Trump himself phoned lawmakers and state governors seeking to tilt the scales in favor of the bill, seen as the Republican Party’s final chance to repeal Barack Obama’s Affordable Care Act without support from opposition Democrats.

But the effort stumbled, with a bipartisan group of 10 governors, as well as multiple major health-related interest groups imploring senators not to pass the controversial legislation.

“We ask you not to consider the (bill) and renew support for bipartisan efforts to make health care more available and affordable for all Americans,” 10 governors, including four Republicans, wrote in a letter to Senate leaders. 

“Only open, bipartisan approaches can achieve true, lasting reforms.”

The governors favored a framework being negotiated in recent weeks by Republican Senator Lamar Alexander and Senate Democrat Patty Murray aimed at stabilizing the existing Obamacare insurance markets.

But in the rush to boost the latest bill that would dramatically reshape the US health care system, those talks broke down Tuesday night.

Vice President Mike Pence meanwhile leaned on rank and file Senate Republicans to back the plan, as its sponsors insisted they were inching closer toward the magic number of 50 votes required to pass the measure.

“I’ve never felt better about where we’re at,” said Senator Lindsey Graham, who chiefly co-sponsored the bill with Senator Bill Cassidy.

Pence, who lunched with Senate Republicans, said the effort had the administration’s full backing.

“This is the moment, now is the time. We have 12 days,” Pence said.

After September 30, procedural rules would require a 60-vote threshold for such bills instead of a simple 51-vote majority.

Should the vote be 50-50, the vice president breaks the tie. Republicans, who hold 52 Senate seats, can afford just two defectors.

Two months ago, Republicans fell just one vote short in their efforts to shred Obamacare. 

But new momentum swelled in the past week, after a group of Republican senators unveiled a bill that would replace the law’s complex system of health care subsidies with block grants to every US state.

All Democrats remain opposed to the measure, which Senate Minority Leader Chuck Schumer savaged as “even more dangerous and reckless than the previous bill that was defeated.”

The plan is “a bill to end Medicaid as we know it, and let governors do the dirty work,” he added, referring to the government health insurance program for the poor and disabled.

Skepticism has bubbled up among some Republicans.

Senator Rand Paul said he is an outright no, criticizing the measure for maintaining Obamacare’s taxes and doing nothing to address the problems with the current system of marketplaces for health insurance.

“This does not look, smell or even sound like repeal,” Paul told reporters Monday, anticipating years of chaos should the bill become law.

– ‘Some convincing to do’ -Attention has focused on flipping the three Republican senators who sank the July effort: Susan Collins, John McCain and Lisa Murkowski.

Murkowski told reporters she remained undecided.

McCain expressed concern that the bill is being rushed through and not following the “regular order” of hearings and debate. 

Collins was worried that the new plan would dramatically slash Medicaid, and that the Congressional Budget Office (CBO) would not have enough time to conduct a comprehensive analysis of the bill’s effects.

“We’ve got some convincing to do,” acknowledged Senator Ron Johnson. “Time is running out.”

Democrats argue that Graham-Cassidy allows states to permit insurers to roll back protections for Americans with pre-existing conditions, and to charge them more for insurance.

Money to states would decline over time, eventually disappearing unless Congress appropriated new funding.

And the new “Trumpcare” measure would decimate Medicaid by halting its expansion and establishing a per-capita cap on spending, Schumer said.

The American Medical Association issued scathing criticism of the latest repeal effort, warning it “would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets, and decrease access to affordable coverage and care.”

In July, the non-partisan CBO projected that the ranks of uninsured Americans would grow by 16 million, and premiums would rise 20 percent annually, over the next decade if the previous Obamacare repeal bill became law. DM