affordable care act and tax reform and policies that republicans have stood for, for decades, frankly. and now you have -- this week has been really a turning point. you've had the failure of health care to pass after promises for eight years. you have signs in the senate and in washington that there's a real crack in the pillar of support for donald trump. with jeff sessions losing support from -- or gaining support from the senate, being this cleaving point between the congress and the president. and all these republicans coming out against the president's position on the trans-military service and voting uniformly for sanctions against russia. you're 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 for donald trump. >> i need everybody to stand by.

alice, you'll get in, but it's the top of the hour and i need to reset for our viewers. this is cnn tonight. i'm don lemon. the republicans ob cair repeal failed in the senate tonight. one of those who voted no, senator john mccain. >> mr. peters? mr. portman. >> so that was john mccain that you saw on your screen there just voting "no," putting his finger down. senator mccain just returned to the senate this week after having brain surgery. so before we get to our panel, let's go to ryan nobles. ryan has been covering this all evening for us. he's on capitol hill. what a dramatic turn of events tonight. >> 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 that ultimately led to this bill being turned down. it wasn't just john mccain. there were two other republicans that voted this down. 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's 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 that we need to make here tonight, don, is that, while both sides are talking about bipartisanship and that they want to find ways to work together, there's still a major problem with them working together. and that is, the 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're talking a good game here tonight. senator chuck schumer, the minority leader said in his speech, that he wants the opportunity to work with his fellow republicans. that's the speech john mccain gave a couple days ago he returned to the senate floor, they want to return and have republicans and democrats involved. but the reality of the situation, they are still a long, long way away from anything like that happening. >> ryan, thank you very much. back now with my panel. margaret hoover, dana bash, scott jennings, jason candor as well. jean pierre and also alice stewart joins us. alice, a stunning defeat.

do you believe this will cause f fissures in republican support for donald trump? >> how many times have we heard repe repe repeal obamacare. yes, some parts of the country only have one choice for health care. all the senators that voted yes for this, they can campaign and said, i did what i could, i tried and i fought. i have a "yes" vote for replacing obamacare. the one person that doesn't have something to hang their hat on is president trump. he campaigned on this as well. he wasn't able to get people together. and unfortunately, he's the one that's going to have to try and explain this to the people. and all this week, he's been saying, you republicans, you republicans, you need to get together. but it's also part of his responsible to corral them

together. [ inaudible ] >> he campaigned on this just as much as everyone else did. and i think mike pence was an advocate for him to bring people together but he has just as much to gain or lose from the victory. >> you know what he's going to lose? the house of representatives in 2018. >> oh, you smart republicans about that. because the president was involved in a big way in the house. and 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'll take some help from mike pence here. and so was that part of it? i don't know. >> 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's been fighting with john mccain for two solid years. how could donald trump help with those three votes? >> he said lisa murkowski of the great state of alaska really let

the republicans and our country down yesterday, too bad. >> but let me take the contrary view on the fissures of support for trump. you're right. the republicans still support the president in the mid 80s, i think that's unlikely to change, because this is the benefit of having a roll call vote, he has people to blame. so if you're a trump supporter and you believe in the president, he's going to 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 himself. that's a big reason the republicans in his base have stuck with him. >> koreen and jason, if you want to jump in, at any time. go ahead. >> well, scott and i don't agree all that often, so maybe i should jump at the opportunity to say that -- >> don't kill my street cred, brother. [ laughter ] >> i agree with him on something, and that is, if

there's one thing that donald trump is real good at, it's blaming other people. >> yep. >> and i think that's exactly what he's going to do. i figure he's rolling around, having trouble sleeping, but we'll wake up, telling him he's gotta tweet to blame somebody. that may be what it says on his phone. i'm not sure, but that's what he's going to do. that's fine, he can do that. right now, there are a lot of people in the country who are not thinking about whether they're going to lose an election. they're breathing a sigh of relief they're not going to lose their health insurance. so that's fine. he can blame whoever he wants, but right now, a lot of good people are not going to lose their health insurance. now it's time to move forward and create something -- try and make improvements that will make a positive difference in those folks' lives. >> the question is -- go ahead, corinne. >> i was going to say, 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. that's really the crux of this. they didn't put anything that was better. it was unpopular. it didn't make people's lives better at all. >> the interesting thing you said, the former communications of the director tweeted and said, trump is going to be shocked when he wakes up and turns on his dvr and watches tonight's episode of don lemon. [ laughter ] >> he's got a really old dvr, i'm sure he'll watch it. >> millions of americans who have had their health insurance canceled, who have lost their doctors, who have seen their premiums skyrocket. the 6.5 million americans who are fined by the irs because they don't make enough money to afford health insurance. so not only do they get health insurance, but they get a fine from the irs and 80% of them are earning $50,000 a year or less.

