Facing implacable opposition and a Sept. 30 deadline to pass a bill to repeal and replace large chunks of the Affordable Care Act, the Republican leadership in the Senate has decided not to vote on a measure that seemed destined to come up short of passage.

GOP senators made the decision to not vote on the latest repeal legislation, dubbed the Graham-Cassidy bill, this afternoon at a weekly party lunch. Majority Leader Mitch McConnell, who was ultimately responsible for the decision, confirmed afterward that the bill won’t be voted on in time to meet the deadline.

Because an ACA repeal bill currently stands no chance of getting the 60 votes usually needed before passing a piece of legislation through the Senate, the Republicans have been trying to use the budget reconciliation process.

While the reconciliation process limits what can and can’t be included in a piece of legislation, it also only requires a simple majority (51 votes) in the Senate. In fact, with Graham-Cassidy supporter Vice President Mike Pence being the tie-breaking vote in the Senate, the GOP would have only needed to get to 50 votes to move the bill on to the House.

However, at least three Republican senators — John McCain of Arizona, Rand Paul of Kentucky, and Maine’s Susan Collins — had each publicly stated their opposition to the bill. With only a 52-48 majority in the Senate, and no Democrats showing any signs of breaking ranks, this means that there could be no path to getting those 50 votes.

Republican leadership made last-minute tweaks to Graham-Cassidy that appeared designed to specifically benefit these senators’ states, with the apparent goal of making it more difficult for them to vote no. However, none of those opposed to the bill were swayed.

What’s more, the budget reconciliation process requires that the Senate pass the budget resolution by the end of the federal fiscal year, which is Sept. 30, meaning there was not enough time to continue revising Graham-Cassidy to make it more palatable.

Even with more time, it’s unlikely that three opposing senators could have had their votes swayed without causing other lawmakers to change their votes from “yes” to “no.” While Sen. Collins has been critical of the various repeal bills’ cuts to Medicaid and other programs, Sen. Paul — a hardline conservative — opposed Graham-Cassidy because he says it didn’t go far enough.

Making the bill more acceptable to Collins would likely have caused Paul to dig in his heels further and possibly convinced conservatives like Sen. Ted Cruz and Sen. Mike Lee to change their vote to “no.” Similarly, making deeper cuts to entitlements to please Paul could have led other moderates like Alaska’s Lisa Murkowski to officially declare their opposition.

McCain — the surprise “no” vote that sank the July ACA repeal bill in the Senate — opposed Graham-Cassidy on procedural grounds, criticizing his colleagues for trying to slam through important legislation without debate or amendment while sidestepping the usual 60 votes needed to end filibuster. It’s possible that McCain could have remained a “no” vote regardless of any changes made to the text of the bill.

Unlike previous repeal bills, where the nonpartisan Congressional Budget Office was given time to provide a detailed analysis of how each bill would affect insurance coverage and rates, with Graham-Cassidy the CBO was only given enough time to conclude that “The number of people with comprehensive health insurance that covers high-cost medical events would be reduced by millions.”

There have been some bipartisan discussions among senators to pass healthcare reform legislation, but those talks recently broke down as the GOP made the 11th hour push to see if Graham-Cassidy would get the votes.

The White House and Republican leadership have both vowed to continue the efforts to repeal the Affordable Care Act. The exact timing of when the next feasible legislative attempt could be made is still a matter for debate. It’s possible that the House and Senate could be going through this all again in 2018 in the middle of the midterm elections.

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