The US senator has said he will oppose the latest Republican attempt to replace Barack Obama's health care law. Another 'nay' from the Arizona senator could be the fatal blow, given the party's small Senate majority.
The announcement by Arizona Senator John McCain - a Republican often at odds with President Donald Trump and who cast a deciding 'no' vote in July that helped defeat the second Republican repeal bill this year - could sink Senate Majority Leader Mitch McConnell's plans to pass the bill before the end of September.
"I cannot in good conscience vote for the Graham-Cassidy proposal," McCain said of the bill proposed by Republican senators Lindsey Graham and Bill Cassidy. "I believe we could do better working together, Republicans and Democrats, and have not yet really tried," the senator said in a statement.
McConnell has been trying to schedule a vote by September 30, the last day on which the bill could pass with only a simple majority of 51 votes in the Senate. A vote taken any later than that would have to get at least 60 votes.
To pass the Graham-Cassidy bill, the Republicans will need at least 50 votes in the 100-seat Senate, which they control 52-48, with Vice President Mike Pence casting a potential tie-breaking vote.
Several other Republicans are undecided, while no Democrats support the bill.
McCain said he would consider supporting the bill if it had come after extensive hearings, debate and amendment. "But that has not been the case," he said.
The bill would take federal money spent on the Medicaid program for the poor and disabled, as well as subsidies to help Americans buy private insurance, and then allocate it to the states in block grants.
The Center on Budget and Policy Priorities - a liberal think tank in Washington - has estimated the bill would cause more than 30 million people to lose insurance.
Third time unlucky
If it fails, it would be the third failed attempt to repeal the Affordable Care Act, the 2010 law often referred to as "Obamacare," which brought health insurance to millions of Americans and became former Democratic President Barack Obama's signature domestic achievement.
President Donald Trump made repealing Obamacare one of his top campaign promises in 2016. Democrats have fiercely defended it.
In July, McCain made a dramatic return to Washington from Arizona after a brain cancer diagnosis to become one of three Republican senators who helped sink their party's earlier efforts to replace Obamacare.
After McCain's surprising vote against that effort, Graham said in a statement he was not giving up. "We press on," he said.
"The Jimmy Kimmel test"
Late night television host Jimmy Kimmel, who criticized the Graham-Cassidy bill on his show, thanked McCain on Twitter. "Thank you @SenJohnMcCain for being a hero again and again and now AGAIN," he tweeted on Friday. Kimmel became part of the healthcare debate in May when he discussed his newborn son's emergency heart surgery.
The talk show host said he felt a sense of personal betrayal from the bill's co-sponsor Cassidy, who made an appearance on "Jimmy Kimmel Live" in the spring. Cassidy came on the show to promise that the health care reforms he was proposing would "pass the Jimmy Kimmel test," meaning that no family should be denied medical care because they cannot afford it.
Kimmel said earlier this week that Cassidy "lied right to my face" by giving him false assurances of Republican health care plans. Cassidy, in turn, said the comedian was misinformed and did not understand the bill's components.
jbh/kl (AFP, Reuters)