we talked moments before this and you said people didn't know where john mccain was going on this. >> it was interesting. i think about six hours ago, this result would have surprised a lot of people. after that press conference this evening where john mccain, lindsey graham, ron johnson and others said they would vote for it if they got assurances from paul ryan. the senate and house leaders outreach and a lot of work done behind scenes to convince those gentlemen to get to yes and all but one did ultimately get to yes. the signs early in the evening all seemed to point to confidence from republican leaders that they would have these votes. the vote was moved up a little bit in the calendar, it was scheduled to have it a little earlier in the night than expected. mike pence came a little bit earlier than people expected. and then there was a development where people just stopped talking about how they would vote. it was an hour before the vote, and john mccain said he just was not going to talk bit. sort of seemed like it shifted maybe around 11:00 p.m., and by the time they got to the floor we were all trying to figure out the body language and the conversations on the floor. but it came clear that the previous vote was left open that the republican leadership just didn't have the votes to go forward with it. you heard some of it in mitch mcconnell's voice when all the votes were counted. this is a stinging defeat for republicans. there is no other way to replace it. >> and mitch mcconnell didn't mince words about it. he turned to the republican conference in the senate and addressed them exclusively and he said this is now over. he said it is now time to look to the democrats to see what their solution is, lawrence o'donnell joins me on the phone, and you heard the first strains of this, lawrence, they want european style health care, socialized medicine. there was no conciliation in his tone, he said he sees it as a failure and that democrats don't have a better solution. >> well, the other word for what he was describing, ali, as you know, is medicaid. which is the system that mitch mcconnell is on himself, it is a federal government system. a single payer system. we throw around a lot of terms that i think are not that clear to a general audience, single payer, things like that. we should always just use the word medicare, because that is what it is. and if the united states were to go to a broader version of medicare to include more people that is how you would do it. the so-called single payer approach is to expand medicare to people below the age of 65. and that is not a scary thing to anyone in america who knows what medicare is and knows anyone who is on medicare. but ali you have to be very careful in these exercises when you are scoring who won here. because it has never been clear to me that mitch mcconnell really wanted to pass this bill. i never saw a way for him to pass it. if he had passed it he would have done it in ways i would have never understood. no one in the senate i know saw a way to pass it. he took the least popular piece of legislation that has ever come to the senate floor and he got it to 49 votes. that is kind of an amazing accomplishment in and of itself. and what he gets to say is he tried. we did everything we could. we really tried. and i'm not sure that he really tried. there is a phrase for this in the congress, which is getting this dead cat off my doorstep. i have heard it said many times when the senate sent a bill to the house that the house could not deal with. i have heard senators say i want this dead cat off my doorstep which means they want to get it to a vote which means it is not adhering to us here, whatever happens we don't care, we're just trying to move it away from us. the most important thing mitch mcconnell said at the end of this vote tonight was let's move on. that is the most important thing to him. is to get this thing over with one way or another and move on to tax cuts. move on specifically now tomorrow to the defense authorization bill but to move on to all the other business that mitch mcconnell wants to conduct because he knew this was hopeless. >> and the references to the senate being paralyzed is because they were stuck, they have been stuck on this piece of legislation. lawrence o'donnell, stand by for me, the democrat from oregon is joining me, i think he is there, are you with us? >> yes, i sure am. >> as lawrence said, mitch mcconnell said let's move on. he commented on how folks on your side of the floor, the chamber, are probably celebrating. he said we're relieved. what are you feeling? >> well, we are tremendously relieved. there was enormous drama because as we sat there tonight and stood there tonight there was health care for millions and millions of americans hanging in the balance. the proposal before us, the third proposal, the skinny proposal would still have destroyed health care for 16 million people by next year. it still would have raised policy prices by 20% for those who were still able to buy policies. so this is really a tremendous moment in which we dodged a bomb going off in our health care system that would have hurt the health care and peace of mind of so many of our fellow citizens. >> senator, stand by for a second where ted cruz is making some comments. i'll be back in a second. >> we have to honor that commitment. and i believe we will. the losers tonight are the millions of americans who have been hurt under obamacare. the millions of americans who have lost their jobs. who have been forced into part-time work, forced to work 28, 29 hours a week. millions of americans who have lost their doctors and seen their health care skyrocket. >> senator, to ted cruz' point, to mitch mcconnell's point, let's see what the democrats have now. i'm not running into a lot of democrats who don't feel that there are necessary repairs to be made to obamacare. specifically as it relates to the individual market. there is a portion of people in the individual market who are rightfully frustrated and whose premiums have increased since obamacare came into effect. do the democrats have a good idea of how to fix this? >> yes, i sure think we do. we know that in order to have the competition that will drive prices down you have to have