were going to get it in some of these special elections and they failed every time.

They finally got a momentum change in politics. And it's true, momentum in politics matters. So now for the Republicans, they have to wake up tomorrow, dust themselves off and find a way to get back on offense and not allow the momentum to continue.

Because Dana can tell you, up on Capitol Hill, in the political sphere, Alice can tell you, Margaret can tell you, momentum makes a difference. And if you let somebody get momentum, it emboldens their supporters, it emboldens their donors. The Republicans cannot navel gaze and kick dirt. They have got to get back on offense. Tax reform may be coming. Other policy matters, they have to get on it now.

LEMON: Margaret.

HOOVER: It's just hard to imagine how they move on to tax reform now. Really? Just dust it off? Eight years down the drain? Seven months down the drain? But here we go. We really should have done tax reform first, guys, so here we -- I mean, it's -- I mean, this is devastating.

It's devastating for Republicans who wanted to see real policy reforms implemented. And we've waited a really long time for tonight. And tonight didn't go the way -- by the way, last six -- I need to be clear. The last several weeks have not gone the way we wanted. This process was in there.

So to me, a lot of finger-pointing tomorrow. I think the Senate will blame the president and the president will blame John McCain. The House will blame the Senate. Everybody will blame somebody else. The House, well, we did our job. We passed our part. [02:25:00]

HOOVER: The House is really now going to have to face the firing squad.

LEMON: I think he will probably blame some Democrats, too, because we didn't have a single Democratic vote on this. Or he'll say Democrat vote, Karine.


JENNINGS: Blame everybody. That's what he does.

JEAN-PIERRE: Yes, that sounds like Trump. Look, the monument, how important this is, is pretty amazing. Democrats don't have anything. They were the opposition party, they were part of the resistance movement and they were able to get this done for the people who really needed this.

This is a huge deal tonight and the folks spoke up, constituents spoke up, millions of people spoke up and they were able to get this done tonight. And I think that's really amazing because, like I said before, Republicans have everything. They should have been able to do this on day one. They should have been able to do this. Trump said he was ready to sign something on day one.

And it just didn't happen. This is a huge, a really big deal for Democrats, the resistance, the movement, the opposition to be able to save health care for millions of people.

LEMON: Jason Kander, I will give you the last word on this. It is -- what is this, seven tries this time and then almost a decade of voting to repeal and replace ObamaCare?

KANDER: They didn't have a better idea. That's what it came down to. They had a pretty good thing to campaign on and they ran on that for a long time but they didn't have a better idea.

What we should return to and remember is they passed just plain out repeal over and over again, when as I said earlier, there was adult supervision at the other end of the trail in the Oval Office. Now that that adult supervision is lacking, people rightfully, people like Senator Collins, people like Senator Murkowski, people like tonight, finally, Senator McCain, they trusted the cold feet that they got about the fact that this was the wrong thing to do for the American people.

And at some point, somebody had to stand up. And those Republican senators, along with the Democratic senators who have opposed it for a while, somebody had to stand up and say, I'm not just going to blame everybody else. Somebody has got to do the right thing for the American people. And finally that's what happened.

LEMON: So, Jason, we said, when he wakes up in the morning and the tweet storm starts, it has already started. Dana, "Three Republicans and 48 Democrats let the American people

down. As I said from the beginning, let ObamaCare implode. Then deal. Watch."

BASH: Yes.


KANDER: Don, he will never get better at his job until he starts taking responsibility. Like any other job, whether you're a president or a postman, if you don't look in the mirror and say, what could I have done better for the American people, you will never get better.

LEMON: Dana.

BASH: I think that's right.

Well, the question is, what is the last part of this?

Let ObamaCare implode and then deal.

What does that mean?

Republicans have been arguing for seven years and, particularly, over the past six months that ObamaCare already is imploding.

So does that mean that he thinks that there is some deal in the works?

Hard to see anything that is going to be -


BASH: -- beyond that. But yes, I mean, the defense has begun from the residence and I assume he is not in the Oval Office; I assume he's upstairs in the residence, from the residence. And he realizes, even though it doesn't say this in this tweet explicitly, you read between the lines, it is his legacy.

It was his promise, just as it was every single Republican on Capitol Hill.

LEMON: Yes, and as we --


LEMON: -- the White House tonight, there it is, and the president, as Dana Bash said, tweeting from the residence.

