Majority Leader Mitch McConnell (R-Ky.) is ramping up pressure on Senate Republicans to allow healthcare reform legislation to move forward, but old antagonist Sen. Ted Cruz (R-Texas) is an obstacle.

McConnell on Wednesday urged colleagues to drop procedural objections to the bill, a sign that his patience is wearing thin — and that he is uncertain he can win the day.

“If we sit on our hands, families will continue to suffer. And if we let this opportunity to move beyond ObamaCare pass us by, what other options will there be?” he said in remarks from the Senate floor. 

McConnell argued that if senators blocked the bill, there would be no opportunity to debate their ideas in public.

Senate Majority Whip John Cornyn (R-Texas) said his colleagues have an obligation to allow the debate to proceed and would break Senate traditions by blocking it.

“The only time I’m aware of around here that people don’t vote yes on a motion to proceed is if they don’t have an opportunity to offer amendments and get votes on them,” he said.

Their pleas, however, failed to move some members of the GOP conference.  

Cruz, the runner-up in last year’s Republican presidential primary, declined to say Wednesday whether he would vote to allow the healthcare debate to begin next week.

“Depends what’s in the bill,” Cruz told reporters before heading into a lunch where lawmakers discussed the outline of the legislation.

Cruz and fellow conservative Sen. Mike Lee (R-Utah) are insisting on an amendment that would allow insurance companies to sell any kind of health plan they want as long as they offer at least one that complies with federal regulations.

Cruz was summoned to Cornyn’s office late Wednesday afternoon but a spokesman for Cornyn said it was to discuss judicial vacancies, not Cruz’s concerns with the legislation.

Critics say the Cruz-Lee amendment would lead healthier people to flock to cheap, bare-bones plans, sending premiums for older and sicker people soaring.

In a document circulated on Capitol Hill, the main insurer trade group, America’s Health Insurance Plans, warned the Cruz-Lee amendment could lead to higher costs for those with pre-existing conditions.

Such individuals could “potentially lose access to comprehensive coverage and/or have plans that were far more expensive, as premiums in the Exchange market would rise much faster,” it said.

McConnell can afford only two defections if he is to still pass the bill, as Republicans control 52 seats. Vice President Pence would break a 50-50 tie. 

Sen. Rand Paul (R-Ky.) is expected to oppose the bill, and many observers also believe it will be impossible to win support from Sen. Susan Collins (R-Maine).

Despite the tough odds, one GOP lawmaker who attended Wednesday’s lunch said there’s generally a “more positive feeling” that the motion to proceed to the bill will pass next week but conceded “no one stood up and said they changed their minds” to express support for the bill.

But several Republican senators left the lunch voicing frustration with McConnell’s strategy of keeping the details of the bill secret until the last minute in order to keep critics from picking it apart. 

“People have asked, ‘Has [the bill] addressed concerns that you have in Alaska?’ I have no idea, so I’m not going to make any commitment to anybody that I’m going to vote for a motion to proceed,” said Sen. Lisa Murkowski (R-Alaska), who remains undecided.

In a bid to entice moderates, Cornyn promised “a substantial” increase to a $62 billion state fund designed to help low-income people with high healthcare costs afford insurance.  

McConnell has scheduled a special meeting of the conference at 11:30 a.m. Thursday to discuss the detailed contents of the legislation. GOP leaders say the bill will be posted publicly sometime Thursday morning.

McConnell used this same playbook when he rolled out the first version of the Senate bill repealing and replacing major parts of ObamaCare on June 22. 

But even when he unveiled the legislation in a morning meeting late last month, the discussion was limited to the bill’s broad goals and lawmakers were not given paper with detailed language.

GOP lawmakers said the leadership’s tactic of limiting information was designed to keep complaints and objections to a minimum.

Republican senators and senior aides have differing opinions on how much support there is for the Cruz-Lee proposal, but they agree it cannot pass as drafted. One GOP lawmaker predicted it would get 47 votes. A senior aide familiar with negotiations last week said it would only get 15.

Cornyn said no final decision has been made on the Cruz-Lee provision.

“The base bill will be released tomorrow morning. There’s going to be a lot of information released but I can’t speak to the exact format,” Cornyn said.

Sens. Mike Rounds (R-S.D.) and Bill Cassidy (R-La.) are negotiating with Cruz and Lee to modify their amendment so that it could gather at least 50 votes on the floor.

Rounds, a former insurance executive, has proposed setting a ratio for how much insurers could charge people for plans meeting federal requirements versus the lower charge for cheaper, simpler plans.

He said that Cassidy has been in touch with Cruz on a “slightly different approach, but a similar concept.”

A spokesman for Cassidy did not comment.

Cruz declined to say late Wednesday whether he would accept their suggested modifications.

“We continue to have productive conversations,” he said.

Correction:

This report was updated on July 13 at 7:10 a.m. after a spokesman for Cornyn said the senator met with Cruz on Wednesday to discuss judicial vacancies.