Sen. Rand Paul (R-Ky.) is a hard no on Graham-Cassidy, the last-ditch Senate Republican plan to gut the Affordable Care Act, and Sen. Susan Collins (R-Maine) is leaning no, but every other iffy Senate Republican appears on the fence, and GOP leaders emerged from a Monday night meeting cautiously optimistic. The 140-page bill, introduced by Sens. Bill Cassidy (R-La.), Lindsey Graham (R-S.C.), Ron Johnson (R-Wis.), and Dean Heller (R-Nev.), faces a Sept. 30 deadline if Republicans want to pass it with 50 votes, without Democrats.

The Congressional Budget Office (CBO) said it will have a preliminary analysis on the bill's fiscal impact next week, but won't have an estimate on how Graham-Cassidy would affect coverage numbers, premiums, or the federal deficit for "at least several weeks." Previous CBO scores of similar bills estimated that millions of Americans would lose coverage. "The odds are improving," Sen. John Thune (R-S.D.) said Monday night. "I told Bill Cassidy he's the grave robber. This thing was 6 feet under. And I think he's revived it to the point that there's a lot of positive buzz and forward momentum."

Sen. John McCain (R-Ariz.), who voted no when the last ObamaCare repeal vote fell short, said he wants to see a bipartisan bill debated in "a regular process rather than, 'Hey I've got an idea, let's run this through the Senate and give them an up-or-down vote.'" He's considered a maybe, and Sen. Orrin Hatch (R-Utah) announced that the Senate Finance Committee will hold one hearing on Graham-Cassidy on Monday, a move derided by the committee's ranking Democrat, Sen. Ron Wyden (Ore.), as "a sham process that makes a mockery of regular order."

Also opposing the bill is Louisiana Health Secretary Rebekah Gee‏, who reminded Cassidy that his namesake legislation "uniquely and disproportionately hurts Louisiana." The bill would end ObamaCare's Medicare expansion and subsidies, transferring much of those funds to states that did not expand Medicaid; Louisiana expanded Medicaid last year. The legislation would also give states wide latitude to end protections on people with pre-existing conditions and allow skimpier plans.

There's no guarantee the House would pass the bill, which it couldn't modify, but House Republicans would be under enormous pressure to do so. Meanwhile, a bipartisan health-care effort is being negotiated between Sen. Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.). Peter Weber