As Mitch McConnell unveiled the Senate’s long-anticipated Obamacare repeal bill at a closed-door briefing Thursday morning, he urged GOP senators to withhold statements announcing outright opposition to the proposal and remain flexible, according to people familiar with the matter.

About four hours later, a quartet of McConnell’s most conservative members said in a joint statement that they are “not ready to vote for this bill.”


But notably, GOP Sens. Rand Paul, Mike Lee, Ron Johnson and Ted Cruz left themselves plenty of room to eventually support it after further negotiation and persuasion — a critical nod to the Senate majority leader’s request.

The Kentucky Republican still has much work to do to get his health care overhaul across the finish line and may have to offer those senators some concessions that move the bill to the right. And somehow while doing so, he also must keep on board a pair of moderates and a half-dozen stalwart defenders of Obamacare’s Medicaid expansion.

Right now, McConnell is far from having a commitment for the 50 votes needed for passage, according to senators who spoke on condition of anonymity to discuss internal politics of the 52-member caucus. But no one on Capitol Hill seems to be betting against the wily majority leader as he plans for one of the most critical roll call votes of his career next week.

“He is extremely talented in cobbling together coalitions of people who disagree,” said Sen. Susan Collins (R-Maine), a moderate Republican skeptical of the GOP’s direction. “I never underestimate his ability to pull something off.”

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McConnell’s strategy has been a slow burn, allowing his members to vent in private party discussions while gradually writing a bill that takes in their considerations over the past six weeks. He’s had more than 30 meetings with his members about taking down the 2010 health law, intended to give his members more input and get them comfortable with the product.

Johnson, for example, doesn’t even serve on the two committees that oversee health care policy, so the process has empowered him more than he might have been through regular order. People close to McConnell believe Lee’s staff has been read in more than any other member on the chamber’s complicated parliamentary procedures that constrain what is possible under reconciliation.

“He believes that given the amount of input we’ve had from everybody, we’ll get to 50. Because everybody’s had a seat at the table,” said Sen. John Thune of South Dakota, a close McConnell ally in leadership. “If you get 80 percent of what you want in a circumstance like this, it’s going to have to be a victory because we’re not going to get 100 percent.”

The most immediate concern is certainly the four Republicans who’ve banded together to enhance their negotiating position.

Republican leaders believe McConnell can probably get Johnson (R-Wis.) to eventually support the bill, either through persuasion or an amendment. Republicans hope that positive comments from insurance companies and health care experts in Wisconsin could sway the senator to the yes column.

Cruz (R-Texas) is a tougher task: He and Lee (R-Utah) have been working together on several conservative proposals. Cruz’s biggest ask is to allow insurance companies that offer Obamacare policies to be able to offer non-Obamacare policies as well, arguing that it would provide consumers an additional option and likely drive down prices.

Adoption of such a proposal could win the votes of those two conservative stalwarts, as well as other Republicans, but there’s a problem: The parliamentarian may not allow them under the Senate’s strict budget reconciliation rule. In fact, it might pose a big enough problem to kill the whole bill. McConnell may be able to win those conservatives over, said a Republican senator, but a “little help from the parliamentarian would be nice.”

There is also some concern that the proposal would destabilize markets because the sickest people would end up in pricier Obamacare plans. Cruz and Lee also want to allow insurance to be sold across state lines, but Republicans are confident that will not pass muster with the parliamentarian. It's not clear what, if anything, McConnell can do to satisfy them if those measures are not included.

In addition to the joint statement with his colleagues, Paul went on a media tour de force criticizing the bill as “Obamacare lite” on Thursday. He’s still viewed by GOP insiders as a likely “no” vote, but with a stronger hand as part of the conservative gang.

McConnell “said this morning that this is a draft and that he’s open to changes. But I think it’s more likely we get changes if there’s four of us asking for changes,” Paul said on Thursday afternoon. “The bill’s got to look more like repeal and less like we’re keeping” Obamacare.

In the past, Paul, Cruz and Lee have all defied McConnell. But they also all entered the Senate on campaigns to repeal Obamacare. McConnell’s message ultimately will boil down to: “It’s time to put up or shut up,” said the party’s chief vote counter, John Cornyn of Texas.

“I think he’s right. We could talk about this endlessly and never reach a conclusion,” Cornyn said in an interview.

Thune added that a more dire argument is beginning to circulate among Republican leaders.

“If we don’t get this done and we end up with Democratic majorities in ‘18, we’ll have single payer. That’s what we’ll be dealing with,” Thune said.

On the other side of the party’s ideological spectrum, Collins said Thursday she’s angling for a vote to strip the bill’s Planned Parenthood defunding provision, which could roil the rest of the conference’s social conservatives.

And senators from Medicaid expansion states like Rob Portman of Ohio and Dean Heller of Nevada raised “concerns” about future funding constraints, though they also did not come out forcefully against the bill as leaders had feared.

“I’m still up in the air,” said Sen. Shelley Moore Capito of West Virginia, another backer of robust Medicaid funding.

Despite the public perception — partly pushed by Democrats — of a rushed process and closed-door negotiations, most Republican lawmakers say McConnell has done as much as he can to incorporate each senator’s wants and craft a bill that could satisfy a wide-ranging conference.

Rank-and-file lawmakers say they would want more time to review the bill, but they understand McConnell has to make the push now instead of letting the controversial plan twist in the wind or further stall the GOP’s agenda.

“We have 23 work days between now and the end of the fiscal year,” a second Republican senator said. “So what he’s saying is, ‘You know guys, if we talk about this for another month, we’ll still be bickering.’”

Now, the majority leader has one week before his self-imposed deadline to convince the parliamentarian on key legislative language and corral 50 votes — all while facing the risk that he’ll be held responsible if the GOP doesn’t repeal Obamacare, as the party has promised for four election cycles.

Republicans said their hope is that if the bill does fail, McConnell won't be the one held responsible.

“I don’t think he’ll get the blame. I think he’ll get credit for trying,” said a third Republican senator. “It’ll be the people that vote against it that get the blame.”

Jennifer Haberkorn, Elana Schor and Rachana Pradhan contributed to this report.