Go ahead, Karine.

JEAN-PIERRE: I was just going to say, most presidents on both sides of the aisle root for the American people. They want them to do and have better. Here you have a president that is saying, it's going to implode, that wants people to lose their health care.

That's really awful and tells it you everything you need to know -- (CROSSTALK)

JENNINGS: But that's not what he's saying. He doesn't want people to lose their health care. He is pointing out that this law has driven up premiums, driven up deductibles and it is having major problems. Don't take his word for it. Listen to Claire McCaskill said tonight. Premiums are going up. The insurance market has to be fixed.


JEAN-PIERRE: -- when they're saying --


JEAN-PIERRE: -- when you're saying repeal and walk away, that's what you mean. And, please, give me a break here. On day one, when he was sworn in, he signed an executive order on day one, telling his cabinet secretaries to make sure that you dismantle ObamaCare. That's what he did. That's what Donald Trump did.

[02:30:00] LEMON: Listen, I have to go. I'm sorry.

What a stunning evening it has been and a stunning morning. It's historic. Obamacare is the law of the land. We went into this thinking the skinny repeal and replace might pass, and it did not. Mitch McConnell said it's time for Republicans to move on. The Obamacare repeal fails in the Senate. That's the headline. John McCain coming back from brain surgery and voting "no."

That's it for us tonight. Thanks for watching.

Our live coverage continues now with CNN's John Vause and Isa Soares.

JOHN VAUSE, CNN ANCHOR: Don, thank you for that.

And we will continue with the coverage on what has been a historic night in the U.S. Senate with Republicans failing in their last-ditch effort to repeal Obamacare and, in the process, dealing a massive blow to President Donald Trump.

ISA SOARES, CNN ANCHOR: Well, John McCain --

UM: Mr. Portman. Mr. Reed. Mr. Barrasso. Mr. Bennett. Mr. Blumenthal. Mr. Blunt.


VAUSE: We will continue to cover the huge setback for the president. We'll look at what it all means for health care in the United States. We'll also look at what comes next, the political fallout and the future of Obamacare and what it means for John McCain's legacy.

SOARES: First, to Ryan Nobles on Capitol Hill with the very latest.

Ryan, it has been a dramatic night as well as a major setback for both President Trump and the Republican efforts. Bring us up to speed. RYAN NOBLES, CNN CORRESPONDENT: No doubt about that, John and Isa.

It's really important to point out before we break this down, this never happens, especially in the United States Senate. Usually, we have a good idea how a vote will go down. We never have to wait until the final votes are cast before figuring out completely whether or not a piece of legislation will go through.

We did not know until John McCain walked up and pointed his finger down to say he was voting nay on this piece of legislation.

This was a shocking development. This was something that we you knew was in peril and the Republicans would have a very difficult time pushing the vote over the finish line. Vice President Mike Pence was up here on Capitol Hill and ready to cast the tie-breaking vote. Republicans felt confident they will be able to get the votes necessary. But John McCain was coy with us all day long, refused to say which way he was leaning. And ultimately, when he had the opportunity, he voted "no."

Now Republicans are back at the drawing board. How they move forward remains to be seen. Mitch McConnell saying on the Senate floor tonight that they are ready to move on. Does that mean they move on to different issues like tax reform or infrastructure and other issues they view as priorities? We will have to wait and see.

The other thing that we are waiting to see is how President Trump responds to all of this. He did send out a tweet a few minutes ago saying that 48 Democrats and three Republicans let America down. I have to imagine that won't be the last of what he has to say about this particular vote because it is a huge disappointment. And it was a huge loss for his administration which is still yet waiting on their first major legislative victory.

VAUSE: Ryan, a night full of surprises. Predicting that the president will have plenty to say is one of the safest predictions.


Ryan, thank you for bringing us up to date.

We want to get all the analysis of what this means. Joining us in Los Angeles, we have Professor Gerald Kominski, the director of the Center for Health Policy Research at UCLA. David Siders, a senior reporter for "Politico." Democratic strategist, Caroline Heldman. And Shawn Steel, of California's Republican National Committee.

Thank you all so much for being with us. It is very late.

David, I want to start with you.