nearly half are earning $25,000 or less. it's the single moms, the truck drivers, the working men and women who are left behind tonight. that's unfortunate. and there are going to 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. if you stand up and campaign and say, we're going to repeal obamacare and you vote for obamacare, those are not consistent. and the american people are entirely justified in saying, any politician who 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. and the next 24 hours, the next week, democrats will crow exaltedly. they'll claim total victory for a collapsing and failing law that is obamacare. and the media will write 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 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. 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? it's not just going to be 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're going to say, you guys promised to do this and you failed. i understand the frustration and anger of the american people. and i think that frustration and anger is going to be heard by members of the senate. i believe we'll come back after all the victory laps by the democrats, after all the media

exaltations we'll come back and honor our promise. here's how we do it. the way we get to 50, the way we get a majority and honor our promise, we focus on lowering premiums. 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 don't need seven grand a year. they're happy to overcharge you. and by the way, when your premiums go up next year, the democrats are happy for you to pay more year after year after year -- >> senator ted cruz at the capitol tonight, saying something i think is very important. he's saying when they go home,

people are going to say, their constituents, what happened, you promised to do this and you didn't. and that's really the important thing. but quickly, 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 one that we're going to talk to. >> senator ed markey of massachusetts, of course on the democratic side of this, senator, thanks so much for joining us, i would say tonight, but this morning, since it's 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, or maybe forever, we'll 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?

>> i hope it's doable. leader schumer tonight called for that. we do want to work with republicans. we know that the affordable care act has to be improved, it needs more competition. we can lower premiums, we can lower costs. but we have to do it in a bipartisan basis. and hopefully those millions of americans who can sleep easier tonight knowing that their health care hasn't 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 to come to work in a way that i think will help all americans and not just repeat what we've just gone through for the first six months.

hopefully now we can move on. >> because, 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 -- because the market has changed and insurance companies and others have pulled out of their state. so there are things that really do need to be fixed in the short-term. and if they're not, obamacare is still the law of the land, a democratic policy. >> well, you are right. after we passed the massachusetts law, which the affordable care act is based on, ten years ago, it wasn't perfect. and we've had to work very hard in massachusetts to get to a point where we have 98% of all of our citizens, who are now

covered. but we're still struggling with the price of premiums. we're still working hard on that issue. but we've made tremendous progress and we need to make the same progress in every state in the country. and we can 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, which has unfortunately characterized the health care debate now for a decade. >> talk about the shift in public opinion on obamacare. even republicans, john mccain, he and others who gave th 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 been really instrumental in this.

correct me if i'm wrong, but they seem to be kind of leading the way, and you all, in elected official positions, are kinda following their lead. >> 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. and so, beginning in january, when this effort began to repeal the affordable care act, all of a sudden the pain became more real, that people came to realize that they were going to lose protections against pre-existing 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 debate drove up the favorability amongst the american people because they came to understand what was in the bill. so in many ways, it was the republicans who activated the american people into protecting something, in the same way that they ultimately gacame to depen on medicare and social security. well, medicaid is now in the same category and that's the critical component part of the affordable care act. >> senator ed markey, thanks so much for joining us. appreciate it. >> senator, before you go, may i ask you a requequestion? >> sure. >> what do you say to republicans moving forward right now, tomorrow, what do you say to them? >> well, first i say to john mccain and lisa murkowski and susan collins, 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're 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. 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. >> senator ted cruz said that democrats will, you know, be crowing that they won. 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? >> well, i haven't been crowing for the last six or seven minutes on this show, and i don't intend on crowing. 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, 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 a hundred percent, but in those compromises, comes the advance of the good for our country. >> senator, thank you for joining us. i really appreciate it. thank you for talking to me and to dana as well. thanks so much. we know it's late. >> no problem. take care. >> it's important because the senator brazil up susan collins, lisa murkowski, and john mccain, thanking them. there's been lots of focus on john mccain, rightfully so. but we need to also 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 have been different, if that had happened? >> i don't think their votes would have been different. because of where -- of the people they represent. lisa murkowski represents and please tell me if you disagree,

