McConnell to push Obamacare repeal vote without replacement legislation

WASHINGTON, July 17 (Reuters) - Republicans in the U.S. Congress were in chaos over health care legislation after a second attempt to pass a bill in the Senate collapsed late on Monday, with President Donald Trump calling for an outright repeal of Obamacare and others seeking a change in direction toward bipartisanship.

"Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful," Senate Majority Leader Mitch McConnell said in a statement.

Two of McConnell's Senate conservatives announced just hours earlier that they would not support the Republican leader's latest version of legislation to repeal portions of President Barack Obama's landmark 2010 health care law and replace them with new, less costly healthcare provisions.

RELATED: A look at the Senate's all-male health care working group

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A look at the Senate's all-male health care working group
U.S. Senator Tom Cotton (R-AR) (L) and Senator David Perdue (R-GA) (R) unveil legislation aimed at curbing legal immigration by halving the number of legal immigrants admitted into the United States, at the U.S. Capitol in Washington, U.S. February 7, 2017. REUTERS/Jonathan Ernst
U.S. Senator Cory Gardner (R-CO) smiles after he was ceremonially sworn-in by Vice President Joseph Biden in the Old Senate Chamber on Capitol Hill in Washington January 6, 2015. REUTERS/Larry Downing (UNITED STATES - Tags: POLITICS HEADSHOT)
U.S. Senate Majority Leader Mitch McConnell (R-KY) speaks during a media briefing on Capitol Hill in Washington, U.S. April 25, 2017. REUTERS/Joshua Roberts
U.S. Senator Rob Portman (R-OH) speaks during a session called "The New Congress" at the Wall Street Journal's CEO Council meeting in Washington December 2, 2014. REUTERS/Kevin Lamarque/File Photo
U.S. Senator Pat Toomey (R-PA) speaks to the 38th annual Conservative Political Action Conference meeting in Washington DC, U.S. February 10, 2011. REUTERS/Larry Downing/File Photo
U.S. Senator John Thune addresses the media during the 2017 "Congress of Tomorrow" Joint Republican Issues Conference in Philadelphia, Pennsylvania, U.S. January 25, 2017. REUTERS/Mark Makela
U.S. Senator John Cornyn (R-TX)questions Supreme Court nominee judge Neil Gorsuch during a Senate Judiciary Committee confirmation hearing on Capitol Hill in Washington March 21, 2017. REUTERS/Joshua Roberts
Senator Ted Cruz (R-TX) questions Supreme Court nominee judge Neil Gorsuch during his Senate Judiciary Committee confirmation hearing on Capitol Hill in Washington March 21, 2017. REUTERS/Joshua Roberts
Chairman of the Senate Health, Education, Labor and Pensions Committee Lamar Alexander speaks during Rep. Tom Price's (R-GA) nomination hearing to be Health and Human Services secretary in Washington, U.S., January 18, 2017. REUTERS/Joshua Roberts
Senator Orrin Hatch (R-UT) during the second day of confirmation hearings on Senator Jeff Sessions (R-AL) nomination to be U.S. attorney general in Washington, U.S. January 11, 2017. REUTERS/Joshua Roberts
Sen. Mike Lee (R-UT) speaks at a rally for nominee Neil Gorsuch outside the Supreme Court in Washington, D.C., U.S. March 29, 2017. REUTERS/Aaron P. Bernstein
UNITED STATES - APRIL 4: Sen. John Barrasso, R-Wyo., speaks as Senate Republican leaders hold their media availability focusing on the confirmation of Neil Gorsuch as associate justice of the Supreme Court following their policy lunch on Tuesday, April 4, 2017. (Photo By Bill Clark/CQ Roll Call)
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With Republican Senators Mike Lee and Jerry Moran joining Senators Susan Collins and Rand Paul in opposition - and amid a solid wall of opposition from Democrats - McConnell no longer had enough votes to pass a Republican health care bill in the 100-member Senate.

It was the latest in a series of healthcare setbacks for Republicans, despite their control of both chambers of Congress and the White House.

It also came after seven straight years of promising voters that they would repeal Obamacare if they were to control Congress and the White House, only to find that the public liked Obamacare more than their proposed substitutes, according to public opinion polls.