And i want to put this into context. For seven years, repeal and replace, repeal and replace. They couldn't get a skinny repeal through. How momentous is this? How big of a blow is it for the Republican Party? DAVID SIDERS, SENIOR REPORTER, POLITICO: You are right. It's hard to

overstate how significant this is for Mitch McConnell and his leadership and for not only for the Republicans in the Senate, but the Republicans in House races that will be contested next year. They took a tough vote and now they have nothing in the Senate to back them up. I think it's monumental for the moment. We are still -- just keep this in mind -- a long way away from the 2016 election. How many different things will play out in the interim? Tonight, for this moment, it's a monumental deal.

SOARES: We have President Trump tweeting in the last few minutes. He tweeted, "Three Republicans and 48 Democrats let the American people down. As I said from the beginning, let Obamacare implode and then deal. Watch."

This is coming from the president in the last few minutes.

We saw Senator John McCain giving the decisive "no."

Shawn, to you, a lot is being said about John McCain. How do you think this will go down in the party and how will President Trump see this?

SHAWN STEEL, CALIFORNIA REPUBLICAN COMMITTEEMAN: It's spectacular. McCain got the final finger and was able to get all the anger he had all these years. He is an angry man, and well-known for that. He stuck it to Donald Trump. That's his pride and joy. That's his last great wish in life, and good luck with that.

From the Republican strategy side, all the Democrats, including Schumer and McCaskill, going back to Bill Clinton, it's a crazy system, it's not working and it's failing. And it's hurting the working class. Being a perfectly political person, it's great news in 2018. The risk of trying to put a Band-Aid on health care system and trying to make it worth a little bit, the Democrats are blaming us. And a lot of people thought Trump had created a medical system that is failing and leaving counties and states and a lot of people without coverage. They don't get their doctors and premiums are skyrocketing. Now we have a clean political issue. It's them. There's 10 Democrats and 10 Republicans --


STEEL: Let me finish -- they will be running and their chances are in serious trouble.


STEEL: I'm just telling you, from a political side, it's good news.


STEEL: Bad news for the American people, but good news for Republicans.

VAUSE: Gerald, how badly is Obamacare failing in reality? Republicans say it's a death spiral. The Democrats say, no, it's not. It can be fixed. What does it stand?

DR. GERALD KOMINSKI, DIRECTOR, CENTER FOR HEALTH POLICY RESEARCH, UCLA: In my opinion, it's working fairly well. Not perfectly. It's not in a death spiral, but getting worse because of the rhetoric. It becomes a self-fulfilling prophecy when the president is tweeting that let's let it fail. This is not inspiring confidence in the markets and inspiring confidence in insurers and people who will be buying insurance in the exchanges later this year in open enrollment.

VAUSE: Caroline, to you, one thing that McCain said on Tuesday, he predicted that this skinny repeal would fail, when he risked his to come back to Washington to cast his vote in all of this. On Tuesday, he called for a return to the old ways of legislating. Send it to a committee and have a hearing and put it to the floor and have a debate. If the Republicans went back to that strategy, if they did consult with Democrats, Chuck Schumer called for that, time to work together. Is that possible?

CAROLINE HELDMAN, DEMOCRATIC STRATEGIST: I think they will probably forget those words tomorrow. It's absolutely possible. And that's what we did for perhaps 200 years prior to the last 10. It's interesting that Chuck Schumer was bipartisan about it. He said both sides have fault in this. If you look at the origin of it, it is McConnell's scorched-earth policy of coming in and saying, we are going to stop anything the Democrats put up. This is a new way of governing. And I think John McCain may have been driven more by his conscious, and that he is probably not going to run again, that he has a serious health concern. It was inspiring to see him put country above party.

VAUSE: He said it was the right thing to do.

HELDMAN: He did say it was the right thing to do.

SOARES: On that note, David, how much do you think his decision to have that, how much was about his legacy, and how much about the fact that he didn't agree with it, or he was sticking it to President Trump?

SIDERS: Maybe all of the above. What did he say as he left yesterday, don't get into my thought process.


SIDERS: I think, clearly, he has no allegiance to the president and they have a history that wouldn't set him up to cast that vote.

I wanted to throw back to Shawn's point. I think Republicans are going to own this. They don't get to say we are done now. It's on the Democrats' again, as you heard Mitch McConnell say on the floor, let's hear what the Democratic ideas are. The reason you had so many House Republicans go up on this and the problem now for Republicans in '18 is that so many voters demand it and wanted them to get something, anything done. I'm not sure those voters were looking at specific policy prescriptions or would have cared if it was skinny or fat or whatever, I think they wanted an accomplishment. Tonight, they didn't get it.

