The Senate majority leader, GOP Sen. Mitch McConnell of Kentucky, is reportedly struggling to draw enough support from his colleagues to pass the Better Care Reconciliation Act, a GOP health care proposal to repeal and replace the Obama administration's Affordable Care Act.
The GOP occupies 52 seats in the Senate. McConnell must corral 50 votes to pass the BCRA under a budget reconciliation procedure, with Vice President Mike Pence serving as a tie-breaking vote, but McConnell's ability to drum up those 50 votes is looking increasingly unlikely.
McConnell had hoped to hold a vote on the BCRA before the chamber's July 4 recess. On June 27, the Kentucky senator announced that he would have to delay a vote until after the recess because the legislation did not have enough GOP support.
"We're going to continue the discussion," McConnell said, according to Fox News. "We will not be on the bill this week."
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On June 26, the Congressional Budget Office released an estimate that the BCRA would result in 22 million fewer Americans having access to health insurance by 2026 than if the ACA was kept in place, prompting several Republican senators to balk at the proposal.
As of July 10, GOP opposition towards the BCRA had only grown, and 10 Republican senators had publicly announced that they would vote against the BCRA. On July 11, McConnell will be able to fully size up the deficit in support for the legislation during a lunch with his Senate colleagues, CNN reports.
On July 9, GOP Sen. John McCain of Arizona asserted that his party's hopes of a partisan repeal of the ACA had likely been dashed and that they would have to work with Democrats to reform health care.
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"I think I fear that it's going to fail," McCain told CBS News. "And then we should convene a Republican conference, say: 'What are we going to do?' Introduce a bill. Say to the Democrats: 'Here's a bill.' It doesn't mean they don't, that they control it. It means they can have amendments considered. And even when they lose, then they're part of the process. That's what democracy is supposed to be all about."
GOP Sen. Ted Cruz of Texas struck a more optimistic tone toward the BCRA's prospects of passage.
"There's no doubt this has been a rocky path to getting there," Cruz said. "But I continue to believe we can get this done."
On June 30, President Donald Trump offered another alternative: simply repealing the ACA fully without a replacement.
"If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL and then REPLACE at a later date!" Trump tweeted out.
On July 6, Cruz seconded Trump's suggestion that GOP lawmakers repeal the ACA fully and figure out a replacement later if the BCRA fails to garner enough votes.
"If we cannot bring the conference together and agree on repeal legislation, then I think President Trump's absolutely right that we should pass a clean repeal," Cruz said, according to the Washington Post.
While Republican senators debate how to proceed if the BCRA dies in the Senate, GOP lawmakers have grown increasingly frustrated with their inability to rally around a replacement plan.
"Republicans we talk with are impatient -- they want to ditch the health debacle and move on to pivotal budget issues and then, of course, begin deliberating tax cuts," Greg Valliere, chief global strategist of Horizon Investments, told Business Insider.
McConnell currently aims to hold a vote on the BCRA during the week of July 17.