Republicans were forced to postpone a decision on their healthcare plan on Tuesday, delaying a Senate vote until after the July 4th recess having failed to win sufficient support among their own ranks.
In a significant blow for the much-hailed Republican promise to repeal and replace President Obama’s signature healthcare policy introduced seven years ago, Senate majority leader Mitch McConnell confirmed that a vote would now take place after next week’s congressional recess.
It followed a series of defections from both the conservative and moderate wing of the Republican party.
Mr McConnell, the Senate’s top-ranking Republican, had pushed for a vote before the July 4th break in order to secure consent for the controversial healthcare replacement bill that will affect the healthcare provisions of tens of millions of Americans.
The Senate proposal differs in scope to the bill passed by the House of Representatives last month, mainly by including a proposal to link federal subsidies to income rather than age. It also proposes a more gradual phasing-out of the expansion of Medicaid, the programme for low-income Americans.
But both Republican bills threaten to make it more difficult for lower-income Americans to access healthcare, as well as curtail access to services such as Planned Parenthood and programmes that tackle drug addiction, according to Democrats and campaigners.
Trump ‘optimistic’
Sarah Huckabee Sanders, the deputy press secretary, said President Donald Trump remained "optimistic" about the healthcare bill after news of the delay emerged.
The president was due to host senior Republicans at the White House later on Tuesday to discuss the impasse. Mr Trump stoked surprise last week when he described the Republican House plan as "mean" during a meeting with Republicans, despite having previously backed the deal.
The political obstacles facing the bill had been laid bare on Monday evening, when a report by the Congressional Budget Office predicted that 22 million people would be left uninsured under the proposal.
The budget office – a federal agency that provides budgetary analysis to Congress – found that 15 million people would be left without insurance next year alone if the bill passed.
The federal deficit would reduce by about $321 billion over a decade, a fallout that would be welcomed by most of the traditional Republican base, although it still does not go far enough for some conservative members of the party. Five conservative senators had already publicly spoken out against the bill last week, among them Senator Rand Paul, who told reporters "it's worse to pass a bad bill than pass no bill". He has previously described the proposal as "Obamacare lite".
Slender majority
Following the budget office's report, more moderate Republicans such as Senator Susan Collins from Maine also withdrew support, forcing Mr McConnell to delay the vote.
With Republicans controlling the 100-seat Senate by 52 to 48, the leadership cannot afford to lose more than two Republican defectors, with vice-president Mike Pence casting the deciding vote.
Earlier, the White House dismissed the budget office’s report on the cost of the American Healthcare Act, as the Republican plan is known. “The [budget office] has consistently proven it cannot accurately predict how healthcare legislation will impact insurance coverage,” the White House said in a statement. “This history of inaccuracy, as demonstrated by its flawed report on coverage, premiums and predicted deficit arising out of Obamacare, reminds us that its analysis must not be trusted blindly.”
The statement added that Mr Trump is “committed to repealing and replacing Obamacare, which has failed the American people for far too long.”
With members of Congress due to return to their constituencies next week, they are likely to face a barrage of questions from voters about their position on the contentious healthcare reform policy.