The non-partisan Congressional Budget Office has determined that the various versions of Republican health care legislation would result in anywhere from 18 million to 23 million people losing their health insurance.

However, Republicans argue that Obamacare is a government over-reach and costs too much money.

MAJOR BLOW

Monday's developments had an immediate impact on financial markets as Asian shares stepped back from more than two-year highs on Tuesday and the dollar extended losses.

In the United States, the latest setback delivered a major political blow to Trump, who has failed to win any major legislative initiative in the first six months of his presidency.

In response, Trump said on Twitter Congress should immediately repeal Obamacare and "start from a clean slate" on a new healthcare plan. He said Democrats would join such an effort, even though they have refused to have any part of an Obamacare repeal.

McConnell, apparently backing Trump's latest approach, announced that he would try to bring legislation to repeal Obamacare to the Senate floor in coming days, but with a two-year delay in implementation to assure a smooth transition.

That idea was rejected by Republicans months ago in favor of simultaneously repealing and replacing Obamacare in order to avoid chaos in insurance markets.

Republican Senator John McCain, who is recovering from surgery in his home state of Arizona, urged a much different change of course - bipartisanship.

"The Congress must now return to regular order, hold hearings, receive input from members of both parties" and pass a bill that "finally provides Americans with access to quality and affordable health care," McCain said in a statement.

"START FROM SCRATCH"

It was not yet clear whether Republicans would get behind the latest Trump-McConnell plans or McCain's prescription.

Like McCain, Senate Democratic leader Chuck Schumer held out the possibility of bipartisanship. In a statement, he urged Republicans to "start from scratch and work with Democrats on a bill that lowers premiums, provides long-term stability to the markets and improves our health care system."

Republicans in Congress had been hoping to settle on a healthcare bill before an upcoming August recess so they could begin work in earnest in September on a wide-ranging rewrite of the U.S. tax code.

House of Representatives Speaker Paul Ryan had no immediate comment on the next steps he would like to see following the collapse of the healthcare bill in the Senate.

One health industry lobbyist said that, in the run-up to the second collapse of the Senate's healthcare bill this summer, there was growing anger among senators over proposed Medicaid cuts and an amendment by Senator Ted Cruz that would have allowed insurance companies to offer cheaper plans that did not have Obamacare's guaranteed coverage of services such as maternity care.

