Unwilling to concede defeat on a bedrock GOP promise, President Donald Trump on Saturday tried to sway two Republican holdouts on the party's last-ditch health care hope while clawing at his nemesis who again has brought the "Obamacare" repeal-and-replace effort to the brink of failure.
Trump appealed to Sen. Lisa Murkowski, a possible "no" vote, to swing around for the sake of Alaskans up in arms over high insurance costs, and suggested that Kentucky Sen. Rand Paul might reverse his stated opposition "for the good of the Party!"
Arizona Sen. John McCain, whose announcement Friday that he would not vote for the proposal seemingly scuttled efforts to revive the repeal, came under renewed criticism from the White House. It was the second time in three months that McCain, at 81 in the twilight of a remarkable career and battling brain cancer, had emerged as the destroyer of his party's signature and yearslong pledge to voters on health care.
"He campaigned on Repeal & Replace. Let Arizona down!" Trump tweeted. He jabbed at the senator with another tweet later in the day: "Democrats are laughingly saying that McCain had a "moment of courage." Tell that to the people of Arizona who were deceived. 116% increase!"
The effort to rally support for the bill took another hit Saturday when the nation's doctors, hospitals and health insurance plans unified in opposition to it. In a joint statement, major groups such as the American Medical Association, the American Hospital Association, America's Health Insurance Plans and the BlueCross BlueShield Association called on the Senate to reject the bill and said, "Health care is too important to get wrong."
With Senate Democrats unanimously opposed, two is the exact number of GOP votes that Majority Leader Mitch McConnell, R-Ky., can afford to lose. McCain and Paul are in the "no" column, Sen. Susan Collins, R-Maine, is leaning against the bill and Murkowksi is also a possible "no."
But Trump isn't letting go, as seen by his series of tweets while he spends the weekend at his New Jersey golf club.
Aiming at Murkowski, Trump cited increases in premiums and other costs in Alaska under the Affordable Care Act. "Deductibles high, people angry! Lisa M comes through," he wrote.
Trump, without offering support for his assertion about former presidential rival Paul, said: "I know Rand Paul and I think he may find a way to get there for the good of the Party!"
But there was no doubt where Trump stood on McCain.
"John McCain never had any intention of voting for this Bill," Trump said. The measure was co-written by South Carolina Sen. Lindsey Graham, McCain's closest Senate ally, and Sen. Bill Cassidy, R-La.
"McCain let his best friend L.G. down!" Trump said, adding that the health bill was "great for Arizona."
McCain, in explaining that he could not "in good conscience" vote for the legislation, said both parties "could do better working together" but hadn't "really tried." He also he could not support the measure "without knowing how much it will cost, how it will affect insurance premiums, and how many people will be helped or hurt by it."
His opposition all but ensured a major setback for Trump and McConnell, and appeared likely to deepen rifts between congressional Republicans and a president who has begun making deals with Democrats out of frustration with his own party's failure to turn proposals into laws.
During the election campaign Trump had pledged to quickly kill the Affordable Care Act — "It will be easy," he contended — and he has publicly chided McConnell for not winning passage before now.
Up until McCain's announcement, McConnell allies were optimistic McCain's relationship with Graham might make the difference. GOP leaders hoped to bring the legislation to the full Senate this coming week. They face a Sept. 30 deadline, at which point special rules that prevent a Democratic filibuster will expire.
Democrats hailed McCain's announcement and pledged to commit to the bipartisan process he sought. GOP Sen. Lamar Alexander of Tennessee and Democratic Sen. Patty Murray of Washington have been working on a package of limited legislative fixes to the health law's marketplaces.
"John McCain shows the same courage in Congress that he showed when he was a naval aviator," said Senate Minority Leader Chuck Schumer, D-N.Y. "I have assured Sen. McCain that as soon as repeal is off the table, we Democrats are intent on resuming the bipartisan process."
Trump charged that Schumer "sold John McCain a bill of goods. Sad."
The Graham-Cassidy bill would repeal major pillars of the health law and replace them with block grants to states to design their own programs.
"Large Block Grants to States is a good thing to do. Better control & management," Trump tweeted.
But major medical groups said millions of people would lose insurance coverage and protections. A bipartisan group of governors announced their opposition.
The House passed its own repeal bill back in May, prompting Trump to convene a Rose Garden celebration, which soon began to look premature.
After the Senate failed in several attempts in July, the legislation looked dead. But Cassidy kept at it with his state-focused approach, and the effort caught new life in recent weeks as the deadline neared. Trump pushed hard, hungry for a win.
The bill would get rid of unpopular mandates for people to carry insurance or face penalties. It would repeal the financing for Obama's health insurance expansion and create a big pot of money states could tap to set up their own programs, with less federal oversight. It would limit spending for Medicaid, the federal-state program that now covers more than 70 million low-income people. Insurance rules that protect people with pre-existing conditions could be loosened through state waivers.
Over time, the legislation would significantly reduce federal health care dollars now flowing to the states. But McConnell had little margin for error in a Senate split 52-48 between Republicans and Democrats, and could lose only two votes, counting on Pence to break the tie.
Associated Press writers Erica Werner, Alan Fram and Ricardo Alonso-Zaldivar in Washington contributed to this report.