reassurance for companies. this was set aside by my colleagues which was insurance going into new markets, that is insurance that if you get a disproportionate share of really ill people you will have your rates adjusted for that. the second thing, the cost insurance, that tells people that lower premiums and deductibles have to be nailed down, the president has held on to those, saying i'm not sure, i will release them. third, we have to do a lot more to take on the opioid epidemic. it's ravaging the country, we all know we have to do something about it. the premiums and insurance deductibles and out of pocket costs come down even further. for those who are just able to be a little bit better off than the 138% for medicaid. those folks get a lot of coverage to buy insurance now. but as you go up it becomes more difficult. >> senator, part of the problem for democrats with tonight's failure of the republican attempt is that this now gets handed back to democrats as your problem. in other words, the failure of obamacare as ted cruz would like to call it or mitch mcconnell or the death spiral that many republicans talk about that we know that many americans respond to whether or not we know that is factually accurate is the kind of thing that will be laid on democrats and republicans are going to say we tried to fix it. this is a tough position for democrats to be in. because you make these interesting suggestions but how do you get them done? >> well, i don't think it will play out the way you just said because markets are sabotaged, the studies show the various things done, paring down the insurance last year and proceeding to hold onto cost insurance, the time for people to sign up for insurance this year. also we have time and time again said to our republican colleagues set aside this basic deception you have been pushing, which is that millions of people are being hurt. millions are people are being helped. two weekends ago i had five town halls in very red counties. i had seven main street walks in very red cities. those folks were coming out to the town hall in conservative areas saying please save us, one out of three individuals in the oregon area is on -- >> i hear you, senator, the individual market is about 7% of the population and of that there is a small percentage of people who have been adversely affected by this but it does amount to a lot of people. to hear people like you say it's all been good and it's not been broken, and their premiums went up before donald trump was elected and before the republicans controlled all legislative branches of government. >> and let me point out the main factor that has been driving up the cost has been the high cost of drugs. we've come forward time and time again and said that medicare needs to be able to negotiate these prices. we should not be charged more for drugs than these drugs were invented with also the research we paid for in america that they should not have had to pay for in canada for the same drugs. we have to be willing to take on the high cost of drugs. we're ready to do that with them if they will join us. >> senator, thank you for joining us, we appreciate the time you have taken with us. senator jeff merkeley of oregon. lawrence, you and i have had this conversation before. what is the advance of obamacare? what does it look like? you mentioned medicare and you're saying let's keep it single and not call a single payer. it's the government that covers everybody's health insurance. do the democrats need a plan to say this is how we would fix it if we were in power? >> they will need a plan if they get the presidency back and if they get the house and senate back and they don't need a plan a day before that. because nothing but nothing is going to happen on this subject during the remainder of this presidency and during the remainder of the republican control of the senate, republican control of the house. this is completely over. this is not a policy discussion. there is no policy discussion that will go on among -- between these parties going forward. what you saw tonight was a pure exercise in politics, republicans made a promise that some knew would never keep but sounded good. that is the repeal and replace. it was the replace part that they were never going to be able to do because that is the incredibly complex exercise. if the republican promise from the start was repeal and repeal only and if they could have built enthusiasm for that and if they could have built majority support for repeal only they could have done that. that is an easy thing to do, repeal. but replace is virtually impossible. and that is what tied them up. no one -- i hate to have to go back to give this elementary lesson about politicians, but please don't believe them. no one out there believe politicians -- >> lawrence, here is my point, okay? ted cruz comes out after this vote and says oh, you know, this is terrible and we really have to do something. ted cruz voted for this tonight. if this thing became law, ted cruz would have voted to take health care away from 1,750, 000 people in texas. i promise you, ted cruz did not want this to pass. marco rubio did not want to take health care away from 1.5 million people in florida which is what this would have done. and i promise you, mitch mcconnell would not have wanted to take health care away from millions in kentucky. this would decimate -- this was about the politics of what to do about the impossible language that republicans brought to this subject for seven years. what do we do? we said repeal and replace, what do we do? this was the best that they could do. they made an effort that looks like a real effort that i do not believe was a real effort in the senate. and they are -- the 49 senators who voted for this, a minimum of 40 of them are very, very glad it did not pass. >> let me ask you something, does donald trump see things your way? >> donald trump has not understood one minute of anything that has happened in this job since inauguration day. he has no idea what happened on the senate floor. but he has a very limited attention span and is bored and will give up on it. just like you saw him give up the first time when the house failed to pass it. he will give up and move on to tax cuts and everything else. this is