RELATED: The contentious battle over Obamacare

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UNITED STATES - MARCH 23: Pro-choice demonstrators including Stephanie Castro, right, and Sandra Sanchez of the National Latina Institute for Reproductive Health, appear outside of the Supreme Court as arguments were heard in a case which religious organizations are challenging the Affordable Care Act's provision that requires employers to cover birth control in health care plans, March 23, 2016. (Photo By Tom Williams/CQ Roll Call)
US President Barack Obama greets attendees after speakin on the Affordable Care Act at the United Community Center in Milwaukee, Wisconsin on March 3, 2016. / AFP / MANDEL NGAN (Photo credit should read MANDEL NGAN/AFP/Getty Images)
Demonstrators opposed to U.S. President Barack Obama's health-care law, Obamacare, hold signs in front of the U.S. Supreme Court in Washington, D.C., U.S., on Wednesday, March 4, 2015. A U.S. Supreme Court argument over Obamacare's tax subsidies divided the justices along ideological lines, potentially leaving two pivotal justices to decide the law's fate. Photographer: Andrew Harrer/Bloomberg via Getty Images
Demonstrators opposed to U.S. President Barack Obama's health-care law, Obamacare, hold signs in front of the U.S. Supreme Court in Washington, D.C., U.S., on Wednesday, March 4, 2015. A U.S. Supreme Court argument over Obamacare's tax subsidies divided the justices along ideological lines, potentially leaving two pivotal justices to decide the law's fate. Photographer: Andrew Harrer/Bloomberg via Getty Images
Representative Steve King, a Republican from Iowa, speaks at the Tea Party Patriots podium in front of the U.S. Supreme Court in Washington, D.C., U.S., on Wednesday, March 4, 2015. A U.S. Supreme Court argument over Obamacare's tax subsidies divided the justices along ideological lines, potentially leaving two pivotal justices to decide the law's fate. Photographer: Andrew Harrer/Bloomberg via Getty Images
Pamela Hurst, center, speaks to the media as her husband Douglas Hurst, a plaintiff in King v. Burwell, right, looks on in front of the U.S. Supreme Court with Michael Carvin, lead attorney for the petitioners and partner at Jones Day, left, in Washington, D.C., U.S., on Wednesday, March 4, 2015. A U.S. Supreme Court argument over Obamacare's tax subsidies divided the justices along ideological lines, potentially leaving two pivotal justices to decide the law's fate. Photographer: Andrew Harrer/Bloomberg via Getty Images
Kathleen Sebelius, former secretary of Health and Human Services (HHS), center, speaks to members of the media in front of the U.S. Supreme Court in Washington, D.C., U.S., on Wednesday, March 4, 2015. A U.S. Supreme Court argument over Obamacare's tax subsidies divided the justices along ideological lines, potentially leaving two pivotal justices to decide the law's fate. Photographer: Andrew Harrer/Bloomberg via Getty Images
Demonstrator Donna Hurlock, a medical doctor from Virginia opposed to U.S. President Barack Obama's health-care law, Obamacare, holds a 'No Obamacare' umbrella in front of the U.S. Supreme Court in Washington, D.C., U.S., on Wednesday, March 4, 2015. A U.S. Supreme Court argument over Obamacare's tax subsidies divided the justices along ideological lines, potentially leaving two pivotal justices to decide the law's fate. Photographer: Andrew Harrer/Bloomberg via Getty Images
UNITED STATES - MARCH 04: Rep. Louie Gohmert, R-Texas, speaks at a rally outside of the Supreme Court during arguments in the King v. Burwell case which deals with tax credits in the Affordable Care Act, March 4, 2015. (Photo By Tom Williams/CQ Roll Call)
UNITED STATES - MARCH 04: Rep. Louie Gohmert, R-Texas, speaks at a rally outside of the Supreme Court during arguments in the King v. Burwell case which deals with tax credits in the Affordable Care Act, March 4, 2015. (Photo By Tom Williams/CQ Roll Call)
Demonstrator Nell Robinson, a medical student from George Washington University, holds a sign in favor of to U.S. President Barack Obama's health-care law, Obamacare, in front of the U.S. Supreme Court in Washington, D.C., U.S., on Wednesday, March 4, 2015. A U.S. Supreme Court argument over Obamacare's tax subsidies divided the justices along ideological lines, potentially leaving two pivotal justices to decide the law's fate. Photographer: Andrew Harrer/Bloomberg via Getty Images
Demonstrator Elodie Huttner holds a sign in support of U.S. President Barack Obama's health-care law, Obamacare, in front of the U.S. Supreme Court in Washington, D.C., U.S., on Wednesday, March 4, 2015. A U.S. Supreme Court argument over Obamacare's tax subsidies divided the justices along ideological lines, potentially leaving two pivotal justices to decide the law's fate. Photographer: Andrew Harrer/Bloomberg via Getty Images