SOARES: Mitch McConnell said, "It's time to move on."

VAUSE: Let's listen to Mitch McConnell. A lot rested on Mitch McConnell. who described as a master legislator. Even Mitch McConnell couldn't get this repealed through the Senate. This is what he said in the face of defeat. Poor.


[02:39:54] SEN. MITCH MCCONNELL, (R-KY), SENATE MAJORITY LEADER: So, yes, this is a disappointment indeed. Our friends in the House, we thank them as well. I regret our efforts were simply not enough this time.


SOARES: So, Shawn, to you, what do the Republican get home and tell constituents? What have they done?

STEEL: The Democrats are the problem. We have a system that they admit needs fixing. Or others are saying it's in desperate trouble. We thought there would be a number of commercials and ads and strategies against Joe Donnelly, the ex-Senator soon-to-be from Indiana, McCaskill (ph), the ex-Senator from Missouri, is going to get candidates against them and fire up the troops. A defeat like this is short-term. I completely disagree. We don't own it. This is called Obamacare for a reason. It's not called Trumpcare. It's more than a great opportunity. The political reality is that the Democrats will own this and suffer every moment when the rates go up this coming fall. It's going to be a constant drumbeat. Look what the Democrats have given us. At the same time, there is going to be house cleaning in the Republican Party.

SOARES: We've been saying this is historic, but they are voting for something they do not understand. They don't know what it is, and really they are against. Should we be surprised we are here in the first place?

HELDMAN: The surprise is Paul Ryan could not convince John McCain he was not just going to pass it and send it to the president. I cannot remember a time where you have a House so distrustful of others. This is unprecedented the way it's coming apart. Nobody wanted to vote for this and kickoff 60 million people and have premiums raised 20 percent. They wanted to talk further about it. Why don't you start the process again? Why don't they come together and fix what is broken so Obamacare, or the Affordable Care Act, did nothing to reign in the cost for medical devices and bring competition in and look at prescription drugs and have negotiations. So many things they need to get to the table, and they can do that.


VAUSE: The skinny bill didn't make it through. And let's say it had, in its current form, as enacted in the House, what were Americans looking at? What was in this bill. KOMINSKI: There was very little in the bill. So the skinny bill was to repeal mandates and they provided benefits.

VAUSE: The thing that makes Obamacare work.

KOMINSKI: Yes. The two features that have been popular and there has been consistent opposition to the individual mandate. Democratic polling has shown that supporters of Obamacare don't like the individual mandate. It's problematic. But there are ways of doing that differently. Democrats could work to change that requirement as well. But you need to have a penalty for people sitting on the sidelines and they will sit on the sidelines until they get sick.

VAUSE: The insurance lobby weighed in for the first time. They were concerned about the fate of the mandate, the individual mandate. This is what they said. This is from -- where are we -- the AMA, the doctor's association, "Eliminating the mandate to obtain coverage only exacerbates the affordability problem that critics say they want to dress. Instead, this would increase premiums and destabilize the market."

So, Shawn, the skinny bill is what people don't want to happen.

STEEL: I disagree. The easiest hanging fruit was mandates, and now the Democratic Senators will have to justify why people have to buy insurance that is way too expensive that they don't want. The polling is accurate on that. It's bad for the Democrats and they have a lot of explaining to see why it's not getting fixed. I have news for you. Not interested in fixing it. There are other things to do, defense, terrorism, infrastructure and taxes. When it finally has a nice thorough demolition, the Republicans will come back with a better Senate and different circumstances and different personalities. This to me for the Democrats is a victory. Let them have a happy dance, but there is a number of Democratic Senators you will not see in a year and a half.

[02:45:16] SOARES: David, for the Republican Party, this is something they were hoping to put their hats in and really have a moment of glory for them. President Trump hoping for the legislation. I want to play Senator Ted Cruz. Let's listen.


SEN. TED CRUZ, (R), TEXAS: If you stand up and campaign and say repeal Obamacare and you vote for Obamacare, those are not consistent and the American people are entirely justified in saying any politician told me that and voted the other way didn't tell me the truth. They lied to me.


SOARES: Doesn't he have a point?