over for trump, although he will blame people. he will go around blaming people and say i did my best, sat here with my pen ready to sign it and all that nonsense, but trump has no concept of what happened in the senate tonight. >> lawrence, good to talk to you with your analysis tonight. i want to go to senator tammy duckworth, she is a democratic senator from illinois. senator, i want to ask you what i asked senator merkeley tonight, how do you feel what happened? >> well, of course i'm glad we won this one. but i'll tell you it really was not about a republican win or a republican loss, this was really about the american people, all those who would lose health care. all day i talked to families with babies, and little babies with disabilities who said please save our lives, that is what this is about tonight. >> what do you propose gets done, if anything, about obamacare? do you think it needs any fixes and do you know what they should be? >> oh, most certainly it needs fixes. i have voted to repeal the medical device tax for one in the past. i also think we should look at the cost of prescription medication. this is something i struggled working on when i was in the house and worked on in the senate. we pay higher costs for prescription medications than anybody else in the world and those are some of the things we can do to bring down the costs in our health care system. >> senator, my producer is telling me there is a lot of cheering going on outside of the capital. certainly a lot of people who will be happy with this news. many were sleeping for it and will wake up to it in the morning. there are people with legitimate concerns about obamacare, we're listening to that. it is quite loud, actually. what do you do for those people? >> those are people fighting for their lives. >> what about those americans -- there are a number of them who did see their premiums go up before donald trump was elected president. so under obamacare with the subsidies not being threatenened to the insurance companies their premiums did go up. what would you say to them? >> well, what we can do to get them lower and one thing we can do is to make sure people who are buying into the exchanges stay for the entire period and that they're not just actually buying to health -- a week or two before they need to have knee surgery and that was one of the elements that came out the way the affordable care act was set up. people were actually waiting until they needed surgery, buying insurance, getting covered for the knee surgery and then dropping the health care. one thing i always proposed is that if you are going to sign it and buy it then you need to stay within the exchange for the entire year at the very least so that we don't have this abuse of the system that has been occurring. >> what would you say about those who say look, the messaging was so difficult and so wrong that republicans were able to win an election in some part on the idea of repealing obamacare. there is something that people don't understand. i use mitch mcconnell's home state of kentucky as an example where obamacare and the aca have polled as being relatively unpopular while connect. the state exchange is wildly popular. it's the same thing. >> right, exactly. i can only tell you what i tell the people of the great state of illinois that i represent. and that is i will work to make sure that we have a health care system where we expand access to people and lower cost. whatever that is, whoever comes up with it i will support it and work in a bipartisan way to fix that. that is the message i took on the campaign trail for the last two years. i won my seat just this past election cycle, the same election cycle that president trump won on that message. and that is i will work for the people of illinois to make sure we expand your access and reduce your cost and i will do it in a bipartisan way and i think that is the message the american people are looking for. >> and in the same sentence where mitch mcconnell said let's -- it's time to move on. he also spoke about the fact that left to the democrats they will come up with single payer european socialist medicine. i am asking you fairly, is that a goal that democrats would like to see? most countries in the world, most rich countries have universal health care. we don't have that yet. lawrence o'donnell said why don't you just expand medicare? that would be the same as having universal access. >> well, i don't know that single payer is achievable right now. it certainly is something that is a goal for most democrats. what i have told people is that we should take a serious look at allowing buy-in to medicaid, buy in to medicare, and perhaps offering the idea of offering a publics option on the exchange so that there are options. part of the reason premiums are going up so high for some, there is no market forces at play to force that insurer to provide a lower cost care. and i think a public option on the exchange would provide some of that market competition that should be there. so there are many things that we can do. i don't know that we can get to single payer health care any time soon, but we should look at a public option, buy into medicare, buy into medicaid, all of those should be on the table. >> senator, thank you for joining us, it's good to have you here. david jolly has been here for several hours, ron clain, i think the two are still with us, are you there? >> hang on a second, do i have ron? there you go, how are you, ron? >> good, ali, you and i and brian were talking as the vote was going down. and really, until we saw john mccain turn his thumb down we didn't know how this was going to go. lawrence was saying that look, it's done now. they're got going to go after this again, how do you see it playing out? >> well, you know, i think the republicans may take another run at it. but i think it's done for a while at least. and i saw lawrence had a very interesting insight about the whole dead cat problem and the senate moving the cat off. the thing lawrence didn't get to when the senate moves the dead cat off it goes to somebody else's door step. right now it's on donald trump's door step, he ran on a promise to repeal-and-replace obamacare, and said it would happen the first day he was president. that