GOP ObamaCare fight faces do-or-die procedural vote

Time is ticking away on Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellBudowsky: Pelosi can break shutdown stalemate GOP seeks to change narrative in shutdown fight On The Money: Shutdown Day 32 | Senate to vote on dueling funding measures | GOP looks to change narrative | Dems press Trump on recalled workers | Kudlow predicts economy will 'snap back' after shutdown MORE’s hopes of passing ObamaCare repeal legislation before the July 4 recess.

A CBO score that found the legislation would leave 22 million more people without insurance in the next decade has raised the stakes on a procedural vote that could come as soon as Tuesday.

At least four Republicans say they may vote against their party on the motion to proceed, underscoring the opposition to McConnell’s bill.

The defectors include centrist Sen. Susan CollinsSusan Margaret CollinsGOP seeks to change narrative in shutdown fight Trump pitches new plan to reopen government amid Dem pushback The Memo: Concern over shutdown grows in Trump World MORE (Maine), who panned the bill on Twitter Monday evening; fellow moderate Sen. Dean HellerDean Arthur HellerOregon Dem top recipient of 2018 marijuana industry money, study finds Trump’s shifting Cabinet to introduce new faces Trump's most memorable insults and nicknames of 2018 MORE (R-Nev.); and two conservatives, Sens. Rand PaulRandal (Rand) Howard PaulSinkhole opens up a block away from White House Civil rights group marks MLK Day with call for 'Trump card' national ID Pressure mounts for Trump to reconsider Syria withdrawal MORE (R-Ky.) and Ron JohnsonRonald (Ron) Harold JohnsonCongress sends bill renewing anti-terrorism program to Trump The Hill's Morning Report — Shutdown fallout — economic distress Hillicon Valley: Republicans demand answers from mobile carriers on data practices | Top carriers to stop selling location data | DOJ probing Huawei | T-Mobile execs stayed at Trump hotel as merger awaited approval MORE (R-Wis.).

McConnell can only afford two defections.

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A loss on the procedural vote would certainly end work on the measure this week, and it could be a brutal blow to getting the legislation through the Senate on a later timeframe.

Despite the uphill climb, McConnell’s lieutenants on Monday voiced optimism.

“I’m very optimistic, yes,” Senate Republican Whip John CornynJohn CornynGraham angers Dems by digging into Clinton, Obama controversies Trump tells GOP senators he’s sticking to Syria and Afghanistan pullout  Texas governor, top lawmakers tell Trump not to use hurricane relief funds to build border wall MORE (R-Texas) told reporters when asked if he still stood by his guarantee from a week ago that the legislation would muster 50 votes.

But Cornyn isn’t saying when the vote will take place.

If GOP leaders can wrangle the votes, it will happen Tuesday. If they can’t get it Tuesday, they will try for Wednesday.

And if that doesn’t work, it may get pushed to beyond the July 4 recess, which would give opponents time to pressure GOP senators over the holiday break.

“We may not know if we have the votes to pass it until we bring it up,” said Senate Republican Conference Chairman John ThuneJohn Randolph ThuneRove warns Senate GOP: Don't put only focus on base Leaders nix recess with no shutdown deal in sight Senate advances measure bucking Trump on Russia sanctions MORE (R-S.D.), the third-ranking member of the GOP leadership.

Rank-and-file Republican senators realize that they have limited time to further mold the legislation and once the motion to proceed passes, kicking off 20 hours of debate and a flurry of amendments in the Senate’s vote-a-rama process, the proceedings will become harried and hectic.

GOP leaders are confident the rebels will come around if given the right concessions – or at least the chance to claim a victory to constituents back home.

Paul is the only senator who’s viewed as a certain no.

He has said for months that he does not support creating a new system of tax credits to funnel federal dollars to insurance companies to help low-income people buy insurance. He argues this would set up a new entitlement that he calls “ObamaCare Lite.”

The junior Kentucky senator hopes to broker a deal to repeal parts of ObamaCare that all Republicans agree should go, even if they make up a small part of the controversial deal.

The other lawmakers are considered in play, despite their posturing in the days ahead of key floor votes.

John Weaver, a Republican strategist and former senior advisor to Ohio Gov. John Kasich (R), who opposes the Senate bill, said it would be very difficult for conservatives to kill the legislation — especially on a procedural vote.

Johnson, Lee and Sen. Ted CruzRafael (Ted) Edward CruzGroup aiming to draft Beto O’Rourke unveils first 2020 video Howard Dean looking for a 'younger, newer' Democratic nominee in 2020 Congress can stop the war on science MORE (R-Texas) are demanding regulatory reforms for their votes, which risks upsetting the political balance that has kept moderates on board so far.

But conservatives would face a backlash if they blowup the ObamaCare repeal and replace effort, Weaver said.

“Their demands are tougher to meet but the political pressure on them to support it is greater. I think that’s why they’ll support it,” he said.

One Republican source close to McConnell noted that Johnson ran for office as a long-shot Tea Party candidate in 2010 in response to the conservative outcry over ObamaCare.

“Ron Johnson ran for political office to repeal ObamaCare. I can’t believe he won a second term to prevent that from happening,” said the source.

Another group of Republicans, Sens. Rob PortmanRobert (Rob) Jones PortmanUSDA to recall more than 9,000 furloughed workers to provide farm aid Senate Dem introduces 'Stop Stupidity' act to end government shutdowns Senators look for possible way to end shutdown MORE (R-Ohio), Shelley Moore CapitoShelley Wellons Moore CapitoOvernight Energy: Wheeler weathers climate criticism at confirmation hearing | Dems want Interior to stop drilling work during shutdown | 2018 was hottest year for oceans Dems blast EPA nominee at confirmation hearing Republican senators skeptical of using national emergency for wall funding MORE (R-W.Va.) and Cory GardnerCory Scott GardnerGOP seeks to change narrative in shutdown fight The Memo: Concern over shutdown grows in Trump World Senate Republicans eye rules change to speed Trump nominees MORE (R-Colo.), are worried about phasing out generous federal funding of expanded Medicaid enrollment. They met with leaders in McConnell’s Capitol office Monday evening to extract last-minute changes.

“Just continue to talk about ways that we can assure that we’re bringing down costs and understand the analysis that’s going to show that,” Gardner said after the meeting.

Placating moderates such as Collins, Heller, Portman and Capito could come down to guaranteeing resources for constituents who face the biggest potential impact, such as people who rely on Medicaid to treat opioid addiction.

While the Congressional Budget Office score released Monday projected that there would be 22 million more people without insurance by 2026 because of the legislation, it contained some good news, too.

The score estimated that premiums, a major concern of Johnson and other GOP critics, would lower average premiums after 2020 relative to projections under current law.

It also projected the bill would reduce the federal deficit by $321 billion over the next decade, considerably more than the House version.

That gives McConnell room to make concessions to wavering moderates in the form of extra spending for constituents who could be hardest hit, such as low-income seniors in rural areas or families struggling with opioid addiction.

“I think we’ll have some additional work to do,” Thune told reporters, noting “there’s enough excess revenue” above the House bill to make significant concessions.