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The Senate in the early hours of Friday morning rejected a new, scaled-down Republican plan to repeal parts of the Affordable Care Act, derailing the Republicans’ seven-year campaign to dismantle President Barack Obama’s signature health care law and dealing a huge political setback to President Trump. Senator John McCain of Arizona, who just this week returned to the Senate after receiving a diagnosis of brain cancer, cast the decisive vote to defeat the proposal, joining two other Republicans, Susan Collins of Maine and Lisa Murkowski of Alaska, in opposing it. (Pear and Kaplan, 7/27)

The Senate voted 49-51 against the "skinny" bill, which would have repealed ObamaCare's individual and employer mandates and defunded Planned Parenthood. (Sullivan, 7/28)

"I do my job as a senator," McCain said after he left the Senate chamber, saying he voted against the Obamacare repeal bill "because I thought it was the right vote." ... Later, McCain issued a statement offering a more thorough explanation of his vote, saying that he has always believed that Obamacare should be repealed and replaced with a solution that "increases competition, lowers costs and improves care for the American people." (Bresnahan, Everett, Haberkorn and Kim, 7/28)

McConnell said at about 2 a.m. that it was "time to move on" rather than trying again to pass a GOP bill. He said he wants to hear ideas from Democrats about what to do next on health care. "What we tried to accomplish for the American people was the right thing for the country," McConnell, who was clearly shaken, said after the vote. "And our only regret is that we didn't achieve what we had hoped to accomplish. I think the American people are going to regret that we couldn't find a better way forward." (Kelly and Collins, 7/27)

Friday’s vote leaves Republicans without any clear next step in their monthslong effort to roll back the ACA and with no significant legislative accomplishment during President Donald Trump’s first seven months in office. “This is clearly a disappointing moment,” Senate Majority Leader Mitch McConnell (R., Ky.) said on the Senate floor moments after the vote. “I regret that our efforts were simply not enough this time.” (Peterson, Hackman and Hughes, 7/28)

With the vote on a “skinny” repeal bill, Republican leaders were trying what amounted to a legislative Hail Mary pass. But they could afford to lose only two party members, and three Republicans voted no: Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona. Here are some of the key lessons from the evening. (Kaplan, 7/28)

The GOP plan was to take the “skinny” bill to a conference with the House on a more substantial bill the House approved in May that would repeal and replace the ACA. With that path no longer available, and the failure to pass other proposals that would replace the Affordable Care Act, McConnell said, “Now it is appropriate to ask (Democrats) what their ideas are” to address escalating premiums and the flight of insurers from state ACA exchanges. (Radelat, 7/28)

Budget reconciliation allows the measure to pass the Senate on a simple majority vote, but requires that all of its provisions pass muster with the Senate parliamentarian as budget-related. The text of the bill posted publicly at 10 p.m. The CBO report on it began circulating on Twitter around midnight and the vote finally closed around 1:45 a.m. Friday. (Michael McAuliff, 7/28)

The plan would have revoked the current law’s mandate on individuals to buy insurance and end the requirement on employers who have 50 or more workers to provide insurance coverage. It would also have reversed the Affordable Care Act’s tax on medical devices. (Lochhead, 7/27)

The bill would mean 15 million more people would be uninsured next year than under Obamacare, with 16 million more in 2026, the Congressional Budget Office said in a report released late Thursday night. Premiums would jump 20% next year, compared to current law. (Lee, Fox, Barrett, Mattingly and Killough, 7/28)