now is on his doorstep, he is the president of the united states and controls the house and senate. he did not deliver, this is really on his doorstep. secondly, ali, you heard mitch mcconnell say we worked hard on this. and as i listen to that it was a little bit like listening to a kid who does not study all year and then crams like crazy a few days before the final exam. they had seven and a half years to repeal-and-replace obamacare, this took place on a piece of paper that they wrote at lunch today. so a little more work should have gone into it to be ready for this moment, now hopefully people will take senator schumer up on his request to work on this. you heard ideas to improve obamacare, maybe we can move forward on that maybe not. but it would be great if the senate took senator schumer's lead and did that. >> david jolly is with us, david, you were a former congressman, did you ever handle legislation like this? it was reverse engineered based on what may get votes as opposed to an idea that is then written out by a staff and looked at by committees. >> and it only works when leadership can actually push it through. when they can't you see what we saw tonight. i took some obamacare repeal votes but i was part of a class that was also expecting a replace measure. and frankly there came a breaking point a couple of years ago where a dozen of us said about leadership, look, to ron's point, one thing that is obvious tonight but really has not been said too much, the gop really never had a replace plan, look at the gop for the last six months, that is the fault of leadership. tomorrow, they will wake up with a real problem in their base, they will hear a lot. the conservative world is going to wake up tomorrow with anger, raw anger at this gop for not delivering on the promise in the last several years. >> let me ask you about it, david, i love bringing it up. the 34 out of the 35 richers est -- richest countries in the world, you see them with slightly better outcomes. when did this become a liberal versus a conservative thing, because if i'm a conservative and want government to spend less, i would look at some of the other conservative policies. why did this become a political conservative thing? >> i think there were just not enough single payers, listen, the two senators you had on tonight talked about the cost of prescription drugs. they didn't offer, and i say it respectfully, a real plan. ali you know what happened, obamacare injected into the risk pool, highly subsidized families, i say take the high risk pools and move them into medicaid enrollment. keep the medicaid in place for those who need financial assistance and you have stabilized and driven down cost for the medium low pool. they recognize there is a high risk pool that does need extended coverage and there is a financial challenge, financially challenged pool that does need federal assistance. >> donald trump tweeted as was expected. three republicans and 48 democrats have let the country down. he said also, i said from the beginning, let obamacare implode, then deal. watch. tell me how you interpret that. >> listen, this is the president shifting his plan again based on whatever happens on the hill. we saw this, right, initially it was repeal and replace, it was wither on the vine. this president is not a policy leader of the gop. we know that. he leads by insult, and frankly his insult to colins, murckowski and john mccain tonight, are only going to make them more popular with their constituents. he is fighting a battle he will not win with these three senators. >> let me ask ron clain, what do you think the president will do about it? will he let it go? mitch mcconnell sounded very clear that for him for now this fight is over. that does not seem to be the sort of thing donald trump likes to do. >> he is not the kind of guy who takes a loss so easily. but david is right. his options are very few here. he will face an enraged conservative base and will watch on cable television in the next 24 hours a thousand replays of him saying it would be easy, i would get it done on day one. that will fire him up but again, he never got enough consensus to build the republican party around an alternative. it is kind of hard to get this done, he is at a fork in the road, change his style, stop the crazy threats and tweetings. try to build a consensus or he will have to accept the fact this thing he promised to do will not get done. >> let's go to garrett. >> our team ali is doing amazing work talking to some of the senators as they leave for the night and probably the week. we have spoken to john mccain and lisa murckowski about the no vote. john said he felt it was simply the right thing to do. apparently he told senator schumer about this, and eventually sat on it until the vote came around. the democratic leader knew this would happen, as for lisa murckowski she has faced a lot of pressure in the last couple of days and told a member of our team, look, this was tough. it was hard to let down their colleagues. she and john mccain felt they were letting republicans down but had to do something they felt was the right thing to do. murckowski said look, we still want to get obamacare repealed and fixed but they knew it was not the right way to do it. a couple of senators taking a very tough vote tonight. and i'm sure they will feel the wrath of the white house as early as tomorrow morning if there are not more tweets. >> there are pictures on the left of john mccain walking out of the capital, is that happening now? that just happened a few moments ago that john mccain followed by a pack of reporters out there. so garrett, just to be clear you're telling me that while we were all watching it live after midnight, mitch mcconnell knew that john mccain was going to vote no? >> i don't know that mitch mcconnell knew but i knew that chuck schumer knew, he told reporters this was something he knew about and was talking to john mccain several times a day and knew this would be the outcome. >> because at some point, john mccain had come into the chamber and had gone over to some democrats, all the other democrats got around him, dianne feinstein was there, put her arms around him. they were joking and not in a serious conversation. we could not read from people's