Three Republican amendments to a bill to repeal the Affordable Care Act failed to pass in the Senate this week.

1. Repeal and Replace

Revised version of the Senate’s Better Care Reconciliation Act

The Senate’s draft bill has gone through several iterations over the past month, and Senate leadership brought yet another version to the floor. The bill needed 60 votes to overcome a parliamentary objection, but failed to garner enough support on Tuesday night.

The proposal included the so-called Cruz amendment, which would allow insurers to sell plans that do not comply with some current insurance regulations, as long as they also offer a set of plans that do. Insurers would be able to deny coverage to customers with a history of health problems.

It would also keep in place two taxes on high-income earners that were eliminated in earlier versions, and add new state stability funding, to be devoted to cost-sharing reduction.

What the C.B.O. Says

The C.B.O. has not issued a score for the version with the Cruz amendment, but said it is working on one. Under two other versions that have been scored, about 50 million people would be uninsured in 2026, 22 million more than under the current law, with those on Medicaid being the largest group affected.

A Hitch

Because Congress is trying to pass this bill using a special budget process, it has to comply with certain rules. The Senate parliamentarian, the chamber’s referee, has said that some parts of this bill are in violation of budget rules. Other parts cannot be evaluated until the budget office provides a score.

The Bottom Line

Because of the budget rule issues, the provision needed 60 votes to pass. As expected, no Democrats supported the bill on Tuesday night. Nine Republicans also voted against it.

2. Partial Repeal

Obamacare Repeal and Reconciliation Act

This version repeals the coverage provisions in the Affordable Care Act, including the individual mandate, Medicaid expansion and premium subsidies in two years, but it leaves in place insurance market reforms like ensuring a base level of coverage. It is similar to a 2015 repeal bill that was vetoed by President Barack Obama.

What the C.B.O. Says

The Congressional Budget Office estimates that 32 million more people would be without health insurance than under the current law, the most of any of the Republican proposals.

The Bottom Line

This option is favored by Senator Rand Paul of Kentucky and other conservatives who have long called for a repeal of the bill. The bill failed to pass even though a simple majority was needed.

3. ‘Skinny’ Repeal

Repeal of individual and employer mandates and other provisions

This version, officially released by Republican leaders on Thursday night, would basically eliminate the least popular parts of the Affordable Care Act, but would make no changes to the Medicaid program. It does little to help Republicans reach important policy goals, like eliminating the Affordable Care Act’s insurance regulations or lowering premiums.

What the C.B.O. Says

The C.B.O. released an analysis of the plan late Thursday, estimating 16 million fewer Americans would have health insurance in 2026 and premiums would be roughly 20 percent higher, compared to current law.

The Bottom Line