Mr McConnell called his bill the Health Care Freedom Act, but among his colleagues it was known as "skinny repeal." It's not intended to become law, but to open a path for a House-Senate conference committee to try to work out comprehensive legislation Congress can pass and send to Mr Trump.

The amendment was a last resort for Senate Republicans to pass something - anything - to trigger negotiations with the House.

In addition to Mr McCain, Lisa Murkowski of Alaska and Susan Collins of Maine voted with all Democrats to defeat the measure.