body language what was going on in there. >> right, you didn't get the sense that the stakes were super high in the conversation, not the same impression you got when john mccain was talking to his republican colleagues. remember, we were watching him talk to the vice president for quite a while. two of them even left the floor together for a little while. you know, there are some talks that maybe it would take a phone call or have another conversation, sort of away from the cameras. so you know, in hindsight, the dynamic between john mccain and the democrats was so much different from the dynamic between he and his republican colleagues, who are understandably very frustrated. it's not as if john mccain was not somebody who has campaigned on repealing and replaced obamacare, just as the rest of them have. >> no, it's a good point, david jolly, we had senators murckowski, colins and john mccain voting against this. three different people and three different reasons to do so. already, donald trump is out there, he did not name them in his first tweets but he will. he will talk about them and drop their names over the next few days. do these three people have something to worry about, or do they benefit from having stood their ground? >> no, they're stronger at home. they voted their state tonight. listen, collins and murckowski are due great remarks for their independence streak. the 2008 presidential nominee not joining the republican party in this repeal vote that -- understand what it mean, it means mitch mcconnell has weakened and donald trump is weaker, and also says that john mccain may be the lion of the senate for the continuing time he has. this is now his time. he was a maverick tonight and gave a lot of americans something to believe in. >> everybody had their eyes peeled on john mccain to see which way he will go. he walks into the senate, puts his hand out to the vote counter to indicate that he is ready to vote. he gets the gentleman's attention and john mccain puts his hand out and puts his thumb down and says no. and gets announced that he has said no. it was the moment where everybody realized that vote was dead. ron clain is with us. ron, what do you make of those three mavericks who voted against it? >> well, you know, i agree with david, they did themselves well at home. it much dawned on donald trump tonight that his fate rested on someone in the middle of what he called american heroes week. john mccain, who is a hero, who during the campaign, donald trump said he was not a hero because he had been captured by the north vietnamese. and to have your fate ride on john mccain's vote just shows how trump's style, we have to talk about how he is the teflon president, he said a lot of stuff and gets away with it. he didn't get away with it tonight. when push came to shove it would have been impossible to imagine donald trump calling john mccain and saying hey, do me a favor, i really need this one. he is paying the price for it tonight. >> and let's go back to garrett, seeing these pictures, chuck schumer coming out to a lot of cheers and people shaking his hand, what do you have there? >> yeah, this is a celebration, a protest that turned into a celebration outside the capital tonight, all day and all night long we have had dozens, occasionally hundreds of demonstrators outside the capital protesting what they thought was this repeal vote that at times seemed much more likely to occur, in fact, you could even hear them on the floor, in the hallways leading into the chamber, a lot of the democratic senators getting hailed as heroes as they leave the room. and ali, just as we stand here talking i have gotten an e-mail, a statement from john mccain on his no vote tonight. a big part of this was the question whether the skinny repeal had a chance of coming into law. after paul ryan said -- addressed this earlier, he said john mccain said the speaker's statement that the house would be quote willing to go to conference does not ease my concern that this is a shell of a bill that could be taken up and passed at any time. he said this, look, i still -- said from the beginning i believed obamacare should be repealed and replaced, it increases competition, lowers cost and improves care. this is not somebody who says this is a good law, obamacare, i want to keep it. i am glad somebody stood up for it. he said this is the wrong vehicle for it and is that is how we got to it tonight. >> garrett, stand by, i want to go to lonnie chen, former adviser to mitt romney and others. lonnie, you and i talked the other day about how thoroughly this bill had been examined. i said it had not at all. that was the point that john mccain actually came to the floor with the other day when he returned after the cancer diagnosis a week later and said why don't we do it the right way? you can see right now the republicans didn't hold hearings. >> ultimately the process here was not a good process and that is what we have come to. the reality is there was an opportunity, particularly with the last bill, the skinny bill, ali, it really did not come together until the last couple of hours. there was not an opportunity to figure out what was in there, that was a problem. >> right, at some point we can't hang it on -- we didn't get enough time. bills are done a certain way, i guess republicans want to fix it. and democrats need to do it the right way the next time. >> that was john mccain's point going forward. you know, republicans tried this by going through this budget reconciliation path, which was a one-party path and going forward it will have to be different, the regular order as john mccain alluded to. that was the big rationale for his vote, look, we have a regular process we have been through in the last several months, that is just not the way to do it. >> so lonnie, i'm going to ask you this, if what mitch mcconnell says is true, i doubt that was president trump. and increased access, when did that stop becoming something conservatives were interested in. >> well, you know, it's a good question, ali, there certainly has been a division within the republican party about the value of coverage. again, that is another truism. i think what we've seen throughout the debate, how much disagreement there is between republicans