but she 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. and 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 in 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. it certainly would have made the process better. and i'm not just saying this because i'm a woman, just in mai observations, but things to tend work better and gt done more easily when the women are in the room. because they tend to -- >> hey now. >> -- leave a little more of their egos at the door.

legislatively, not in general. but i'm not so sure it would have made a difference. >> excuse me. it's also important to realize there are 50 different states that have different needs on what works with 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. 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 didn't agree that way. and to senator markey's point, we do need to work together. not just with republicans and democrats, but we had a real problem with republicans working together this time. i think moving forward, that would be helpful. >> before everyone gets in, and

margaret, you can go next, i just want to -- john mccain was asked when he was leaving said, why did you vote "no," he said it was the right thing to do. why did you vote no, it was the right thing to do. and then he made another comment, if i can find it here. >> i'm not going to go into my thought process. >> and he said, i wish reporters would ask better questions. >> a word i've been thinking about the last few minutes and 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. if you let somebody get momentum, it emboldens their supporters, their donors. the republicans cannot kick dirt. they've gotta get back on offense. tax reform may be coming. other policy matters, they have to get on it now. >> margaret? >> it's hard to imagine how they move on to tax reform now. right? really? just dust it off, eight years down the drain. seven months down the drain. but here we go. i mean, we really should have done tax reform first, guys. i mean, this is devastating for republicans who wanted to see real policy reforms implemented. we've waited a really long time for tonight and tonight didn't go the way -- by the way, i need to be clear, the last several weeks of this process, to me, a lot of finger pointing tomorrow. the senate will blame the

president. the president is going to blame john mccain. the house will blame the senate. everybody is going to blame somebody else, and the house will say, we did our job, we passed our part, but the house is really now going to have to face the firing squad. >> i think he's probably going to blame some democrats too. we didn't have a single democratic vote on this. >> why not? that's what he does. >> that sounds like trump. the monument -- how important this is, it's pretty amazing. democrats don't have anything. right? 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, 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 without -- on day one, they should have been able to do it. trump said he was ready to sign something on day one and it just didn't happen. so 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. >> jason kander, i'll give you the last word on this. it is seven tries this time and, what, almost a decade of voting to repeal and replace obamacare. >> they didn't have a better idea. that's what this came down to. they had a pretty good thing they could campaign on. they ran on that for a long time. but they didn't have a better idea. and what i think we should return to and remember is that they passed just plain out repeal over and 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 and lacking, people like murkowski, collins, mccain, they trusted the cold feet they got about this being the wrong thing to do for the american people. 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's gotta do the right thing for the american people and finally that's what happens. >> so we said, when we wakes up in the morning and the tweet storm starts, it's already started. three republicans and 48 democrats let the american people down. as i said from the beginning, let obamacare implode, then deal. watch! >> he'll 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 are if the american people, you'll never get better. >> the last part of this, let ob cair implode, then deal. what does that mean? republicans have been arguing that obamacare already is imploding. so does that mean that he thinks there's some deal in the works? hard to see anything that's going to unfold. but, yeah, the defense has begun from the residents -- i assume he's 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, if you read between the lines, it is his legacy. it was his promise, just as it was every single republican on capitol hill. >> yeah. and as we look at the white house tonight, there it is. as dana bash said, tweeting from the resident.

go ahead, koreen. >> i was going to say, most presidents on both sides of the aisle root for the american people. they want them to do better, have better. here you have a president that's goi saying, he wants it to implode, he wants people to lose their health care, that's really awful. >> that's not what he's saying. he's pointing out this law has driven up premiums and deductibles, it's having major problems. premiums are going up, insurance market has to be fixed. >> when you're saying repeal and walk away, that's what you mean. and 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.

