WASHINGTON – It was 1:30 a.m. Friday, and Pennsylvania Republican Sen. Pat Toomey was in no mood to talk as he glumly left the floor of the U.S. Senate.

His party unable to pass even a scaled-down health care bill, Toomey waded silently through dozens of news reporters anxious for response to the GOP’s failure to scrap only parts of the Affordable Care Act known as Obamacare.

It was only after he found himself stuck waiting for an elevator that Toomey offered a terse comment: “It was a setback.”

Sen. John Cornyn of Texas, the usually talkative Republican leader responsible for keeping GOP lawmakers loyal and on message, said nothing as he disappeared behind the safety of the elevator doors.

The object of their despondency: Inability of the Republican Senate majority to pass any legislation to undo Obamacare despite four days of marathon discussions over the need to fix the nation’s health care system.

A last-ditch effort to pass the so-called skinny repeal bill – ending mandates that individuals buy health insurance and that large employers offer it – ended badly in the wee hours of the morning when GOP Sens Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona voted against the measure.

McCain’s vote came as a surprise. He had been hailed as a hero Monday by Senate Majority Leader Mitch McConnell for flying from Arizona to Washington to participate in the health care showdown despite blood clot surgery last week and a diagnosis of brain cancer.

McCain said he could not vote for the partial repeal bill because it did not meet his requirements of health care, had been forged without bipartisan input and ignored the usual deliberative Senate process for passing significant legislation.

Republicans and conservative groups were still reeling hours after the vote. Six years of promising voters they’d get rid of former President Barack Obama’s signature law didn’t come to fruition even though they control the Senate, the House and the presidency.

Sen. Chuck Grassley, R-Iowa, captured the GOP leadership’s dismay, lamenting that a continuation of Obamacare means many Americans will get no relief from high insurance premiums.

“The result is disappointing,” said Grassley. “The health care situation is the same as before. Obamacare has not delivered on its promises and is failing.”

Sen. David Perdue, R-Ga., railed at Senate Democrats for standing united in opposition to Republican proposals to undo unpopular parts of Obamacare, including the mandate every American receive health insurance.

“Throughout this entire process, we have witnessed everything that’s wrong with Washington,” he said. “Because of politicians who put their political self-interests ahead of national interest, Obamacare remains the law of the land.”

The American Conservative Union focused its ire on Collins, Murkowski and McCain, calling them “the three ‘Republican’ sellouts (who) sided with liberals in the Senate to force this failed healthcare system on all Americans.”

There was lingering resentment as well toward Sens. Shelley Moore Capito of West Virginia and Rob Portman of Ohio, though both Republicans voted for skinny repeal. They had voted against an earlier GOP measure for a more sweeping repeal of Obamacare.

In an interview, Tim Phillips, president of the conservative political action committee, Americans for Prosperity, criticized Capito and Portman for what he described as a “cynical” flip-flop.

Capito had been torn between wanting to repeal unpopular parts of Obamacare yet preserve its Medicaid features. Her state has the greatest share of its population covered by Medicaid than any other.

Chris Plein, West Virginia University public administration professor, said it was fascinated watching Capito “tacking this way and that in rough seas resulting from pressure by Senate leadership and President Trump on one hand, and ACA advocates on the other.”

Capito went along with leadership in voting Monday to allow debate on Republican health care proposals, then voted for a Republican repeal and replace plan for voting against the repeal-only bill.

Friday she supported the skinny repeal bill. In a statement afterwards, she said she wanted to protect those who “rely on health coverage” and opioid treatment through Medicaid while at the same time realizing insurance premiums are too high and West Virginians don’t have enough coverage choices.

Going forward, Capito -- and other senators from both parties – urged Democrats to join with Republicans in coming up with bipartisan legislation to address problems with the nation’s health care system.

Republican Sen. Todd Young of Indiana said he will “work with my colleagues on both sides of the aisle.” Young is a member of the Senate Health, Education, Labor and Pensions Committee that plans to hold hearings on health care.

Indiana’s Democratic senator, Joe Donnelly, said that by “working together we can improve our health care system,” adding that he attended a dinner Wednesday night where a bipartisan group of senators discussed how to work on improvements.

Senate Majority Leader McConnell didn’t exactly warm to the idea in his remarks on the Senate floor after defeat of the partial repeal bill.

“It’ll be interesting to see what Democrats suggest as the way forward,” he said. “For myself, I can say that bailing out insurance companies, with no thought of any kind of reform, is not something I want to be part of.”

Democrats and medical groups that opposed the Republican-only effort for health care reform expressed relief over the outcome of the GOP proposals.

“The Senate Republican scheme was a terrible bill for the middle class and that’s why it was rejected on a bipartisan basis,” said Sen. Bob Casey, D-Pa. “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.”

Frederick Isasi, executive director of Families USA, a health care policy group that supports Obamacare, warned he debate is not over. “Make no mistake, this likely is just a pause in the attack, not a final victory,” he said in a statement.

Indeed, several Republicans said they will continue to work hard for repeal of the Affordable Care Act.

“I’ll fight Obamacare until my dying breath,” said Sen. Ted Cruz, R-Tex.

Sen. Joni Ernst, R-Iowa, said the current law is “not sustainable in Iowa and we have to act. Iowans in the individual market have seen their choices vanish and have seen massive rates increases”

Sen. James Lanford, R-Okla., vowed to “continue to work to get relief for all Oklahoma families who daily deal with the consequences of Obamacare.”

Contact Washington reporter Kery Murakami at kmurakami@cnhi.com.

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