Senate deals major blow to Republican health care push

“I thought it was the right vote,” McCain told reporters as he left the Senate floor. Outside, there were cheers as the Arizona senator – who has bedeviled members of both parties through his years – went home shortly after 2 a.m.

Just before midnight, Democratic Pa. Sen. Bob Casey took a red Sharpie to the bill.

[ He posted pictures on Twitter, ]

criticizing how he and other Democrats say the bill would take health care away from 15 million Americans.

Later Friday morning, he released a statement.

"The Senate Republican scheme was a terrible bill for the middle class and that's why it was rejected on a bipartisan basis," Casey said. "It's now time for Democrats and Republicans to work together on common-sense solutions that will make our health care system more affordable and bring down costs for families."

His counterpart, Republican Sen. Pat Toomey, also released a statement.

"For the hundreds of thousands of Pennsylvanians suffering from the higher costs and fewer choices caused by Obamacare's collapse, Congress must not give up on repealing and replacing the failed health care law," he said.

Here is how it looked from the halls of the U.S. Capitol:

1. McCain goes Maverick on health care. When the vote on the GOP 'skinny bill' was set to begin at about 12:35 am, it was obvious that Republicans might not have the votes to prevail, as Vice President Mike Pence lobbied McCain, Sen. Susan Collins (R-ME) and Sen. Lisa Murkowski (R-AK). But all three stuck to their guns, and torpedoed the GOP effort on health care. McCain was the key, as he attracted the most attention from the Vice President during a 45 minute delay on the Senate floor. The Arizona Republican had made clear for days that he didn't like the process, he didn't like the details of the 'skinny' bill, and he wanted to see more bipartisan cooperation. McCain had his GOP colleagues gritting their teeth.

2. Republicans stunned by health care setback. The looks on the faces of GOP Senators told the whole story on the Senate floor, as the realization hit home that McCain was not going to vote with them. After the vote it was grim in the hallways just off the Senate floor. "It was a big setback," Sen. Pat Toomey (R-PA) said tersely. "This is sad," said Sen. Ron Johnson (R-WI). The normally chatty Sen. Ben Sasse (R-NE) pushed through a crowd of reporters without saying anything. "No, I don't want to talk right now, Jamie," Sen. James Lankford (R-OK) flatly said to me as he headed back to his office. What's next now for the GOP on health care? "No big reforms," said Sen. Bob Corker (R-TN). "That unfortunately will not occur."

3. An unhappy President Donald Trump. After showering McCain with praise earlier in the week, when the 2008 Republican nominee for President returned to cast the key vote to begin this debate, Mr. Trump had to watch as McCain threw the bill into a Legislative Ditch. At 2:25 am, the President got on Twitter to issue his first reaction, taking the 51 Senators in both parties to task, and again repeating his threat to simply stand off to the side and watch the individual exchanges go down the drain. It's not clear whether the White House will sanction bipartisan negotiations on health care, but it's hard to imagine that this issue is just going to melt away.

4. Zombie health care bill. I have cautioned my colleagues for months not to declare this GOP effort dead, and I will repeat that advice again, even in the wake of this defeat on the Senate floor for Republicans. All it takes is one deal to flip McCain, Murkowski or Collins, and the GOP would be back in business. Remember, lots of people thought Speaker Ryan was wrong to keep pushing in the House, but then he suddenly found the votes for a bill that many thought was dead in early May. I wouldn't write off that possibility in the Senate, especially if Republican Governors – like McCain's in Arizona – get more involved in the process. All it takes is one vote, and it could be the Democrats looking glum. "We're going to have to pick up the pieces and keep going," said Sen. Ron Johnson (R-WI).

5. Can there be any real bipartisan deal making? There have been talks for some time among Senators who are former Governors and insurance commissioners in both parties – now we'll see if those gain more traction in a bid to find common ground to do something on health care. Some like Sen. Joe Manchin (D-WV) have been talking about brokering a bipartisan deal for months – Manchin told reporters repeatedly that he didn't think those efforts would have a chance until the GOP lost a vote in the Senate. Now we'll see if anything changes on that front.

6. The demonstrators outside the Capitol. When I went out to grab some dinner around 7 pm, I was surprised at how few people were outside the Capitol; I had expected a larger crowd with the health bill ready to come to a vote. Well, the size of the crowd did grow in the hours after that, and when the GOP 'skinny' bill was defeated, you could hear the roars from outside echoing back into the halls of the Senate. Just as it was a defeat for Republicans, it was a victory for Democrats and progressive groups, which had worked hard to try to preserve the Obama health law. The House victory for Republicans on health care in early May had been a bitter setback for Democrats. This time, those opposed to GOP reform plans enjoyed the moment.

7. What was in the "skinny" GOP bill? If you went to bed at a reasonable hour on Thursday, you missed the two hour life span of the new GOP proposal, the "Health Care Freedom Act." After complaining for seven years (in many ways incorrectly), that Democrats had abused the legislative process in the passage of the Obama health law, Senate Republicans made the Democrats look like pikers. The bill surfaced just after 10 pm, there was two hours of debate, and then a vote. In between, a report surfaced from the Congressional Budget Office. Yes, the bill was only 8 pages long, but it was a brand new proposal that had suddenly emerged, with little time to be evaluated. Don't overlook these details – as I mentioned above, they could resurface at any time in the future.