>> but, listen -- >> i have to go, i'm sorry. what a stunning evening it's been and morning. it's historic. obamacare is the law of the land. we thought the skinny repeal might pass, it did not. the obamacare repeal fails in the senate. that's the headline. john mccain coming back from brain surgery, voting "no." that's it for us tonight. thanks for watching. our live coverage continues tonight with cnn's john vause and isa soares. >> we'll continue with the coverage on this historic night, with republicans failing in a last effort to repeal kob cair in the process dealing a massive blow to president donald trump. >> well, john mccain -- >> no. >> mr. portman?

mr. reed? mr. blumenthal? mr. blunt? mr. booker? -- >> we're continuing to cover this huge setback for the president. we'll look at what it means for health care in the united states. we'll look at what comes next, the political fall-out, and of course the future of obamacare and what this means for john mccain's legacy. >> but first to ryan nobles at capitol hill with the very latest. and ryan, it's been a pretty dramatic night as well as a major setback for both president trump and republican efforts. bring us up to speed. >> no doubt about that, i think it's really important for us to point out before we begin breaking down exactly what happened here tonight, this never happens. especially in the united states senate. usually, we have a very good idea exactly how a vote is going to go down. we never have to wait until the final votes are cast before

figuring out completely whether or not a piece of legislation is going to go through. we honestly did not know until john mccain walked up and pointed his finger down that he was voting nay on this piece of legislation. it's a shocking development. we knew it was in peril, that the republicans would have a difficult time pushing the vote over the finish line. but vice president mike pence was up here on capitol hill. he was ready to cast the tie-breaking vote. republicans felt confident throughout the day that they were going to 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 then ultimately when he had the opportunity, he voted "no." so now republicans are essentially back at the drawing board. exactly how they move forward remains to be seen. mitch mcconnell saying on the senate floor tonight that they are ready to move on. so does that mean they move on to different issues like tax reform or infrastructure, some of the other issues they view as

priorities? that we'll have to wait and see. the other thing that we're obviously waiting to see is how president trump responds to all this. he did send out a tweet a few minutes ago, saying that 48 democrats and 3 republicans let american town. i have to imagine that won't be the last of what he has to say about this particular vote tonight. because it is a huge disappointment and it was a huge loss for his administration, which still yet is waiting on their first major legislative victory. >> ryan, in a night full of surprises, predicting that the president will have plenty to say probably is one of the safest predictions. thank you for bringing us up to date. we want to get all the analysis now on what this means. joining us in los angeles, professional kaminsky, the director of the center for health policy research at ucla, senior reporter for politico, democratic strategist and shaun steel with california's national

republican committee. we know that it's very late. david, i want to start with you. just put all of this into context. for seven years, repeal and replace, repeal and replace. they couldn't even get a skinny repeal through. just how momentous is this, how big a blow is this for the republican party? >> you're right, it's hard to overstate how significant this for mitch mcconnell and his leadership, and the republicans in the senate, the republicans in house races that are going to 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. at least for the moment. we're still, and we should keep this in mind tonight, a long way away from the 2018 election. and it's unclear what will be playing, you know, how many different things will play out in the interim, but for tonight, for this moment, it's a monumental deal. >> we have president trump tweeted in the last few minutes. three republicans and 48 democrats let the american people down. as i said from the very

beginning, let obamacare implode, then deal. watch. this is from the president in the last few minutes. we saw senator john mccain giving the decisive "no." a lot is being said about john mccain. how do you think this will go down within the republican party? how will president trump see this? >> i think it's spectacular. mccain really got the final finger. he finally was able to really get all the anger that he's had all these years. he's a very angry man. he's well known for that. he really stuck it to donald trump. and that's his pride and joy. apparently his last great wish in life. good luck with that. from the republican strategist side, all the democrats, including schumer and mccaskill tonight, going back to bill clinton, said 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 on this, it's great news in 2018. because the risk of trying to do, trying to put a bandaid on the health care system and