This image taken March 31, 2014 in Washington, DC shows the home page for the HealthCare.gov internet site. Today is the deadline day for uninsured Americans to sign up for coverage through US President Barack Obama's signature healthcare law, the Affordable Care Act. (KAREN BLEIER/AFP/Getty Images)
UNITED STATES - JULY 16: Nicholas Diebel, 14, son of Chairman Pete Sessions, R-Texas, sits at the dais before a House Rules Committee hearing in the Capitol, July 16, 2014, on the constitutionality of a House Republican led lawsuit against President Obama for allegedly overstepping his authority with certain provisions in his health care law. (Photo By Tom Williams/CQ Roll Call)
UNITED STATES - JULY 10: From left, Sen. Mark Udall, D-Colo., Charles Schumer, D-N.Y., Senate Majority Leader Harry Reid, D-Nev., Senate Majority Whip Richard Durbin, D-Ill., and Sen. Patty Murray, D-Wash., conduct a news conference in the Capitol's Senate studio, July 10, 2014, on legislation regarding the Supreme Court decision to allow employers to opt out of the contraception mandate in the Affordable Care Act. (Photo By Tom Williams/CQ Roll Call)
UNITED STATES - JULY 10: Sen. Mark Udall, D-Colo., conducts a news conference in the Capitol's Senate studio, July 10, 2014, on legislation regarding the Supreme Court decision to allow employers to opt out of the contraception mandate in the Affordable Care Act. (Photo By Tom Williams/CQ Roll Call)
Activists opposed the Affordable Care Act's employer contraceptive mandate celebrate outside of the U.S. Supreme Court in Washington, D.C., U.S., on Monday, June 30, 2014. The Supreme Court dealt a blow to President Barack Obama's health-care law, ruling that closely held companies can claim a religious exemption from the requirement that they offer birth-control coverage in their worker health plans. (Pete Marovich/Bloomberg via Getty Images)
Activists who support the Affordable Care Act's employer contraceptive mandate hold signs outside of the U.S. Supreme Court in Washington, D.C., U.S., on Monday, June 30, 2014. The Supreme Court dealt a blow to President Barack Obama's health-care law, ruling that closely held companies can claim a religious exemption from the requirement that they offer birth-control coverage in their worker health plans. (Pete Marovich/Bloomberg via Getty Images)
Activists who support the Affordable Care Act's employer contraceptive mandate demonstrate outside of the U.S. Supreme Court in Washington, D.C., U.S., on Monday, June 30, 2014. The Supreme Court dealt a blow to President Barack Obama's health-care law, ruling that closely held companies can claim a religious exemption from the requirement that they offer birth-control coverage in their worker health plans. (Pete Marovich/Bloomberg via Getty Images)
Anti-abortion demonstrators hold signs during a Priests for Life protest outside the US Court of Appeals for the DC Circuit Court as the Court hears the oral arguments in the 'Priests for Life v. US Department of Health and Human Services (HHS)' case in Washington, DC, on May 8, 2014. The case centers around the HHS mandate in the Affordable Care Act, known as Obamacare, that religious organizations must cover contraceptions and abortion as part of their health insurance benefits, even if that goes against the organization's religious beliefs. (SAUL LOEB/AFP/Getty Images)
Anti-abortion demonstrators hold signs during a Priests for Life protest outside the US Court of Appeals for the DC Circuit Court as the Court hears the oral arguments in the 'Priests for Life v. US Department of Health and Human Services (HHS)' case in Washington, DC, on May 8, 2014. The case centers around the HHS mandate in the Affordable Care Act, known as Obamacare, that religious organizations must cover contraceptions and abortion as part of their health insurance benefits, even if that goes against the organization's religious beliefs. (SAUL LOEB/AFP/Getty Images)
HOLLYWOOD, FL - APRIL 15: Felue Chang who is newly insured under an insurance plan through the Affordable Care Act receives a checkup from Dr. Peria Del Pino-White at the South Broward Community Health Services clinic on April 15, 2014 in Hollywood, Florida. A report released by the Congressional Budget Office indicates that the Affordable Care Act will cost $5 billion less than originally projected for 2014. (Photo by Joe Raedle/Getty Images)
US President Barack Obama speaks about the Affordable Care Act, also known as Obamacare, with Vice President Joe Biden (R) in the Rose Garden at the White House in Washington on April 1, 2014. Hundreds of thousands of Americans rushed to buy Obama's new health insurance plans on March 31, prompting a victory lap from a White House that paid a steep political price for its greatest achievement. The scramble to sign up under Obama's health care law at the end of a six-month enrollment window caused website glitches and long lines at on-the-spot enrollment centers. AFP PHOTO/Nicholas KAMM (Photo credit should read NICHOLAS KAMM/AFP/Getty Images)