SIDERS: In Republican districts, this is a problem for Republican lawmakers. In the broader scheme, it's a problem for the party and the president and they need a victory. They need tax reform or infrastructure or something. Maybe they get that after the recess. Mitch McConnell was not speaking about this in glowing terms as we this are this. He sees it as defeat. And it is for the Republicans. It may not be long-term, but it's something that only lasts momentarily. But for tonight, this is a setback.

VAUSE: John McCain said, in the last couple of moments, it could be reintroduced at any time and the Republicans can run with it again.

With that, we'll take a short break. A lot more of our continuing coverage of a very bad night and bizarre day in Washington.

Stay with us. You are watching CNN.




[02:50:55] VAUSE: Welcome back, everybody. We are covering breaking news from Washington, where Republicans and President Donald Trump suffered another stinging defeat in their effort to repeal and replace Obamacare.

SOARES: John McCain joined two other Republican Senators in defying party leaders and casting deciding "no" votes on the s-called skinny repeal measure. As a result, Obamacare remains the law of the land.




VAUSE: Outside Congress, demonstrators cheered when they heard the bill failed. All this as the fallout is just beginning to sink in in Washington and around the United States.

Joining us again, Professor Gerald Kominski, director for the Center of health Policy Research at UCLA. David Siders, senior reporter for "Politico." Democratic strategist, Caroline Heldman. And Shawn Steel, with California's Republican National Committee.

David, first to you, you saw people cheering outside. And a lot of people are pleased with what happened. They seem to think that the Republicans can move on from this. Can they?

SIDERS: I think the vote tonight, the inability of Republicans to get something together, was an indication that it's going to be difficult for them to do it. There is no evidence that they have momentum in that chamber to get something done. Now we are not in the first month of the presidency. We are getting into the year here.

VAUSE: Wasn't the tax reform part the cut part of the repeal?

SIDERS: I think so and what we have seen was so minimal, you had people in the party frustrated for things getting done. If you're a Democrat, you cheer every day that something doesn't get done. Things like health care where they were polling poorly. Every day you get closer to 2018, the prospects diminish for some kind of deal on this. Health care could come back, but the prospects are lowering.

SOARES: We're just hearing from Senator John McCain, who issued a statement on his "no: vote. I'll read it, "I believed that Obamacare should be replaced for something that improves care for the American people. The so-called skinny repeal would not accomplish those goals. The burdensome regulations, it offered no replacement to affordable quality health care".

He calls it -- the speaker's statement that "the House would be willing to go to conference does not ease my concern that is the shell of the bill could be passed at any time."

Caroline, what are your thoughts on that?

HELDMAN: I think he has the inside track and was looking at this and didn't feel comfortable because he knew something. When he had a press conference with Lindsey Graham, he said there were rumblings there was a plan to get it to the president's desk and circumvent the process. It could have been again million people off of health care within the next year.

VAUSE: Speaker Ryan didn't do a lot to put those concerns to rest either in the statements he put out.

Gerald, the inability for the Republicans to get even the most minor reform to health care through the Senate and through the House, does this in a way move them closer to a single payer bill in.

KOMINSKI: It might. We couldn't move closer and there is a lot of popular support for universal coverage in this country. Whether or not Medicare-for-all is the right way to do it or not, it's an open question. There are a lot of ways they provide universal access, but the key is that everyone has access and the government is providing the financing. They don't rely on the markets when markets don't exist. Obamacare is not failing because of a lack of competition. There is a lack of competition in a number of areas of the country prior to Obamacare. In the large group market, that serves about 160 million Americans, markets through the south and the rural areas where there are one or two insurers, that's not competition. And Obamacare didn't create those conditions.

[02:55:27] SOARES: David, we were looking at the votes and seeing Mike Pence really working the floor and asking what role is President Trump have in this? Do you think he has done enough to push for this?

SIDERS: It was an hour before the vote that he tweeted

SOARES: About an hour.

SIDERS: Here's the green light, basically, get this in the conference committee? Has he done enough? Clearly, no. I'm not sure if they agree with him. SOARES: You call it support and some call it pressure.

SIDERS: Look at the pressure he put on Lisa Murkowski.


VAUSE: Shaking them down for the administration.


VAUSE: OK. Thank you all for being with us.

We have come to the top of the hour. We will take a short break.

Some of you are going to be back later in the hour.


VAUSE: We are enrolling companies right now.

I'm John Vause, in Los Angeles.

SOARES: I'm Isa Soares. We are back with more news after this.

Stay with us at CNN, the world's news leader.