trying to make it worse a little bit. the democrats are blaming us and a lot of people thought trump created a new medical system that's failing, that's leaving counties and states, a lot of people without coverage, they don't get their doctors and the premiums are skyrocketing. it's now a clean issue. it's ten democrats and republicans that are running for re-election, and their chances are in serious trouble. >> so from the political side, it's good news. bad news for american people, but good news for republicans. >> jerry, you look at all this. so how badly is obamacare failing in reality? because you hear republicans say it's in a death spiral. democrats say, no, it's not. it can be fixed. where do things stand? >> it n my opinion, it's not working perfectly, but it's getting worse because of the rhetoric. when the president is tweeting

tonight that, let's let us fail. it's not inspiring confidence in the markets, in insurers and it's not inspiring confidence in people who are going to be buying insurance in the knowledge ands lat -- in the exchanges during open enrollment. >> he predicted this skinny repeal would fail, and he risked his life to come back and cast his vote. on tuesday, he said send it to a committee, to a hearing, have the democrats weigh in, have a debate. if the republicans went back to that strategy, if they did consult with the democrats, chuck schumer called for it tonight on the senate, time to work together. is that possible? >> well, i think that they'll probably forget those words tomorrow. i think it's absolutely possible, in fact, that's what we did for, you know, perhaps 200 years, to a certain extent, prior to the last ten.

it's interesting that chuck schumer was very bipartisan about it. he said both sides have fault in this. but if you look at the origin of it, it's mcconnell's scorched earth policy of coming in and saying, we are going to stop anything that democrats put up. this is a new way of governing and i think that john mccain might have been driven more by his conscience. he might have been driven by the fact that he's probably not going to run again, that he has a serious health concern. so it was quite inspiring to see him put country above party. >> he did say it was the right thing to do. >> he did say that. and on that note, how much do you think that his decision, how much of that was about his legacy, about the fact that he didn't agree with it, or about, as we were saying, sticking it to president trump? >> maybe all of the above. what did he say as he left the chambers today? don't get into my thought process. >> i'm not going to explain my thought process. >> i think clearly, he has no allegiance to the president. and they have a history going

back that certainly wouldn't have set him up to cast that kind of vote. you know, i just wanted to throw back to shaun's point. i think republicans really are going to own this. they don't get to just say, we're done now, this isn't us, it's on the democrats again. you heard mcconnell say, let's hear what the democrats' ideas are. the reason you had so many republicans go up against this, and the problems now for republicans, so many voters in the districts demanded them to get something done, anything. i'm not sure the voters were looking at the specific policies, prescriptions, or would have cared if it was skinny or fat. i think they wanted to see an accomplishment. they didn't get it. >> although mitch mcconnell did say, it's time to move on. those were his words. >> indeed. >> a lot rested on mitch mcconnell who is described as master ledge latgislator.

he's tougher than a $3 steak and this is what he said in the face of defeat. >> so, yes, this is a disappointment, a disappointment indeed. our friends over in the house, we thank them as well. i regret that our efforts were simply not enough this time. >> so, shaun, to you, what do the republicans go home and tell their constituents? what have they done in the last seven months? >> democrats are the problem. we have a system that they admit themselves needs fixing. that's at the minimum. or others like mccaskill saying it's in desperate trouble. and what we're going to do, there's going to be a number of commercials and ads and strategies against the ex-senator, soon to be in indiana, the ex-senator, mccaskill, soon to be from missouri, it's going to get our candidates against them,

embolden them. a defeat like this, a short-term, a completely disagree. we don't own this thing. it's called obamacare for a reason. it's not called trumpcare. it's more than just a great opportunity. i think the political reality is that the democrats are gonna own this, and they're going to suffer every moment when the rates go up this coming fall. it's going to be a constant drum beat, look what the democrats have given us. at the same time, i guarantee it's going to be a little house cleaning in the republican party. >> i know we've been saying this is historic, but throughout the day, we've been hearing they're voting for something they don't understand, they don't know what it is and really they're against. so should we be surprised that we're here in the first place? >> well, i think the surprise is that paul ryan could not convince john mccain that he wasn't just going to pass this bill in the house and send it to the president. i don't remember a time in american political history where you have one house of congress, of your party, so distrustful of

