Senate Majority Leader Mitch McConnell is still expected to hold a vote to try to begin debate on the repeal effort, likely on Tuesday. | Pablo Martinez Monsivais/AP Senate GOP’s latest health care push sputters Even after a positive White House meeting, Republicans appear unlikely to find the votes to repeal Obamacare.

A harsh reality is setting in among Senate Republicans: They're extremely unlikely to repeal Obamacare in the coming days.

Republicans felt somewhat buoyed by Wednesday’s White House meeting and late-night senators-only gathering, which left them feeling as though they’re making progress and that nearly every GOP senator is trying to get to yes.


But the math is increasingly working against them, with four Republican senators having announced opposition to starting debate — though the bill could further change — and more unannounced but likely no's. Key Senate Republicans were set to meet again on Thursday afternoon, said Sen. Dean Heller (R-Nev.), a critic of the GOP's latest approach. But Heller won't be there and said he'd send staff in his place.

Sen. John McCain’s diagnosis of brain cancer also has the GOP one vote down, or at least leaves a huge question mark regarding whether the beloved Arizona Republican would be able to make the trip back to Washington. And Heller said at a GOP lunch on Thursday, there was no clarity from GOP leaders on what the party would even be voting to debate next week.

"We didn't have a firm commitment at lunch today," Heller said. "We still can't figure out what the first amendment is going to be after the motion to proceed."

That uncertainty is blunting the GOP's momentum as it heads into a weekend back home. So is President Donald Trump's Wednesday interview with the New York Times, which allies of GOP leaders said had stomped all over a productive Wednesday meeting on health care with Republican senators by criticizing Attorney General Jeff Sessions.

"They had their first productive day on health care in two weeks, and by 6 o'clock, Trump had screwed it up with his AG story," said a Republican close to GOP leaders.

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GOP leaders can lose only two Republicans and move forward. There could be as many as 10 GOP defections on the bill Tuesday if the current, informal tallies hold, according to GOP sources.

One persistent critic, Sen. Rand Paul (R-Ky.), said he might vote to proceed to the bill after saying he wouldn't for several weeks.

"I've let leadership know I would vote to proceed if we can proceed to at least one of the choices being clean repeal. It's still very vague and nebulous and that's why it's hard to say whether you'll vote to proceed to something that you don't know you're proceeding to," Paul said.

However, at the Wednesday night meeting, Sen. Lindsey Graham of South Carolina told Republicans that McCain had indicated privately that he would not support repeal only with no replacement, according to an attendee. That makes the path to 50 on a bill even more complex.

"Nearly all of our members still want to get to yes," conservative Sen. Mike Lee of Utah, who has opposed recent drafts, said in an interview. "I wish I could tell you we found the magic pathway last night."

Sen. Lamar Alexander (R-Tenn.) said the White House lunch with Trump on Wednesday drove home the importance of living up to the GOP’s seven-year campaign pledge on Obamacare repeal. Afterward, Republicans scrambled to revive their beleaguered efforts.

“The math has always been difficult, but there’s a feeling that we have a responsibility to get a result,” Alexander said. “And we’ve worked for a long time to get one, and we’re still trying.”

But besides Paul cracking the door open, there was little other evident movement after Wednesday. Heller and Rob Portman of Ohio are still publicly uncommitted on whether to start debate until they know what the bill is. Sen. Jerry Moran (R-Kan.), one of the four announced “no” votes, said Thursday he has not changed his opinion on the motion to proceed.

“Everybody analyzes what they’re interested in for a 'yes' vote,” Moran said. “That was a significant part of the discussion last night.”

Sens. Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska, two more senators critical of recent bill drafts, seemed completely unmoved by a recent attempt by the president the leaders to create a burst of momentum. Sen. Susan Collins (R-Maine) was even more firm.

"As long as we are fundamentally changing Medicaid and taking some 700 billion dollars out of the program, I do not see myself voting for a bill that does that," Collins said. "My intention unless the bill is substantially changed is to vote against the motion to proceed."

Indeed, privately several senators say they don’t see the configurations of a bill that gets them to 50 votes. Aides working on the bill were equally downbeat.

Some Republicans are beginning to think that a failed vote — and the critical headlines and conservative blowback that would follow — might drive some senators back to the negotiating table.

Majority Leader Mitch McConnell is still expected to hold a vote to try to begin debate on the repeal effort, likely on Tuesday.

"That's my expectation. We can always come back if it's not successful by one vote; we can come back when [McCain] is available,” said Sen. John Cornyn (R-Texas), the majority whip. "There is some benefit to moving forward and seeing where we are next week."

The Congressional Budget Office on Thursday provided more dour news: The revised Senate repeal and replace bill would leave 22 million more Americans uninsured over a decade.

The new coverage projection — which accounts for billions of dollars in additional funding to appease moderate Republicans — is nevertheless the same as CBO’s estimate for the first version of the bill. The CBO report does not include an analysis of Sen. Ted Cruz’s amendment that would let insurers sell "skinny plans" — health plans with fewer benefits that don't meet Obamacare insurance regulations — as long as they also sell ACA-compliant ones.

Josh Dawsey contributed to this report.