Senators on Wednesday rejected a key proposal that would repeal much of ObamaCare, despite intense pressure from conservatives.

Senators voted 55-45 against an amendment from Sen. Rand PaulRand PaulCurtis wins GOP primary for House seat vacated by Jason Chaffetz Glimmer of hope in bipartisan criminal justice reform effort Trump barrage stuns McConnell and his allies MORE (R-Ky.) that would repeal the Affordable Care Act and give lawmakers two years to come up with a replacement.

GOP Sens. Lamar AlexanderAndrew (Lamar) Lamar AlexanderTrump to make ObamaCare payments to insurers for August CBO: ObamaCare premiums could rise 20 percent if Trump ends payments CBO to release report Tuesday on ending ObamaCare insurer payments MORE (Tenn.), Shelley Moore CapitoShelley Moore CapitoNo. 2 Senate Republican backs McConnell in Trump fight The fight to protect the Affordable Care Act isn’t over Will Congress preserve monopoly power for healthcare lobbyists? MORE (W.Va.), Susan CollinsSusan CollinsOPINION: Congress should censure Trump for his unfit conduct No. 2 Senate Republican backs McConnell in Trump fight The fight to protect the Affordable Care Act isn’t over MORE (Maine), Dean HellerDean HellerWhy 'cherry-picking' is the solution to our nation’s flood insurance disaster Club for Growth endorses Nicholson in Wisconsin GOP primary Sen. Heller reveals: I voted for Trump MORE (Nev.), John McCainJohn McCainBush biographer: Trump has moved the goalpost for civilized society White House to pressure McConnell on ObamaCare McCain: Trump needs to state difference between bigots and those fighting hate MORE (Ariz.), Lisa MurkowskiLisa MurkowskiFeds to sell 14 million barrels from oil reserve Immigration battlefield widens for Trump, GOP Trump barrage stuns McConnell and his allies MORE (Alaska) and Rob PortmanRob PortmanCongress should think twice on the Israel Anti-Boycott Act Senators push for possible FCC enforcement over Lifeline fraud The fight to protect the Affordable Care Act isn’t over MORE (Ohio) joined all Democrats and independents in voting no. 

A vote on the amendment, which was widely expected to fail, was originally scheduled for late Wednesday morning but was delayed as senators tried to get clarity on a provision tied to abortion. 

It was the second healthcare plan rejected after the Senate voted down a separate repeal-and-replace amendment on Tuesday night.

Three GOP senators had already announced they wouldn’t support repeal-only. Alexander, the chairman of the Senate’s health committee, predicted he didn’t “think there are 40 votes to repeal” without a replacement.

But conservatives ramped up pressure for GOP senators to support the proposal, noting Senate Republicans passed a repeal bill in 2015 when they knew then-President Obama would veto it.

“Republicans promised to repeal ObamaCare, and as we move forward in this process, I urge them to join me in supporting a clean repeal of as much of this disastrous law as possible,” Paul said ahead of the vote.

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FreedomWorks, a conservative outside group, blasted out a “key vote” notice hours ahead of Wednesday’s vote, arguing President Trump would sign a repeal-only bill.

“For more than seven years, Republicans successfully campaigned on ObamaCare repeal. ... Grassroots conservative activists are not going to accept excuses if Republicans fail to pass a bill that they have passed once before,” the group said in a notice to members.

Michael Needham, CEO of Heritage Action for America, added separately on Wednesday morning that "around 11:30, the Senate will vote on the 2015 repeal bill. It would be a first step towards repeal and all Senators should support it."

Repealing portions of ObamaCare without enacting a replacement could leave 18 million people without health insurance the following year, according to a report released by Congressional Budget Office (CBO) in January.

After the elimination of ObamaCare's Medicaid expansion and insurance subsidies, 27 million people would lose insurance, rising to 32 million by 2026, the CBO found.

The proposal comes as senators are searching to find a path forward on how to fulfill their years-long campaign pledge to repeal and replace ObamaCare.

Senate Majority Leader Mitch McConnellMitch McConnellTrump’s isolation grows Ellison: Trump has 'level of sympathy' for neo-Nazis, white supremacists Trump touts endorsement of second-place finisher in Alabama primary MORE (R-Ky.) scored a victory on Tuesday when he wrangled 50 GOP senators to agree to start debate on the House-passed healthcare bill, being used as a vehicle for any action, and let Vice President Pence break the 50-50 tie.

But during the first amendment vote Tuesday evening, nine GOP senators joined with Democrats and independents to vote against a key repeal-and-replace proposal, known as the Better Care Reconciliation Act (BCRA). The setback doesn’t prevent GOP leadership from offering another version of BCRA during what is expected to be a days-long floor debate with hundreds of amendments. 

McConnell said that while the proposal failed, it “represented a number of important healthcare reform ideas developed by our members.”

He added on Wednesday that the effort to get either an ObamaCare repeal, or an ObamaCare repeal and replace bill, through the Senate “certainly won’t be easy.”  

“We’ll consider many different proposals throughout this process from senators on both sides of the aisle. Ultimately, we want to get legislation to finally end the failed ObamaCare status quo through Congress and to the president’s desk for his signature,” he said Wednesday morning.

Republicans have a 52-seat majority and will need the support of at least 50 senators to pass a proposal.

GOP leadership could ultimately try to pass a “skinny repeal,” which would include a repeal of the individual and employer mandates and the medical device tax, if broader proposals aren’t able to garner enough support.

The move could buy Republicans time to work out a deal as they try to merge their healthcare bill with a proposal passed earlier this year by the House.

“I think the endgame is to be able to move something at the end of this process across the Senate floor that can get 50 votes and then get into conference with the House,” Sen. John ThuneJohn ThuneWaymo taps Senate Commerce staffer for government affairs team Billboard ads target Republicans who want to roll back net neutrality GOP debates tax cuts vs. tax reform MORE (R-S.D.) told reporters.

Sen. John CornynJohn CornynImmigration battlefield widens for Trump, GOP Congressional investigations — not just special counsels — strengthen our democracy Wrath of right falls on Google MORE (R-Texas), the No. 2 Senate Republican, added on Wednesday that the GOP wants to "get to conference quick" but no decisions had been made about what the Senate could ultimately pass, or what could be included in a "skinny repeal."

Democrats, however, have blasted that path as a setup to try to ultimately pass full repeal of ObamaCare.

“Make no mistake about it, skinny repeal is equal to full repeal. It’s a Trojan horse designed to get the House and Senate into conference where the hard-right flank of the Republican caucus, the Freedom Caucus, will demand full repeal or something very close to it,” Senate Minority Leader Charles Schumer (D-N.Y.) said ahead of the vote.