Alexander's comments suggest that there is even less support among Senate Republicans than previously believed for an outright repeal of Obamacare without offering a replacement. Vice President Mike Pence has been very personally involved, as has Seema Verma, who is the White House's top Medicaid official.

Under the House bill, those who lack insurance for more than 63 consecutive days could be charged a higher premium when they buy a plan.

One might think that Trump, having suffered through the embarrassment of an ill-fated health-care bill in the House, would have placed his shoulder more forcefully behind the Senate's effort.

Also, premiums would about double by 2026, compared to current law.

Now that Plans A, B and C have failed for repealing and replacing Obamacare, maybe Congress can get down to the business of fixing the health care law and then move on to other issues. That includes overhauling the tax code and that long-promised infrastructure bill that the president and Republicans and some Democrats in Congress say that they want the most. A recent Quinnipiac poll found 71 percent of Americans are against a decrease in federal funding for the program, including 53 percent of Republicans.

In reality, senators were aware that that procedural vote would be viewed as a vote on whatever health care package leaders were pushing, perhaps reflecting changes negotiated with GOP senators.

On the other hand, moderates point to the latest Congressional Budget Office analysis of the bill that estimates 22 million people could lose their insurance coverage over the next 10 years if it became law. The Trump administration has been reimbursing insurers for the subsidies on a monthly basis, but has not committed to do so in the future.

And if there's one thing we know about entitlements, it's that they are almost impossible to take back once people have them. Heller opposed the original Senate health care bill, siding with his centrist Republican governor Brian Sandoval over concerns for Nevadans who benefited from the state's acceptance of the Obamacare Medicaid expansion. That will make it more likely to comply with Senate rules that will allow it to be passed with a simple majority.

Warren's re-election campaign is already drawing interest from national Republican groups, who are eyeing her race as a chance to damage her popularity ahead of a potential presidential campaign in 2020.

Whether Republicans have the brains and backbones to rid America of the curse of Obamacare remains to be seen, but they need to quit griping and start fixing before it's too late.

Trump himself didn't shy away from the suggestion of encouraging challengers for people who don't get in line, joking with Sen.

Only 27 per cent preferred making changes 'to reduce government spending, even if it means fewer people would have health insurance'. But expecting remorse or reflection that might lead him toward greater political commitment and magnanimity is a misunderstanding of what has always animated his thinking and actions.

The Senate is expected to vote as soon as Tuesday on debating a repeal bill, but not on the bill itself. Unless the subject is Trump, he doesn't care too deeply about outcomes.

GREENE: (Laughter) To say the least. "People are hurting. Inaction is not an option", Trump implored at a luncheon meeting.