Senate Republicans appear on the verge of having enough votes to start debate on Obamacare repeal, with the dramatic announcement Monday night that Sen. John McCain, diagnosed with brain cancer just a few days ago, would return to Washington for the Tuesday vote.

The whip count is still in question with several GOP senators publicly undecided, but Republicans feel a surge of momentum heading into the high-profile vote after a furious pressure campaign by President Donald Trump and Senate Majority Leader Mitch McConnell on Monday.


McConnell spent the day cajoling his members and meeting with Vice President Mike Pence to plot strategy. The majority leader was still short of the votes to even open debate, and Republicans still don't know what they'd be voting to allow debate on if they agree to go along with McConnell on the procedural vote.

If McConnell manages to round up the 50 votes for the motion to proceed, it would be a huge political victory. McCain's vote in favor of starting debate would help, but the undecided positions of about a half-dozen senators have left McConnell with a tiny margin for error, and no one's quite sure what his end game is.

To get their members on board, Republican leaders are being as vague as possible about what the final bill to replace Obamacare would include, after two recent drafts met fatal opposition. McConnell is reminding his members that there will be a price to pay for inaction after the GOP railed against Obamacare for seven years.

“The sight of the gallows focuses the mind,” said Sen. John Kennedy (R-La.).

Still, McConnell must pull an inside straight to bring the bill to the floor. From there he’d hope to buy enough time to negotiate with holdout senators to sub in a final proposal at the end of the week. He’ll likely have to throw as much as $100 billion at centrist Republican senators like Rob Portman of Ohio and Shelley Moore Capito of West Virginia to gain their support. It’s an idea that Trump personally endorsed in conversations with senators last week, according to a source familiar with the conversations.

But simply getting to a debate on the bill is the most immediate task, and McConnell is expected to continue working his members in phone calls and personal meetings to get to 50 — or as close as he can come to prove the GOP is near a solution on repeal. If the Tuesday vote fails, McConnell can bring it up again at any time, senators said. Republican leaders hope conservative blowback over a failed vote would pressure senators back to the negotiating table.

Republicans are strongly considering a strategy that would tee up two separate votes — one on the repeal only and another on the plan the Senate has been working on to repeal and replace Obamacare.

If one fails, "you set up a vote on the other one," said Sen. John Thune (R-S.D.). The theory behind the strategy is that by making that assurance, Republicans could pick up votes to start debate from ardent conservatives as well as waffling moderates.

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In private, McConnell was blunt on Monday, telling conservative activists that Republicans who oppose a key procedural vote on Tuesday to advance debate on Obamacare repeal are effectively endorsing the Democratic health care law.

"You either vote for the motion to proceed, or it is a vote for the status quo," McConnell told the groups, according to Tea Party Patriots co-founder Jenny Beth Martin, paraphrasing the Republican leader.

Capito, Portman, Cory Gardner of Colorado, Lisa Murkowski of Alaska, Mike Lee of Utah, Dean Heller of Nevada and Jerry Moran of Kansas are all undecided on the procedural vote. They are seeking clarity on whether repeal and replace, or just repeal, is the ultimate end game. Capito, who has opposed the various GOP repeal bills because of their steep cuts to Medicaid, spent Monday evening with Trump.

Sen. Rand Paul of Kentucky is a harder get and simply wants to vote on what he calls “clean repeal.”

Sen. Susan Collins (R-Maine) said she was opposed to proceeding to a litany of possibilities and seems like the firmest “no” vote on Tuesday — unless, she added, “it's going to be a brand new bill, in which case I can't tell you.”

Then there’s McCain, whom GOP leaders sorely need on the procedural vote. He has been critical of both the substance and process of Obamacare repeal-and-replace measures in the Senate, but has signaled that he would at least vote to advance the measure.

"We need him," said Sen. Roger Wicker of Mississippi.

Earlier Monday, McConnell also teed up the National Defense Authorization Act to come next on the Senate floor – a major priority for McCain, the Senate Armed Services Committee chairman.

To get their members on board, they are being as vague as possible about what the final bill to replace Obamacare would include, after two recent drafts met fatal opposition.

But Republicans said they hoped they wouldn’t need McCain to get over the hump. And to get their members on board, they are being as vague as possible about what the final bill to replace Obamacare would include, after two recent drafts met fatal opposition.

“We’re trying to maximize the number of votes. I’m sorry, am I guilty of telling the truth?” said Senate Majority Whip John Cornyn (R-Texas), explaining the GOP’s intentionally ambiguous strategy.

Still, Sen. Orrin Hatch (R-Utah) said he expects the Senate to vote on “some version” of the 2015 bill to repeal Obamacare with no replacement. He expects the vote to start debate will be successful.

When asked why he thinks that when many others are predicting failure, Hatch said, “There are a lot of folks who’ve gotten their heads kicked in, too.”

In addition, the Senate parliamentarian indicated Friday that several provisions in the GOP health care measure violated the so-called Byrd rule and would need 60 votes on the Senate floor to remain in the bill. Among the provisions flagged by parliamentarian Elizabeth MacDonough is language that would defund Planned Parenthood, ban abortion coverage in Obamacare plans, end a requirement that Medicaid cover certain minimum services starting in 2020 and allow states to determine what percentage of premiums insurers spend on medical care. GOP aides are already reworking some of the problematic provisions.

One idea under consideration is to broaden the defunding amendment so that it could apply to more entities than Planned Parenthood, according to sources working on the issue. That would counter the parliamentarian guidance that the earlier version targeted Planned Parenthood.

Conservatives are also hoping the GOP can repair their abortion restrictions for plans on insurance exchanges by funneling those tax credits through other programs, like Medicaid or the Children's Health Insurance Program. Those are already barred from using taxpayer funds to cover abortion with some exceptions.

And senators and aides also said they worried a Congressional Budget Office score for an amendment by Sen. Ted Cruz (R-Texas) to allow the sale of cheap, deregulated plans might not be available this week. Any backlog at CBO could make it difficult to score other additions to the bill, a necessity under Senate rules.

Yet despite the steep task ahead, senators supporting the effort said they are feeling some momentum. After arriving Monday afternoon not knowing what was going to happen with the bill, Sen. Bob Corker (R-Tenn.) exuded some confidence as he left the Senate floor in the evening.

“I’m leaving here feeling maybe progress is being made,” Corker said.