the other house. perhaps it's happened, but it hasn't happened in recent history. this is unprecedented what is happening with the republicans, the way in which it's coming apart. nobody wanted to vote for this, nobody wants to kick off 16 million people and have premiums raise 20%. they wanted to get to conference and talk further about it. why don't you start the process again. why don't the democrats and the republicans come together and fix what is broken so the affordable care act extended coverage, but it did nothing for cost, did nothing to rein in the cost for medical devices and bring competition into the market and look at prescription drugs and have negotiation, which is now prohibited. so many things they need to do to get to the table. >> so flawed from the very beginning. >> specifically, the skinny repeal didn't make it through, but assuming, let's say, it had in its current form, what were americans looking at? what was in this bill? >> there was very little in the

bill. the skinny bill was to repeal mandates on individuals and on employers with more than 50 employees provide health insurance benefits. >> the thing that makes obamacare work? >> yes, but the two features that have been also been very unpopular and there's been consistent bipartisan opposition to the individual mandate. democratic polling has shown that supporters of obamacare also don't like the individual mandate. so it's problematic. but there are ways of doing that differently. and democrats could work to change that requirement as well. but the law does -- you need to have some penalty for people sitting on the sidelines. otherwise, people will sit on the sidelines until they get sick. >> what was interesting, the insurance lobby actually weighed in for the first time. they were concerned about the fate of the individual -- of the mandate, the individual mandate.

in fact, this is what they said. this is from -- this is from -- where are we? the ama, actually, the doctors association. eliminating the mandate to obtain coverage exacerbates the problem, leads to increased premiums and destabilize the individual market. the only thing the skinny bill would have done is what everyone doesn't want to happen. >> i disagree. i think the easiest low hanging fruit was mandates. now the democratic senators are going to have to justify why people have to buy insurance that's way too expensive that they don't want, that's required to do. i think the polling is accurate on that. i think it's a bad issue for the democrats and they're going to have to do a lot of explaining to see why it's not getting fixed. i got news for you, not interested in fixing it. not interested in having little -- there's other things to do. there's defense, there's

terrorism, there's infrastructure, there's taxes. and guess what, when it finally has a nice complete and thorough demolition, then the republicans will come back with a better u.s. senate and different circumstances and different personalities. so i don't -- this, to me, for the democrats is a fearic victory. let them have a happy dance. but there's a number of democratic senators that you will not see this next year and a half. >> david, for the republican party, of course, this is something they were hoping to put their hats in, really have a moment of glory, something they've campaigned throughout, president trump hoping for the legislation. let's play senator ted cruz who talked about the promises they pledged. let's take a listen. >> if you stand up and complain and say, we're going to repeal obamacare and you vote for obamacare, those are not consistent. and the american people are

entirely justified in saying, any politician that told me that and voted the other way didn't tell me the truth. they lied to me. >> doesn't he have a point? >> i think he has a point. i think in republican districts, this is a problem for republican lawmakers. the inability to get something done. i think in the broader scheme of things, it's a problem for the party and for the president, and that the republican party needs a victory. they need something big. they need tax reform or infrastructure or something. and maybe they get that after the recess. but mitch mcconnell was not speaking in such glowing terms about this as a campaign issue, as we're hearing here tonight. i think he sees it as a defeat. and i think it is tonight for the republicans. it may not be a long-term defeat. it may be something that only lasts momentarily as shaun says, but for tonight, this is a setback for the gop. >> john mccain also has just said in the last couple moments that he is concerned this bill could be picked up and

re-introduced at any time, that republicans could run with it again. with that, we'll take a short break. a lot more of our continuing coverage of what has been a very bad night and a very bizarre day in washington. stay with us. you're watching cnn. ything keep you sidelined. that's why you drink ensure. with 9 grams of protein and 26 vitamins and minerals. for the strength and energy to get back to doing... ...what you love. ensure. always be you. i enjoy the fresher things in life. fresh towels. fresh soaps. and of course, tripadvisor's freshest, lowest prices. so if you're anything like me... ...you'll want to check tripadvisor. we now instantly compare prices from over 200 booking sites... ...to find you the lowest price... ...on the hotel you want. go on, try something fresh. tripadvisor. the latest reviews. the lowest prices. forhas adapted to my weightic

