WASHINGTON — Congressional lawmakers said on Friday that the collapse of Republican efforts to demolish the Affordable Care Act had created an opening for bipartisan work to shore up health insurance markets and protect consumers against sharp increases in premiums.
But any such effort would have to overcome the firm resistance of President Trump and Republican leaders on Capitol Hill who have refused to participate in any effort to fortify President Barack Obama’s health law.
The professions of a desire for bipartisan cooperation were as profuse on Friday as the short-term outlook for tangible results was grim.
“On health care, I hope we can work together to make the system better in a bipartisan way,” said the Senate Democratic leader, Chuck Schumer of New York, who led efforts to preserve the Affordable Care Act. “And I’m optimistic that that can happen,” he added, saying that he recognized flaws in the law.
The Republicans’ seven-year promise to repeal the Affordable Care Act seemed to come to an end in the early hours of Friday when 51 senators — including three Republicans — blocked a narrow version of repeal that would have rolled back only a few provisions of the sweeping health care law.
Senator John McCain, Republican of Arizona, who cast the decisive vote against the Republican bill around 1:30 on Friday morning, appealed for a bipartisan approach. “The vote last night presents the Senate with an opportunity to start fresh,” he said.
The Affordable Care Act “was rammed through Congress by Democrats on a strict party-line basis without a single Republican vote,” Mr. McCain said, and Republicans must not make the same mistake.
But there was no hint of an olive branch from the Senate majority leader, Mitch McConnell, who this summer suggested that a failure to repeal the Affordable Care Act would force him to work with Mr. Schumer.
“Bailing out insurance companies with no thought of any kind of reform is not something I want to be part of,” Mr. McConnell said in the early hours of Friday. He suggested that many Democrats secretly wanted a single-payer health care system, with a much larger role for the government.
President Trump reiterated his threat to force the health law to collapse. “3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let ObamaCare implode, then deal. Watch!” he wrote on Twitter.
And some Republicans did not sound ready to close the door on repeal, despite the exceedingly slim hopes of reviving, yet again, an effort that on Friday morning seemed doomed.
“I am disappointed and frustrated, but we should not give up,” said the House speaker, Paul D. Ryan of Wisconsin. “I encourage the Senate to continue working toward a real solution that keeps our promise.”
If a bipartisan coalition can coalesce around changes to the Affordable Care Act, lawmakers see several vehicles to force such proposals to the floors of the House and Senate. Spending bills for the fiscal year that starts Oct. 1 will have to be signed, and the popular Children’s Health Insurance Program will need additional funds.