The U.S. Senate's healthcare overhaul appeared to be in serious trouble on Monday after two more Republicans said they oppose a revised version of the bill.
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Senators Mike Lee and Jerry Moran each announced on Twitter on Monday night that they could not support the bill in its current form, bringing to four the number of Republican senators opposed and effectively killing the revised version of the bill.
"We should not put our stamp of approval on bad policy," Moran said in a statement on Twitter, slamming what he called a "closed-door" process that produced the bill.
The news came even as other Republicans senators were meeting President Donald Trump at the White House, where the president, who made repealing and replacing Obamacare a major promise of his campaign, was lobbying for the bill's passage.
It represents a significant setback for an administration fervently seeking a major legislative victory.
Senate Majority Leader Mitch McConnell and the White House must now determine whether to chart a new path forward for the bill or abandon the effort altogether and turn their attention to other priorities such as tax reform.
The White House said it would continue to push for the legislation.
"Inaction is not an option," it said in a statement. "We look forward to Congress continuing to work toward a bill the president can sign to end the Obamacare nightmare and restore quality care at affordable prices."
Aides to McConnell were not immediately available for comment. Senate Minority Leader Charles Schumer, a Democrat, said in a statement a second failure of the bill "is proof positive the core of this bill is unworkable."
Republican Senators Susan Collins and Rand Paul had already come out against the bill. With Republicans holding 52 seats in the 100-member Senate, McConnell could not afford another defection from his caucus.
Democrats are united in opposition to the measure to replace the 2010 Affordable Care Act, former Democratic President Barack Obama's signature healthcare legislation, popularly known as Obamacare.
The bill was already teetering after an expected vote on going forward with debate on the bill was postponed by McConnell following Republican Senator John McCain's surgery to remove a blood clot from his head. Collins had estimated on Sunday that at least eight to 10 Republicans had serious doubts about the bill.
A similar version of the bill passed the House in May but passage in the Senate was always expected to be more difficult, given the deep tensions between moderates and conservatives.
Moderates worry about cuts to the Medicaid health insurance program for the poor and disabled, while conservatives want those cuts, as well as a more dramatic dismantling of Obamacare's framework.
The first version of the Senate bill failed to attract enough support, forcing McConnell's office to revise it in a bid to make it more palatable. That version was released last week.
McConnell could also choose to attempt to work with Senate Democrats on a bipartisan bill to reform Obamacare, an option he threatened to pursue earlier this month if Republicans did not line up in support of the revised bill.
Schumer held out that possibility in his statement, urging Republicans to "start from scratch and work with Democrats on a bill that lowers premiums, provides long term stability to the markets and improves our health care system."
Senator Bernie Sanders, the former Democratic presidential candidate, celebrated what he termed the "collapse" of the Republican effort.
"This is a great victory for the millions of Americans who stood up and fought back against this dangerous legislation," Sanders said in a statement.