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welcome back, everybody. we are covering brakieaking new from washington where republicans and donald trump suffered a stinging defeat in their effort to repeal and replace obamacare. >> john mccain cast a no-vote on the so-called skinny repeal measure. as a result, obamacare remains the law of the land. [cheers and applause] >> outside, demonstrators cheered when they heard the bill had failed. and the fallout is just beginning to sink in in washington and around the united states. joining us, from the center of health policy research at ucla, democratic strategist and shawn steel. and david, just, you heard

people cheering outside. a lot of people are very pleased with what happened. sh shawn seems to think republicans can move on from this, tax reform, infrastructure. can they? >> i think the inability of republicans to get something to the on this was an indication that it's going to be difficult for them to do it, if they can. there's certainly no evidence that they have momentum in the chamber to get something done. and now we're not in the first month of the presidency. we're getting into the year here. >> wasn't the tax reform part of the repeal crucial, or the tax cut of the, or the repeal crucial for tax reform? >> i think so. and what we've seen in their statement the other day was so minimal that you have people within the party who i think are very frustrated about the prospects of getting things done. and if you're a democrat, you cheer every day that something doesn't get done, especially something like health care where the repeal proposals were polling poorly.

every day you get closer to 2018, the prospects diminish for a repeal on this. the prospects could come back, but it's lower. >> we are just hearing from john mccain. i'm going to read part of it. from beginning i have believed that obamacare should be repeal and replaced. the so-called skinny repeal amendment would not accomplish those goals, while the amendment would have repealed some of obamacare's most burdensome parts. it does go on, but he calls it, the speaker's statement that the house would be willing to go to conference does not ease my concern that this shelf a bill wou -- shell of a bill could be taken up and passed at any time. >> he probably has the inside track. he ploblrobably was looking at and didn't feel comfortable

because he knew something. he said there were rumblings in the house that there was a plan to get it to the president's desk and circumvent the process, and if that happened, it would have been 16 million people off of hey, withalth care within th year. >> speaker ryan didn't do a lot to put those fears to rest. the inability for republicans to get even the most minor reform to health care through the senate and through the house, does this in a way, in some kind of bizarre way, does this move the united states closer to some sort of single payer, medicare for all? >> we heard mitch mcconnell talk about, we couldn't get anybody to go on the record about that vote. but 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 is an open question. there are many ways that countries around the world

provide universal access to care. there are competitive models in a number of countries, but the key is that everyone has access, the government's providing the financing. and we don't rely on markets when markets don't exist. obama care's not failing because there's a lack of competition. there is a lack of competition prior to obamacare, and in the large group market, there are markets through the south and through rural areas of this country where there are one or two insurers, that's not competition, and obamacare did not create those conditions. >> david, when we were looking at the votes, seeing mike pence, really working the floor, many were asking, you know, what role is president trump having in all of this? do you think he's done enough to actually push for this? >> what was it, an hour before the vote that he tweeted his support? he said here's the green light, basically, get this into

conference committee? has he done it enough? i mean, with the result, clearly no. but i'm not sure if the fault, you know, lays with him. >> you call it support. some call it pressure. different vrersions of it. >> yeah, right, look at the pressure he put on the senator from alaska. >> basically shaking it down. thank you all for being with us. of course we're coming to the top of the hour. some of you will probably stay with us. i'm john vause in los angeles. >> i'm isa soares. do stay with us. we are the world's news leader. . problem is, you're terrible with names. okay, this is the boss. you got this. anna!...yes! new clients? we've been there. and with breakfast on the run, we'll be there for you. book direct for a guaranteed discount. hampton by hilton.

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yeah, we are. no, you're not jimmy. don't let directv now limit your entertainment. xfinity gives you more to stream to more screens. this is cnn, breaking news. -- captions by vitac -- www.vitac.com hello, and a very warm welcome to our viewers in the unit and around the world. >> it's 3:00 a.m. in washington. thank you for being with us. >> dramatic as well as a historic night in the u.s. senate, with republicans failing in a last-ditch effort to repeal obamacare and delivering a massive blow to