All 48 Senate Democrats signed a letter asking the Republican majority for a fresh start on health care reform.

In a letter released Tuesday, the entire Senate Democratic Caucus asked Senate Majority Leader Mitch McConnell and key Republican committee leaders for a “bipartisan, open and transparent” effort to improve the health care system.

“Republicans need to set aside their current partisan efforts and work with us to get this done,” the letter reads.

The letter came one week after House Republicans passed the American Health Care Act, which would dismantle major chunks of the Affordable Care Act. In the letter, Senate Democrats called that effort “a partisan bill that will dramatically increase the cost of health insurance for those who need it most and lower the quality of coverage.”

Senate Republicans have already sounded notes of disapproval of the details of that bill, indicating they will write their own bill. Two Senate Republican women have also come out against that bill’s cuts to federal funding to Planned Parenthood.

With only a 52-member majority, Senate Republicans can’t afford to lose more than two votes from their own side if they try to pass the bill under budget reconciliation rules that allow changes to tax and spending but hamper broader reform efforts. If they tried for a broader bill, they would need eight Democrats to sign on to reach the 60-vote threshold to defeat a filibuster.

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