This is why the Republican Senate health care bill may not get a vote.

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The Congressional Budget Office reported the Senate health care bill would result in 22 million more people losing insurance than under the Affordable Care Act. That drew key Republicans into open revolt.

Sen. Susan Collins (R-Maine) tweeted she will not even vote to let the bill come up for debate before the Senate, let alone support the proposal. Sens. Rand Paul (R-Ky.), Ron Johnson (R-Wis.) and Dean Heller (R-Nev.) will also oppose a vote to bring the bill up for debate — a stunning development for Republican leaders who had hoped to let senators propose amendments to the bill to publicly take credit for altering the final legislation. Senate Majority Leader Mitch McConnell needs 50 votes to debate the bill; senators beyond those four have also suggested they might not support the procedural vote. There are 52 Republicans in the Senate.

Yet with Collins, a moderate, and Paul, a conservative, holding two diametrically opposed viewpoints, it's difficult to see how McConnell will strike a deal that will get him the necessary 50 votes. McConnell originally wanted to proceed to a vote on Tuesday. That move now seems unlikely.

What changes do senators want? Collins said the bill’s deep Medicaid cuts will hurt Maine's rural hospital. Heller has said he does not want Nevadans to lose health insurance. Paul and Johnson, meanwhile, want a wholesale Obamacare repeal — which would guarantee a loss of insurance for millions of people, especially those on Medicaid. The Associated Press breaks down the key players.

From the CBO score:

• By 2026, 49 million people would be uninsured if the Senate bill passes compared to 28 million under current law.

• Premiums for lower income and older Americans would jump compared to the Affordable Care Act.

• Medicaid would be cut by $772 billion.

• Federal subsidies that help people pay for health insurance would be cut by $408 billion.

• Tax cuts would keep $541 billion with wealthy Americans and health care companies.

• Next year, 15 million people would drop off health insurance, largely because they’d choose not to renew coverage with the individual mandate repealed.

Of note: A change to the CBO means the agency will not evaluate a bill's impact beyond 10 years, but the Senate bill's deepest cuts to Medicaid kick-in after that 10-year window, meaning the long-term impact of the legislation is hidden in plain sight.

A must-read: Why your health insurance costs could rise under the Senate bill.

Today's question: The Senate Republican health care plan would cut hundreds of billions of dollars from Medicaid. How would that impact you? Email us at
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What we're watching

Today: Key Republicans are trashing the Senate health care bill.

More: The GOP does not have the votes to advance the bill to a debate.

Late-night siren: The White House sent out a statement on Monday night saying Syria's government is preparing for another chemical weapons attack. Syria will "pay a heavy price" if it proceeds, the U.S. said.

Trump's agenda today: Speaking by phone with the president of France and the prime minister of Ireland. Meeting with national security adviser H.R. McMaster.

How are opponents fighting the bill?

In Washington, is planning a "people's filibuster" Tuesday through Thursday of this week outside the Capitol. After their sit-in last week, Americans with disabilities are continuing to protest the bill. An interfaith health care vigil will be held for 24 hours on Wednesday and Thursday on the Capitol lawn. On Monday night, Sen. Cory Booker (D-N.J.) gathered his colleagues and liberal activists outside the Capitol to rally against the legislation.

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