MIAMI, FL - MARCH 31: Norma Licciardello sits with an agent from Sunshine Life and Health Advisors as they wait for the Affordable Care Act website to come back on line as she tries to purchases a health insurance plan at a store setup in the Mall of Americas on March 31, 2014 in Miami, Florida. Today is the last day for the first yearly sign-up period and Sunshine Life and Health saw a wait of four hours or more for people to see a health insurance advisor. (Photo by Joe Raedle/Getty Images)
MIAMI, FL - MARCH 31: Norma Licciardello sits with an agent from Sunshine Life and Health Advisors as they wait for the Affordable Care Act website to come back on line as she tries to purchases a health insurance plan at a store setup in the Mall of Americas on March 31, 2014 in Miami, Florida. Today is the last day for the first yearly sign-up period and Sunshine Life and Health saw a wait of four hours or more for people to see a health insurance advisor. (Photo by Joe Raedle/Getty Images)
MIAMI, FL - MARCH 31: Jose Villanueva (L) and Doraisy Avila sit with an agent from Sunshine Life and Health Advisors as they look at a pricing plan available from the Affordable Care Act at a store setup in the Mall of Americas on March 31, 2014 in Miami, Florida. Today is the last day for the first yearly sign-up period and Sunshine Life and Health saw a wait of four hours or more for people to see a health insurance advisor. (Photo by Joe Raedle/Getty Images)
MIAMI, FL - MARCH 31: People stand in the line to register to meet with Sunshine Life and Health Advisors that are selling insurance under the Affordable Care Act at a store setup in the Mall of Americas on March 31, 2014 in Miami, Florida. Today is the last day for the first yearly sign-up period and Sunshine Life and Health saw a wait of four hours or more for people to see a health insurance advisor. (Photo by Joe Raedle/Getty Images)
MIAMI, FL - MARCH 31: Andres Cuartas (L) sits with Mercedes Mujica an agent with Sunshine Life and Health Advisors as he purchases a health insurance plan under the Affordable Care Act at a store setup in the Mall of Americas on March 31, 2014 in Miami, Florida. Today is the last day for the first yearly sign-up period and Sunshine Life and Health saw a wait of four hours or more for people to see a health insurance advisor. (Photo by Joe Raedle/Getty Images)
This image taken March 31, 2014 in Washington, DC shows the home page for the White House site indicating the amount of time remaining before open enrollment for the Affordable Care Act closes. Today is the deadline day for uninsured Americans to sign up for coverage through US President Barack Obama's signature healthcare law, the Affordable Care Act. AFP PHOTO / Karen BLEIER (Photo credit should read KAREN BLEIER/AFP/Getty Images)
A Choose Health Delaware sign stands outside an Affordable Care Act enrollment event in Milford, Delaware, U.S., on Thursday, March 27, 2014. Six million Americans have signed up for private health plans under Obamacare, President Barack Obama said, a symbolic milestone for a government that has struggled to get the law off the ground. Photographer: Andrew Harrer/Bloomberg via Getty Images
Marketplace guide Jim Prim works on the Healthcare.gov federal enrollment website as he helps a resident sign up for a health insurance plan under the Affordable Care Act at an enrollment event in Milford, Delaware, U.S., on Thursday, March 27, 2014. Six million Americans have signed up for private health plans under Obamacare, President Barack Obama said, a symbolic milestone for a government that has struggled to get the law off the ground. Photographer: Andrew Harrer/Bloomberg via Getty Images
A Health Insurance Marketplace application checklist hangs at a Westside Family Healthcare center during an Affordable Care Act enrollment event in Bear, Delaware, U.S., on Thursday, March 27, 2014. Six million Americans have signed up for private health plans under Obamacare, President Barack Obama said, a symbolic milestone for a government that has struggled to get the law off the ground. Photographer: Andrew Harrer/Bloomberg via Getty Images
Certified application counselor Tina Gaffney helps a resident create an account for a health insurance plan under the Affordable Care Act at a Westside Family Healthcare center enrollment event in Bear, Delaware, U.S., on Thursday, March 27, 2014. Six million Americans have signed up for private health plans under Obamacare, President Barack Obama said, a symbolic milestone for a government that has struggled to get the law off the ground. Photographer: Andrew Harrer/Bloomberg via Getty Images
