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 PaulRandal (Rand) Howard PaulDem wins Kentucky state House seat in district Trump won by 49 points GOP's tax reform bait-and-switch will widen inequality Pentagon budget euphoria could be short-lived 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 AlexanderOvernight Health Care: Trump health chief backs CDC research on gun violence | GOP negotiators meet on ObamaCare market fix | Groups sue over cuts to teen pregnancy program GOP negotiators meet on ObamaCare market fix 30 million people will experience eating disorders — the CDC needs to help MORE (Tenn.), Shelley Moore CapitoShelley Wellons Moore CapitoAt least Alzheimer’s research is bringing Washington together Overnight Tech: Intel chief says 'no doubt' Russia will meddle in midterms | Dems press FCC over net neutrality comments | Bill aims to bridge rural-urban digital divide | FCC to review rules on children's TV Senators offer bill to close rural-urban internet divide MORE (W.Va.), Susan CollinsSusan Margaret CollinsOvernight Tech: Judge blocks AT&T request for DOJ communications | Facebook VP apologizes for tweets about Mueller probe | Tech wants Treasury to fight EU tax proposal Overnight Regulation: Trump to take steps to ban bump stocks | Trump eases rules on insurance sold outside of ObamaCare | FCC to officially rescind net neutrality Thursday | Obama EPA chief: Reg rollback won't stand FCC to officially rescind net neutrality rules on Thursday MORE (Maine), Dean HellerDean Arthur HellerThe siren of Baton Rouge Big Republican missteps needed for Democrats to win in November What to watch for in the Senate immigration votes MORE (Nev.), John McCainJohn Sidney McCainLawmakers worry about rise of fake video technology Democrats put Dreamers and their party in danger by playing hardball Trump set a good defense budget, but here is how to make it better MORE (Ariz.), Lisa MurkowskiLisa Ann MurkowskiThe siren of Baton Rouge Interior plan to use drilling funds for new projects met with skepticism The 14 GOP senators who voted against Trump’s immigration framework MORE (Alaska) and Rob PortmanRobert (Rob) Jones PortmanCommittee chairman aims for House vote on opioid bills by Memorial Day Flake to try to force vote on DACA stopgap plan Congress punts fight over Dreamers to March 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 McConnellAddison (Mitch) Mitchell McConnellLawmakers feel pressure on guns Bipartisan group of House lawmakers urge action on Export-Import Bank nominees Curbelo Dem rival lashes out over immigration failure 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 Randolph ThuneFlake to try to force vote on DACA stopgap plan Congress punts fight over Dreamers to March The 14 GOP senators who voted against Trump’s immigration framework MORE (R-S.D.) told reporters.

Sen. John CornynJohn CornynLawmakers feel pressure on guns Kasich’s campaign website tones down gun language after Florida shooting Murphy: Trump’s support for background check bill shows gun politics ‘shifting rapidly’ 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.