(CNN) The fate of President Donald Trump's health care plan rests in the hands of Senate Majority Leader Mitch McConnell. The Kentucky Republican has said he wants a final vote on the Senate version of the American Health Care Act before Washington leaves for the July 4 recess. The challenges are clear; a half dozen Republican Senators have already said they can't support the legislation in its current form. McConnell can afford to lose only two. So, how can he hope to pull it off? For answers to that question, I reached out to Josh Holmes, a former McConnell chief of staff and campaign manager, who is now president of Cavalry, a Republican consulting firm. Holmes remains close to McConnell and brings a clear perspective -- strongly pro -- of the majority leader. Nonetheless, his insight into how McConnell goes about his legislative business in invaluable. Our conversation, conducted via email and lightly edited for flow, is below.

Cillizza: Describe Mitch McConnell's strategy so far with the health care bill.

Holmes: McConnell doesn't advertise his strategy but I'll give you my best guess on what's driving the action. In every big effort I've ever been associated with, McConnell begins by absorbing 90% of the political pressure himself. He plots a pathway that shoulders almost all of the political danger and allows his members to work things through without suffocating from critics. You can already see how that's played out in this debate with the prolonged focus on McConnell and the condensed timeline for his members.

Second, one of McConnell's great gifts is his ability to listen to his members. The product is always a direct reflection of the views of his conference -- not his own dictation. He and his staff have clearly spent countless hours talking to Senators about what they need because the bill they've come up with appears to be the closest you can get to consensus without applying the closing arguments. What sits before his members is a bill that does not create the same kind of paralyzing political problems that previous efforts have produced. It also includes gigantic conservative victories that could very well constitute the most significant conservative reforms in generations.

Third, he frames the debate. His members know he would not be taking something up if it weren't vitally important but sometimes everyone needs to reset the dial on why they're about to make a tough decision. McConnell has an uncanny ability to lay out the wisdom behind an approach and the potential pitfalls with various directions. In this case, clearly his members understand the problem. The insurance markets are failing and in all likelihood, without a reform effort undertaken now by Republicans, Congress could very well be addressing this again in the fall with a package that looks a lot more like a bailout than repeal. Worse yet, Republicans could lose a couple elections and the conversation about repairing the insurance markets will undoubtedly mean shifting towards the liberal dream of single-payer. If that weren't enough, it is the only opportunity Republican senators will have to keep their promise with respect to Obamacare. The enormity of the pressure for senators to keep that promise will weigh heavily on most of the remaining holdouts and for others, the failing system should provide ample motivation.

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