Marketplace guide Stephanie Cantres helps a resident sign up for a health insurance plan under the Affordable Care Act at a Westside Family Healthcare center enrollment event in Bear, Delaware, U.S., on Thursday, March 27, 2014. Six million Americans have signed up for private health plans under Obamacare, President Barack Obama said, a symbolic milestone for a government that has struggled to get the law off the ground. Photographer: Andrew Harrer/Bloomberg via Getty Images
MIAMI, FL - MARCH 20: Raquel Martinez, Maria Celia Escalona, Flora Motell and Armando Mesa (L-R) wait for their names to be called to speak with an insurance agent from Sunshine Life and Health Advisors as they and others try to purchase health insurance under the Affordable Care Act at a store setup in the Mall of Americas on March 20, 2014 in Miami, Florida. The owner of Sunshine Life and Health Advisors, Odalys Arevalo, said she has seen a surge in people, some waiting up to 3 hours or more in line, trying to sign up for the Affordable Care Act before the open enrollment period for individual insurance ends on March 31. (Photo by Joe Raedle/Getty Images)
MIAMI, FL - FEBRUARY 13: Hisham Uadadeh walks out of Leading Insurance Agency after enrolling in a health insurance plan under the Affordable Care Act on February 13, 2014 in Miami, Florida. Numbers released by the government showed that about 3.3 million people signed up for health insurance plans under the Affordable Care Act through the end of January. (Photo by Joe Raedle/Getty Images)
MIAMI, FL - FEBRUARY 13: Hisham Uadadeh enrolls in a health insurance plan under the Affordable Care Act with the help of A. Michael Khoury at Leading Insurance Agency on February 13, 2014 in Miami, Florida. Numbers released by the government showed that about 3.3 million people signed up for health insurance plans under the Affordable Care Act through the end of January. (Photo by Joe Raedle/Getty Images)
US Representative Greg Walden, Republican of Oregon and chairman of the National Republican Congressional Committee, speaks during a press conference about healthcare and the Affordable Care Act, known as Obamacare, at the Republican National Committee in Washington, DC, January 28, 2014. AFP PHOTO / Saul LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
JACKSON, KY - JANUARY, 22: Dr. Derrick Hamilton listens to Breathitt County resident Mary Blair's heartbeat during her appointment at the Breathitt County Family Health Center on Tuesday, January 21, 2014 in Jackson, Ky. Despite suffering from a past heart attack and diabetes Blair was able to receive medical coverage through Medicaid expansion under the Affordable Care Act. (Photo by Luke Sharrett/For The Washington Post via Getty Images) Obamacare Affordable Care Act Healthcare Breathitt County
LOS ANGELES, CA - JANUARY 20: Supporters of the Affordable Care Act (ACA) march in the 29th annual Kingdom Day Parade on January 20, 2014 in Los Angeles, California. The Kingdom Day Parade honors the memory of African-American civil rights leader Martin Luther King Jr. and coincides with Martin Luther King Day. (Photo by David McNew/Getty Images)
MIAMI, FL - JANUARY 15: As people stand in line to speak with an insurance agent Dailem Delombard sits with an agent from Sunshine Life and Health Advisors as she tries to purchase health insurance under the Affordable Care Act at the kiosk setup at the Mall of Americas on January 15, 2014 in Miami, Florida. Today is deadline day for those that want insurance to start on February the 1st. According to the owner of Sunshine Life and Health Advisors, Odalys Arevalo, their business selling insurance under the Affordable Care Act has exploded so much so that by the end of the week they will be moving to a 24,000 square foot space at the mall because they have outgrown the kiosk. They have over 25 agents and are seeing hundreds of people daily, last Saturday they saw about 1,000 people with wait times of over 5 hours. (Photo by Joe Raedle/Getty Images)
A woman holding a sign in support of the Affordable Care Act is seen as US President Barack Obama's motorcade returns to his vacation compound from the gym at Marine Corps Base Hawaii on December 29, 2013 in Kaneohe Bay, Hawaii. The first family is in Hawaii for their annual holiday vacation. AFP PHOTO / Kent NISHIMURA (Photo credit should read Kent Nishimura/AFP/Getty Images)
Fliers promoting the Get Covered Illinois health insurance marketplace sit in a box at the Bureau County Health Department offices in Princeton, Illinois, U.S., on Wednesday, Dec. 18, 2013. Todays deadline for Americans to sign up for Obamacare health coverage effective Jan. 1 was extended until midnight tomorrow as heavy traffic to the online enrollment system caused a queuing system to be activated Photographer: Daniel Acker/Bloomberg via Getty Images
