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GOP ObamaCare fight faces do-or-die procedural vote

Time is ticking away on Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellBiden to meet with 6 GOP senators next week GOP is consumed by Trump conspiracy theories The Hill's Morning Report - Presented by Emergent BioSolutions - Upbeat jobs data, relaxed COVID-19 restrictions offer rosier US picture 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 CollinsCheney drama exposes GOP's Trump rifts House to advance appropriations bills in June, July Manchin touts rating as 'most bipartisan senator' MORE (Maine), who panned the bill on Twitter Monday evening; fellow moderate Sen. Dean HellerDean Arthur HellerOn The Trail: Democrats plan to hammer Trump on Social Security, Medicare Lobbying World Democrats spend big to put Senate in play MORE (R-Nev.); and two conservatives, Sens. Rand PaulRandal (Rand) Howard PaulTim Scott sparks buzz in crowded field of White House hopefuls Sherrod Brown calls Rand Paul 'kind of a lunatic' for not wearing mask Overnight Health Care: WHO-backed Covax gets a boost from Moderna MORE (R-Ky.) and Ron JohnsonRonald (Ron) Harold JohnsonOvernight Health Care: WHO-backed Covax gets a boost from Moderna Vaccine hesitancy among lawmakers slows return to normalcy on Capitol Hill FBI was aware Giuliani was a target of a Russian influence campaign ahead of 2020 election: report 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 CornynTim Scott sparks buzz in crowded field of White House hopefuls Cornyn is most prolific tweeter in Congress so far in 2021 Schumer 'exploring' passing immigration unilaterally if talks unravel 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 ThuneCheney fight stokes cries of GOP double standard for women Trump muddles Republican messaging on Afghanistan The Memo: Trump's critics face wrath of GOP base 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 CruzCheney drama exposes GOP's Trump rifts Pollster Frank Luntz: 'I would bet on' Trump being 2024 GOP nominee Tim Scott sparks buzz in crowded field of White House hopefuls 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 PortmanStrengthen CBP regulations to reduce opioid deaths House panel advances bipartisan retirement savings bill Democrats confront difficult prospects for midterms MORE (R-Ohio), Shelley Moore CapitoShelley Wellons Moore CapitoBiden to meet with 6 GOP senators next week Biden pitches infrastructure plan in red state Louisiana House to advance appropriations bills in June, July MORE (R-W.Va.) and Cory GardnerCory GardnerBiden administration reverses Trump changes it says 'undermined' conservation program Gardner to lead new GOP super PAC ahead of midterms OVERNIGHT ENERGY: Court rules against fast-track of Trump EPA's 'secret science' rule | Bureau of Land Management exodus: Agency lost 87 percent of staff in Trump HQ relocation | GM commits to electric light duty fleet by 2035 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.