over this. i do think what this defeat enables is a fuller discussion about going forward, what we can do to actually make things work better and to your point about costs absolutely reducing costs needs to be the first goal for republicans and democrats. >> so in fact, we were referencing tonight, the disagreement between republicans more moderate republicans and some conservatives who don't necessarily think that health care for everyone is or should be an entitlement or a right. but fundamentally those disagreements i think occur across the political spectrum. but as you know as a bit of an expert on this, lonnie, for 58 countries who have universal health care coverage, some like canada, or switzerland, are completely private insurance. but the uniform thing about all of them is that everybody is covered. >> if you look at this ali, you look at the united states, you often times hear this battle cry of no government involvement in the system. you know, medicaid and medicare cover an awful lot of people and those are systems that governments play a role. hopefully we can get past this notion of no government in the middle of health care, that is not realistic. we need to see change to work things better for people, one thing republicans tried to do is to move toward greater state innovation, that may be a thing where republicans and democrats can get together and say hey, we have agreement there. >> david jolly, i want to bring you into it. is there any political capital in republicans doing what lonnie is suggesting, going at it, not with donald trump leading the charge at this time. but going at it and saying let's fix this together. we now all agreed there are things about obamacare that is broken and maybe we won't call it obamacare any more, because that is bad for republicans. is there any political capital in doing that? >> i'm not sure they would accept it. i don't think you could get the vote. there is this narrative among republicans, as we saw during the rallies, keep your government out of my medicare was one of the famous signs. but the reality is so much health care is actually subsidized and earned entitlement through medicare, medicaid and the v.a. so we have a platform for some type of government provisions. the politics can't be lost on this. tonight was a very embarrassing night tonight for the republican party. we also have to recognize it's easy to criticize this president but it is fair tonight. this is a historic failure for donald trump. the first republican president after barack obama, the president who ran saying he would repeal it, saying get government out of health care let's do away with all of it. he lost tonight in a very, very bad way. this republican party is not going to embrace consensus tomorrow, they will be deeply divided. >> ron, let me ask you your take on this. i want to go back to this concept that i was discussing with lonnie, i don't really know how this became a liberals want universal health care coverage and conservatives don't. because america has per capita the most expensive health care by a long shot. the outcomes are similar and sometimes worse than other developed countries. that should be something that republicans should want to fix and democrats show want to fix. >> you know, ali, it's a great point listening to lonnie, i remember all the times working the white house when president obama would say i'm shocked at all the republican blowback i'm getting for my health care plan. it's really based on mitt romney's health care plan in massachusetts howe did it become a radical thing just because barack obama put his name on it? maybe tonight could be a turning point in deescalating politics on it and getting practical solutions. but i do think the point about the republican base is important to keep in mind. not the skinny bills, but the proposals were essentially ones that took a lot away from medicare, health care for poor people and set it aside to give tax breaks to rich people and you can't fix the health care system if that is where you start. if republicans could get a bit more back to the mitt romney position and put more ideas on the table there is a potential middle ground here but it would mean giving up on the idea of slashing medicaid to pay for tax cuts. >> garrett haik at the capital. nobody has said mooch or scaramucci in the last few hours, but that was on the agenda today, anthony scaramucci stealing the headlines today. we wrestled them back for a moment. but what happens tomorrow? there are two big issues, one the failure of the repeal-and-replace obamacare. >> i think when james comey was here, that got a ton of attention, but when you look at what happened in the last 12 hours here on capitol hill i think it's hard to find a worse day for president trump on capitol hill than what we've seen in the last 12 hours. the failure of a health care bill is an enormous problem for republicans that they don't have a path to recover from. earlier in the day, the senate passed 98-2 aggressive sanctions against russia, iran and north korea, the russian part of that has been a real sticking point with the trump administration, now it passed with veto-proof majority. you had two prominent republicans saying if you are thinking about firing jeff sessions and squeezing in an appointment the old fashioned way through recess, it's not going to happen. so very different republican senators all sent messages to donald trump. so the comments from his communications director generate maybe a lot more heat than light about the problems internally and structurely that the republicans will have in getting things this president wants done, done through this body here on capitol hill. >> let me ask you after the shooting at the republican baseball practice in alexandria, there was talk about lowering the level of the heat and the rhetoric and some talk about bipartisanship. and then as -- the obamacare repeal in the last few weeks had started to fail, you heard republicans saying hey, we need to go and talk to democrats about this. we have to come up with a bipartisan bill. we heard that more and more. after what you saw tonight and with the feelings that you have had from people who have been walking by you and you have been talking to, is bipartisanship more likely