Samantha Guzman, an Affordable Care Act navigator with the Bureau and Putnam County Health Department, center, assists Jackie Karns as she shops for health insurance at the Bureau County Health Department offices in Princeton, Illinois, U.S., on Wednesday, Dec. 18, 2013. Todays deadline for Americans to sign up for Obamacare health coverage effective Jan. 1 was extended until midnight tomorrow as heavy traffic to the online enrollment system caused a queuing system to be activated Photographer: Daniel Acker/Bloomberg via Getty Images
MIAMI, FL - DECEMBER 11: Susana Hernandez (L) speaks with Rosaly Hernandez, an insurance agent with Sunshine Life and Health Advisors, about purchasing insurance under the Affordable Care Act at a kiosk setup at the Mall of Americas on December 11, 2013 in Miami, Florida. As Health and Human Services Secretary Kathleen Sebelius tesified in Washington, DC before a congressional panel that the Affordable Care Act website was improving, the Sunshine Life and Health Advisors said, that they are starting to see a steady increase in the numbers of people coming to them to purchase and understand the policies offered under the Affordable Care Act. (Photo by Joe Raedle/Getty Images)
Enrollee Douglas Sparks waits to speak to a health navigator at a health insurance education and enrollment event in Silver Spring, Maryland, U.S., on Saturday, Dec. 7, 2013. Government-run health insurance exchanges are at the core of the Patient Protection and Affordable Care Act of 2010 known as Obamacare that seeks to provide access to health coverage for many of the country's estimated 48 million uninsured. Photographer: Andrew Harrer/Bloomberg via Getty Images
Copies of the application for the Health Insurance Marketplace from the Department of Health and Human Services (HHS) are arranged for a in Washington, D.C., U.S., on Friday, Dec. 6, 2013. The health-care website's improved performance has both U.S. political parties shifting strategies, with President Barack Obama's team preparing a January advertising blitz and a wave of celebrity promotions to boost enrollment, allies said. Photographer: Andrew Harrer/Bloomberg via Getty Images
An affordable health coverage sign stands a health insurance education and enrollment event in Silver Spring, Maryland, U.S., on Saturday, Dec. 7, 2013. Government-run health insurance exchanges are at the core of the Patient Protection and Affordable Care Act of 2010 known as Obamacare that seeks to provide access to health coverage for many of the country's estimated 48 million uninsured. Photographer: Andrew Harrer/Bloomberg via Getty Images
HIALEAH, FL - NOVEMBER 14: Venita Mendez works with Gisselle Rubio, an insurance agent with Sunshine Life and Health Advisors, as she looks to purchase an insurance policy under the Affordable Care Act at the store setup in the Westland Mall on November 14, 2013 in Hialeah, Florida. As the insurance agents continue to help people purchase and understand the policies offered under the Affordable Care Act, U.S. President Barack Obama announced that Americans who have had their health insurance plans canceled because of the Affordable Care Act can keep those plans for another year if they wish to. (Photo by Joe Raedle/Getty Images)
The Healthcare.gov website is displayed on a laptop computer arranged for a photograph in Washington, D.C., U.S., on Monday, Nov. 4, 2013. The race to construct an online insurance exchange by Oct. 1 spurred the Obama administration to use an expedited bidding system that limited its choice of a builder to just four companies, including CGI Group Inc. Photographer: Andrew Harrer/Bloomberg via Getty Images
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A similar version of the Senate bill passed the House in May but passage in the Senate was always expected to be more difficult, given the deep tensions between moderates and conservatives.

Moderates worry about cuts to the Medicaid health insurance program for the poor and disabled, while conservatives want those cuts as well as a more dramatic dismantling of Obamacare's framework.

The first version of the Senate bill failed to attract enough support, forcing McConnell's office to revise it in a bid to make it more palatable. That version was released last week.

Senator Bernie Sanders, the former Democratic presidential candidate, celebrated what he termed the "collapse" of the Republican effort.

"This is a great victory for the millions of Americans who stood up and fought back against this dangerous legislation," Sanders said in a statement.

(Writing by Richard Cowan, additional reporting by Susan Cornwell, Steve Holland and James Oliphant; Editing by Paul Tait)

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