Despite being left out of a working group assembled by Senate leadership, two senators likely to wield bargaining power in negotiations over healthcare reform are Republican Lisa Murkowski of Alaska and Susan Collins of Maine.

The Senate GOP will need to craft a bill that earns the support of at least 50 of their 52 members. That means they need to keep centrists such as Collins and Murkowski without losing the support of conservatives.

FiveThirtyEight flagged both senators as key players in the negotiations, noting "Alaska's Lisa Murkowski and Collins are among the four Senate Republicans who have been most likely to vote against Trump's positions on issues, according to FiveThirtyEight's Trump Score. (Tennessee's Bob Corker and Kentucky's Rand Paul are the other two.)."

Observing that both senators have been critical of the bill passed in the House and that both are opposed to blocking the funding of Planned Parenthood, FiveThirtyEight wrote, "If Collins and Murkowski oppose this legislation, the Republicans can't afford any more defections."

That would mean keeping the support of free-market stalwarts such as Rand Paul, R-Ky., without losing the support of establishment types like Sen. Rob Portman, R-Ohio.

As negotiations begin, here's where the two women stand on healthcare reform:

Lisa Murkowski

At a virtual town hall in March, Murkowski emphasized her interest in repealing Obamacare, stating, "I remain committed to repealing the Affordable Care Act. With rising premiums, only one provider on the individual market, and an opioid crisis, Alaska hasn't thrived under the ACA, even with expanded access to coverage for many Alaskans."

But in a statement released after the House voted to pass the ACHA last Thursday, Murkowski outlined her goals for reform, simultaneously highlighting her desire to keep portions of the ACA in tact without directly criticizing the bill passed last week. "My concerns regarding health-care reform haven't changed – it must work in a state like Alaska and not pull the rug out from those who currently receive coverage," she said. "And while we work to fix the broken current health-care system, I recognize the need to maintain provisions that have worked: the prohibitions on discrimination for pre-existing conditions, no annual or lifetime limits, coverage up to age 26, and Medicaid expansion."

Alaska is one of the states that expanded Medicaid under the Affordable Care Act. A survey taken by Public Policy Polling March 10-12, shortly after the initial release of the AHCA, found 52 percent of registered Alaska voters supported Congressional Republicans efforts to repeal the ACA, though more had an unfavorable opinion of the AHCA than favorable. Nearly 60 percent agreed that "Congress should keep what works in the Affordable Care Act and fix what doesn't."

That sentiment is right in line with Murkowski's expressed ambitions for new legislation.

Susan Collins

In an interview with ABC's This Week on Sunday, Collins was blunt about both her concerns with the House bill and her goals for the Senate's reform legislation. Collins says she was troubled that the AHCA had not been scored by the Congressional Budget Office. She noted that "tax credits are not adjusted for income or geographic regions," which, she believes, "really hurts a state like Maine." Referring to the bill's high-risk pools for people with pre-existing conditions, Collins questioned the efficiency of the legislation's proposal, arguing, "if the coverage is unaffordable that doesn't do any good."

Collins introduced a healthcare reform bill in January together with Sen. Bill Cassidy, R-La., that left much of the ACA in tact. According to Larry Levitt, senior vice president of the Kaiser Family Foundation, the plan "basically block grants the ACA with a cut in federal funding of 5%."

In her interview on This Week, Collins did at least say that high-risk pools on the state level "could be part of a solution." Her willingness to consider that option could be key, given that House Freedom Caucus members see it as a means to lowering premiums, their central goal.

A Portland Press Herald/Maine Sunday Telegram poll taken last June found likely voters were split on Obamacare, with 41 percent opposing the law and 40 percent supporting it, within the four percentage point margin of error. Still, 22 percent of respondents said their families were worse off under the ACA and 41 percent said medical costs have increased because of it. By comparison, only 14 percent said their families were better off and eight percent said medical costs have decreased.

If Senate Republicans manage to draft legislation that keeps the support of Murkowski and Collins, both of whom have concerns about the provisions to protect people with pre-existing conditions, it will be difficult to reconcile any changes made to earn their support with the goals of House conservatives, especially members of the Freedom Caucus.

The GOP's road to healthcare reform is long and will almost certainly pass through these two women.

Emily Jashinsky is a commentary writer for the Washington Examiner.