or less likely in congress than it was 12 hours ago? >> well democrats certainly hope it is. i mean, it's hard to say you saw a sort of bitter upset mitch mcconnell here tonight not in the mood to work across the aisle with democrats. >> he didn't even look at democrats, he hardly looked at them. >> exactly, but we heard from democrats saying hey, in the beginning of the health care conversation there was a health care bill put forward by susan collins and bill cassidy from kentucky, they mentioned the supporters saying look there are ideas out here that we would be willing to talk about it. democrats are playing with a weaker hand here, when you're a minority party you have to do it in a bipartisan way. there is a sort of a little bit of opening here for the possibility of that on the issue of health care, but the next issue up here in the hopper will be tax reform. as for now, the guidance we got in the republican leadership they intend to do that process as a largely one-party exercise. i am hesitant to predict the bipartisan on the hill, but democrats will try to make it happen. i will add to that, the fracture that you have seen in the republican party on the hill is such that maybe there are republicans who decide to join some of these things in opposition to their leadership, just because the republican leadership here seems to be having a hard time steering the ship. >> in fact, david jolly, if you took the group of center that are literally centering the north star there is a bigger group in congress than anyone else. do you think there is likely to be more or less bipartisanship as a result of what happened today? the most bipartisan thing that congress is likely to see this entire session happen tonight. >> i'm not sure either party embraces it, listen, they represent the majority where they get punished. they get punished at home for compromising with the other side of the aisle. that is a structure problem. we have states with closed primaries, many states only represent their parties. i'm not sure that changes but the reality is nothing gets done from here on. but ali, you hit on an important point, talking about scaramucci, and also we have to look forward and say who will trump blame for it? because in the morning, he will blame his leadership one way or another. >> but does it matter? in other words, is the lesson -- if you're a republican in congress, a senator or even if you're a member of the house and you watched it tonight, do you walk away thinking your future is not necessarily about being aligned with the white house or donald trump? >> no, if you're a republican who voted for repeal your constituents will appreciate it. if you're like murckowski, or collins, people voted in their states, in their districts. he once taught me something i have never forgotten and i think we need to see more of in congress and it's this. politics is always is a lagging indicator and never a leading indicator. members of congress are risk averse, waiting too long to make the decision. we need united states senators who step out and become leading indicators on bipartisanship and building consensus and solving real health care challenges in the real world. that requires yes, republicans to do it. it does require democrats, i have listened to so many democrats say listen we're happy to sit with republicans and work on ideas but really see a deficit of ideas, of true reform packages. what is the democratic proposal they all agree to? let's see that start to emerge so we can have a conversation. >> hey, ron clayton, is there political capital in democrats reaching out and trying to get something done across the aisle? >> well, look, i think garrett was right there it. when you're in the minority, you really have no choice but to try to get something done. and that was a suggestion in health care and other areas where you can get republican votes. but i think david is also right. for the republican base and for the republican voters who created a republican majority in both the house and senate they expect their guys to fight hard, stay tough and stay to the right. what you saw sadly during the process unfolding during the past couple of days is not republicans and the house reflect pensiveley about the vote, it's bad formula for getting things done in washington. >> david jolly, for a second let's go though that point. the attacks on murckowski and collins, in one case it was northeast women senators or something like that came from members of the house. apparently conservative house republicans. how does one deal with that? >> did i lose david jolly? >> are you here? >> look, this goes back frankly to 2010 and the tea party movement and the candidates we see emerge and be affirmed by a very strong republican conservative base. they will continue to do that. that is right. how they get reelected, not tomorrow morning saying let's compromise, but tomorrow morning blaming rhinos as i get called all the time and blaming democrats and the truth is what is sad for the country and gop that i believe in, where does a center-right republican like myself go? it's not to the democrats, my policies are not represented by schumer and nancy pelosi, but also not in the trump republican party. they have isolated reasonable republicans throughout the process. >> and is there a rump in congress to be had with people who share your views of whom there are many in congress, and who share views with some democrats? >> yeah, it's a small group. called the tuesday group in the house. frankly after the pulse night club shooting i came up with 30 republicans willing to work on the gun control initiative. and the closed primary systems and a campaign finance system controlled by the far right and far left special interests, and until we fix the structure defects, there will be no changes. >> and garrett haik, we can't sort of underestimate the influence tonight on those mid-term elections. what do you think? >> well, i think both parties will get a huge boost out of it. this has to be probably the first real victory for the resistance movement. i covered a number of these special elections in georgia and montana, kept an eye on the one in kansas, there were all of these places where democrats left with moral victories having come close to