In a dramatic late-night vote, Republicans in the U.S. Senate were unable to get the latest Obamacare reform bill across the finish line. (here) Not surprisingly, Senators Collins (R-ME) and Murkowski (R-AK) voted against the latest “skinny” repeal plan last night. They were the only two Republicans who voted against proceeding to Senate debate on health care reform earlier this week. The real shock came as Senator McCain (R-AZ) joined them in voting against the Republican reform bill. The final vote was 49 to 51.

No one thought the “skinny” reform bill as written was a complete solution to the Obamacare problem. However, it was a first step to convening a conference committee between the U.S. House of Representatives and the U.S. Senate to craft a meaningful reform bill.

Supporters of Obamacare have chided Republicans for their unilateral work on reform. Yet forgotten in this diatribe is the fact that Democrats forced Obamacare through the legislative process with NO Republican votes and virtually no Republican input during the 2009 debate.

Obamacare essentially has two parts – the expansion of Medicaid and the health insurance exchanges with taxpayer premium support. Lawmakers are now talking about stabilizing the insurance markets and making Obamacare work. This is simply shorthand for more money. (here) The Obamacare “fix” will be more taxpayer money to “stabilize” the individual health insurance market and more money to support the financially-distressed Medicaid program.

The take-home lesson here is that once an entitlement is given out, reform is very difficult. Repeal is virtually impossible.