Senate Majority Leader Mitch McConnell of Ky. heads to the Senate on Capitol Hill in Washington, Thursday, July 27, 2017, as the Republican majority in Congress remains stymied by their inability to fulfill their political promise to repeal and replace "Obamacare" because of opposition and wavering within the GOP ranks. (AP Photo/Cliff Owen)

Senate Majority Leader Mitch McConnell of Ky. heads to the Senate on Capitol Hill in Washington, Thursday, July 27, 2017, as the Republican majority in Congress remains stymied by their inability to fulfill their political promise to repeal and replace "Obamacare" because of opposition and wavering within the GOP ranks. (AP Photo/Cliff Owen)

WASHINGTON (AP) — The Latest on the effort by congressional Republicans to pass a health care bill (all times local):

1:45 a.m.

The Senate has rejected a measure to repeal parts of former President Barack Obama’s health law, dealing a serious blow to President Donald Trump and the GOP agenda.

Unable to pass even a so-called “skinny repeal,” it was unclear if Senate Republicans could advance any health bill.

Three Republicans joined with all Democrats to reject the amendment, which would have repealed mandates that most individuals get health insurance and that large companies provide it to their employees. It would have delayed a tax on medical devices.

The vote was 49-51.

The amendment was a last resort for Senate Republicans to pass something — anything — to trigger negotiations with the House. Some Republicans were concerned that the House would simply pass the pared-down bill and send it to Trump. Republican Sens. John McCain of Arizona, Lisa Murkowski of Alaska and Susan Collins of Maine voted with Democrats to defeat the measure.

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10:15 p.m.

Senate Majority Leader Mitch McConnell has released the text of his pared-down bill to repeal parts of the Affordable Care Act.

It’s a legislative maneuver so the Senate can pass a bill that a House-Senate conference committee can use as the base to try to work out a comprehensive “repeal and replace” measure.

House Speaker Paul Ryan had said the House is willing to negotiate with the Senate.

McConnell’s “skinny repeal” bill would end an unpopular requirement that individuals get coverage or risk fines, as well as a similar obligation imposed on larger employers.

It also suspends a tax on medical devices, denies funding to Planned Parenthood, and allows states to seek waivers from consumer protections in the Affordable Care Act.

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9:10 p.m.

Two Republican senators say House Speaker Paul Ryan’s statement that the House is willing to negotiate a final health care bill with the Senate is insufficient.

Their statements deal a blow to Senate Majority Leader Mitch McConnell’s effort to pass legislation.

Republican Sens. John McCain of Arizona and Lindsey Graham of South Carolina say they are still opposed to a minimal bill that would only repeal several provisions of former President Barack Obama’s health law.

The so-called “skinny repeal” is a last resort for Senate Republicans to pass something — anything — to trigger negotiations with the House. McCain and Graham are concerned that the House would simply pass the minimal bill and send it to President Donald Trump.

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7:50 p.m.

Speaker Paul Ryan says the House is willing to negotiate a final health care bill with the Senate.

Ryan’s announcement Thursday evening is meant to ease doubts among Senate Republicans about voting for a minimal repeal bill. It’s not clear if Ryan’s announcement will clear the way for Senate passage.

The so-called “skinny repeal” is a last resort for Senate Majority Leader Mitch McConnell who’s trying to undo the Affordable Care Act.

It would repeal “Obamacare’s” unpopular requirement that Americans have health insurance or risk fines, along with other selected provisions. But just repealing the requirement would lead to a spike in premiums.

Some GOP senators, including Arizona’s John McCain, had demanded guarantees that the House would not simply approve the minimalist bill and send it to President Donald Trump.

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6:10 p.m.

Three Republican senators say they will not vote for a new health care plan being crafted by GOP leaders — unless they get a guarantee from Speaker Paul Ryan that it will not pass the House as-is.

Sens. John McCain of Arizona, Lindsey Graham of South Carolina and Ron Johnson of Wisconsin say they can’t support the so-called “skinny repeal” taking shape in the Senate because it would wreak havoc on health insurance markets.

They say they will vote in favor of it only as a vehicle to open House-Senate negotiations on a more comprehensive bill.

But in light of rumors that the House could pass the bill as-is, they are looking for a guarantee from Ryan that that won’t happen.

Their opposition is enough to sink the “skinny bill.”

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12:12 p.m.

The country’s biggest organization of health plans is opposing the Senate Republicans’ latest approach to scrapping the Obama health care law.

America’s Health Insurance Plans wrote to Senate leaders, saying that ending the requirement for people to buy insurance, without strengthening insurance markets, would produce “higher premiums, fewer choices for consumers and fewer people covered next year.”

GOP leaders unable to win enough votes for a broad revamping of Obama’s law are now focusing on a far narrower bill repealing a handful of the least popular provisions.

Republicans say no decisions have been finalized. But they’ve said one leading idea is to eliminate tax penalties on people not buying coverage, effectively ending that requirement.

The Senate is expected to finish the legislation by Friday.

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4:39 a.m.

Senate Republicans are lowering their expectations on repealing and replacing “Obamacare.” They’re making plans to try to pass a narrowly focused bill undoing just a few of the most unpopular elements of Barack Obama’s landmark health care reform law.

After successive failed votes on other plans, Republicans are coming to believe that what’s being called a “skinny repeal” may be the only thing that can pass and keep the process moving. And it’s not even clear if that will pass.

It should all come to a head Thursday on the Senate floor with a rare and frenzied procedural oddity called a “vote-a-rama” where all sides can offer unlimted amendments in rapid succession. Some Senators are expecting Thursday’s session to extend deep into Friday morning.