All eyes were on three Republican senators – Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona – during a dramatic late-night vote in Washington, D.C., that defeated attempts to repeal and replace the Affordable Care Act early Friday.

The political scene took place on the floor of the Senate, with the crucial vote coming about 1:30 a.m. Collins was in the spotlight, surrounded by Republicans who supported repealing the health care law.

“The first ‘no’ vote from a Republican was Susan Collins. That is really hard,” said Sen. Angus King of Maine, an independent who caucuses with Democrats and has known Collins for decades. “The pressure she withstood was really astonishing.”

King said he hadn’t tried to lobby Collins, but he knew her views and that she would stand with thousands of Mainers who were in danger of losing health insurance if the so-called “skinny repeal” passed.

“She looked comfortable. She had made her decision. It wasn’t timid. She didn’t shout her vote, but it was a firm expression,” King said.

At stake: Sixteen million Americans who would lose health insurance under the “skinny repeal,” the latest repeal attempt touted by Republican leadership.

It took “no” votes from the three Republican senators to sink the effort. If any of them had voted with the rest of the Republican caucus, Vice President Mike Pence would have broken a 50-50 tie to set up the repeal of significant portions of the Affordable Care Act. The bill was likely to pass in the House and President Trump had made it clear that he was eager to sign a repeal measure into law.

Over the past few months, Collins had been a consistent voice criticizing repeal bills, ultimately coming out against both the House and Senate bills to replace the ACA. Murkowski also had been a frequent critic, but McCain was a surprise “no” vote as he had voted to advance the bill in a procedural vote earlier this week. McCain returned to Washington from Arizona this week after receiving a diagnosis that he has an aggressive form of brain cancer.

King described the chaotic scene in the Senate chambers leading up to the vote during a meeting with Maine reporters at the Portland International Jetport on Friday afternoon. King spent nearly 45 minutes talking about the events. While the outcome of votes is often known in advance, King said no one knew what was going to happen early Friday.

“The first inkling I had that we might have a chance at this was after Pence talked to McCain for about 20 minutes. Pence – this is all body language – turned and walked out. There was a sense of frustration in the way he left,” King said.

MCCAIN ‘NO’ VOTE UNEXPECTED

A reporter for U.K.-based The Guardian newspaper, tweeted as the drama was playing out that “Susan Collins, who has a smile on her face, just walked over to Murkowski and McCain and the three are laughing.”

At about 1:30 a.m., McCain walked to the Senate floor and gave the “thumbs down” sign, indicating his “no” vote. It was mostly over.

“There was no celebration. There was a ripple through the building,” King said.

The Senate’s presiding officer then gave senators one more chance to change their vote, King said. He likened it to the moment at a wedding when the pastor asks the crowd whether anyone objects to the marriage.

“There was a collective holding of the breath,” King said. “There was a pause, nothing was said and the presiding officer said, ‘On this vote, the yeas are 49, the nays are 51 and the amendment is not adopted,'” signaling an end to a months-long process. Aside from the current bills, Republicans have been attempting for seven years to undo the Affordable Care Act, former President Barack Obama’s signature domestic achievement that has resulted in more than 20 million Americans gaining health insurance and the uninsured rate plummeting.

Collins did not respond to requests for interviews Friday, but she released a lengthy statement in which she reiterated her position that the health care issue needs a bipartisan solution.

Read a statement from Senator Collins:

DEFENSE OF PLANNED PARENTHOOD

“We need to reconsider our approach,” Collins said. “The ACA is flawed and in portions of the country is near collapse. Rather than engaging in partisan exercises, Republicans and Democrats should work together to address these very serious problems.”

She also highlighted the repeal effort’s “misguided proposal” to defund Planned Parenthood for a year, noting that millions of women rely on Planned Parenthood for a critical array of health care services.

“Let me be clear that this is not about abortion,” Collins said. “Federal law already prohibits the use of federal funds to pay for abortion except in cases of rape, incest or when the life of the mother is at risk.

“This is about interfering with the ability of a woman to choose the health care provider who is right for her. This harmful provision should have no place in legislation that purports to be about restoring patient choices and freedom.”

In January, Collins and Sen. Bill Cassidy, R-La., proposed a moderate approach to health care reform, and she again called for consensus solutions in her statement Friday.

Sens. Lindsey Graham and Susan Collins leave the Senate chambers after the failure of the “skinny repeal” health care bill on early Friday morning. Reuters/Aaron P. Bernstein

COLLINS URGES THOUGHTFUL REFORM

“In developing legislation, our focus should be on the impact on people, premiums and providers,” she said. “We’re dealing with an issue that affects millions of Americans and one-sixth of our economy, and we need to approach reforms in a very careful way. That means going through the regular process of committee hearings; receiving input from expert witnesses such as actuaries, governors, advocacy groups, and health care providers; and vetting proposals with our colleagues on both sides of the aisle.”

Collins said that in contrast to the rushed “skinny repeal” proposal released hours before the vote, health care reform “needs to be a much more deliberative process.”

“Neither party has a monopoly on good ideas, and we must work together to put together a bipartisan bill that fixes the flaws in the ACA and works for all Americans,” she said.

Lori Parham, state director of AARP Maine, said her group met with Collins twice during the past several months, and was impressed at her openness and willing to listen to their concerns and how legislation would affect people who had gained insurance through the ACA. About 80,000 Mainers have ACA individual insurance.

“There was way too much wrong with this legislation,” Parham said. “In the end, Senator Collins listened to the people who voted for her.”

MAINER BREATHES SIGH OF RELIEF

Alyce Ornella, 37, of Brunswick, said she met with Collins in February to tell her about how the ACA saved her family from more than $100,000 in medical bills, and the senator was willing to hear about the positive impact of the ACA on Ornella’s family. Her son, Sam, was born two years ago with several defects, including his esophagus not connecting with his stomach.

Ornella said she and her husband, Andrew Jawitz, were self-employed at the time of their son’s birth and had signed up for ACA insurance. While Jawitz since has gotten a job with employer-based health benefits, Ornella said she has watched the health care debate closely, realizing that her family would have faced substantial financial problems had the ACA not existed when their son was born.

“I’m very happy that (Collins) voted the way she did. It wasn’t an easy position to be in. I’m glad she voted her conscience,” Ornella said.

Joe Lawlor can be contacted at 791-6376 or at:

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