Blake Farenthold of Texas appears to suggest that if those senators were male, he might challenge them to a duel ‘Aaron Burr-style’

A Republican lawmaker has blamed “female senators” for his party’s failure thus far to repeal and replace Barack Obama’s healthcare law, noting that if they were men he would challenge them to a duel.

Blake Farenthold, a congressman from Texas, singled out the women as the US Senate prepares to vote on Tuesday on whether to move forward with legislation that would dismantle the Affordable Care Act (ACA).

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Speaking with a local radio station on Monday, Farenthold said it was “absolutely repugnant” that the Republican-controlled Senate had yet to pass a healthcare bill.

“Some of the people that are opposed to this, there are female senators from the north-east,” Farenthold said. “If it was a guy from south Texas, I might ask him to step outside and settle this Aaron Burr-style.”

That seemed to be a reference to the 1804 duel in which Burr, who served as the third vice-president of the United States, killed the founding father Alexander Hamilton.

Three female Republican senators have come out against their party’s proposals to dismantle the ACA, popularly known as Obamacare: Susan Collins of Maine, Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska. Only Maine is in the north-east of the country.

Republicans hold a narrow, 52-seat majority in the Senate and can afford to lose just two votes on the bill, a scenario in which vice-president Mike Pence would cast the tie-breaking vote. Underscoring just how close Republicans expect the vote to be, the office of Senator John McCain, who announced last week that he had been diagnosed with brain cancer, confirmed late Monday that he would fly back to Washington for the critical vote.

It remained unclear if Senate Republicans had sufficient votes to advance their plan, but McCain’s impending return left them with at least one more “yes” vote to add to the tally. The senator had previously told reporters on Capitol Hill he supported a procedural motion to begin debate on healthcare legislation.

This isn’t the first time Farenthold has stirred controversy. He was sued in 2014 by a former staffer for sexual harassment. The case was settled out of court.

Farenthold voted for a bill passed by House Republicans in May that repealed key elements of the ACA. Senate Republicans have tried in recent weeks to advance their own proposal but failed on multiple attempts to reach the 51 votes required to pass a bill with a simple majority.

But opposition to the healthcare proposals in the Senate has come not just from women, as Farenthold suggested, but also from several male senators within the party.

The most recent replacement plan was killed last week when Mike Lee of Utah and Jerry Moran of Kansas made public their intention to vote against advancing the measure. Dean Heller, a Republican from Nevada facing a tough re-election battle, has also withheld his support and remains undecided on how to proceed.

Collins, Capito and Murkowski opposed a subsequent strategy by Mitch McConnell, the Senate majority leader, to repeal the ACA without a replacement. It was not, however, clear how their male colleagues would have voted on such a plan, since it never came to the floor.

McConnell insisted a procedural vote would occur as scheduled on Tuesday to take up the House-passed healthcare bill and then vote on a series of amendments, the first of which would be a clean repeal of the ACA.

Donald Trump sought to escalate pressure on Republicans in remarks at the White House on Monday, while flanked by individuals described by his administration as “victims of Obamacare”.

“So far, Senate Republicans have not done their job in ending the Obama nightmare,” Trump said.

“They kept saying it over and over again, every Republican running for office promised immediate relief … We, as a party, must fulfill that promise to repeal and replace, what they’ve been saying for the past seven years.”

The president has remained largely disengaged from the policy details of the debate, despite convening Republican senators at the White House on more than one occasion. Over the weekend, he attacked members of own party in a series of tweets that appeared to preemptively blame failure on Republicans in Congress while also suggesting they had done little to support him.

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“It’s very sad that Republicans, even some that were carried over the line on my back, do very little to protect their president,” Trump wrote on Sunday, while adding in another post: “If Republicans don’t Repeal and Replace the disastrous ObamaCare, the repercussions will be far greater than any of them understand!”

The last version of the Senate Republican healthcare plan would leave 22 million more uninsured by 2026, according to the nonpartisan Congressional Budget Office (CBO), which previously estimated that the House-passed bill would leave 23 million more without health insurance over the same period. The CBO has also projected that repealing the healthcare law without a replacement would result in 32 million people losing health insurance over the next 10 years.

A series of polls have found that the American public overwhelmingly disapproves of Republican efforts to repeal the ACA thus far. The Senate Republican bill had the support of just 17% of Americans in one survey, mirroring an earlier poll that showed a 17% approval rating for the House-passed bill. Another survey found even less support for the Senate Republican proposal, with only 12% of Americans indicating a favorable view.

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