achieving their goals, this is something where the democratic base poured their heart and soul into getting this result tonight. we have had protests and letters and phone calls, e-mails, campaigns, you name it. from democrats i expect to see tonight become a huge fundraising tool, a huge ralliy cry, here is how we want to pursue it as we approach 2018. >> chuck schumer made a point of standing up in the house saying we're not celebrating, we're relieved. >> sure, as the democratic leader of the senate that is a perfectly appropriate position for him to take. if you are a democrat running for congress in kansas or missouri or oklahoma or somewhere else, and you're trying to crack through and win in a redder district, all of a sudden you have something you can fire up your democratic base with. and on the flip side of that coin, republicans are going to say see, we need more republicans in congress if we really are going to get it done. let's get more of the rhinos and vote in more base republicans. >> ron, tell me what you think of that. that is interesting, my optimism garrett just stamped all over. is there any reason the believe anybody gets more moderate out of this and walks away saying not talking to the other side doesn't get us anywhere. >> i don't want to sound like a politician, but i think you're both right in this way. first, garrett is right that tonight is a huge win for resistance, for the grass roots activists and the party who have been fighting for six months, obviously, john mccain cast the vote but the reason it took so long to get done the reason it happened this way was because of this grass root movement. this will increase their enthusiasm and increase the willingness to fight. that will obviously increase the partisanization of some of these issues. the debt ceiling is coming up. a lot of republicans will not vote to raise the dealt ceiling. the only way this will move forward is if donald trump and the democrats, and some republicans get together to do it. so there is something on the calendar that will force bipartisan action in a few weeks or months whenever the date comes. so i think the political movement will remain intense, there is something going on in washington that would require the two parties to get together. >> the problem, ron, of course the resistance doesn't have a face. democrats came out earlier this week with some plan that looked like -- i don't know what. it was a highly non-specific plan about getting people jobs and increasing wages and better health care. but there is not a person or blueprint, if there is something to capitalize on how do democrats actually capitalize on it right now. >> we argue the lack of face for the resistance is a better thing, making it more resilient and widespread. people take ownership of it. there is this kind of tension between the democratic grass roots and the democratic establishment in washington. and this win tonight for them, i think will do something to soften that tension and i think that the democratic establishment in washington understands the grass roots are the important parts in victories and they will see that their senator is delivered. chuck schumer got every single democrat, all of them to vote in line. that is a rare achievement. so i don't think necessarily the movement needs a face. it has a lot of people just real people, i mean, that was the most amazing thing about this. it was all the men and women who have never been involved in politics and got out of their homes, went to town halls, that is what made such a difference here. >> let me ask you about leadership on the republican side. what does it look like? do these three, collins, murckowski and john mccain, obviously john mccain has to deal with his health care issues now. and he has been sort of a splinter in the side of others. mcconnell took a blow like he never took before. >> trump often talks about republicans kind of in the third person. his followers blame republicans on capitol hill and call them rhinos, while embracing donald trump as the standard-bearer of republicanism. paul ryan is under scrutiny, and mitch mcconnell, frankly, he will wake up and still see donald trump as a martyr. i do think the question of 2018 on the democratic side, i think nancy pelosi goes into 2018 as the leader of the democratic party but it will come with a lot of challenges. because a party led by nancy pelosi, even if you are selling mainstream economics that is a hard message to deliver that message in the counties and states that donald trump won just a year ago. so i think both teams face challenges, if they get it right they could take the house. i'm not sure if they get it right if they stick with nancy pelosi as the leader of the democratic party in the house. >> well, let me tell folks who are just looking at us before i tell them that i have to say good night and get a couple of hours of sleep. the house skinny repeal bill went down to defeat, 49-51, john mccain, the one that nobody knew how he would vote. he walked into the chamber in a very dramatic fashion. got the attention of the person telling the votes and put his thumb down for a no. that gave it to the democrats and that closed the discussion, mitch mcconnell saying that it's time to move on. that is how this night ended. this morning started. donald trump tweeting the three republicans and 48 democrats let the country down. my conversations this evening, there it is, three republicans and 48 democrats let the american people down as i said from the beginning let obamacare implode then deal. that is the first and last that we've heard from donald trump on that. i have been with david jolly, former republican congressman ron clain, and garrett haik, as always, we'll stay on top of this story. gentlemen, thank you for joining us, we stayed up much later to complete this complete. my name is ali velshi, as i said all coverage on health care and all-related matters will continue. you're watching msnbc, thank you for joining us tonight. breaking overnight. job mccain cast the deciding vote. plus, a war inside of the white house. anthony scaramucci. jeff sessions weighing in on the president's attacks against him as opposition mounts to replacing the ag.

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