What is clear is that the bill McConnell released will need to change to survive.
Cruz, Lee and Paul are pushing for the bill to more fully repeal the ACA, while Johnson has worried that the legislation is being rushed.
Like the bill that passed the House in May, the Senate measure would cut off expanded Medicaid funding for states — but at a more gradual rate, by phasing out the higher federal spending between 2020 and 2024.
But the bill would allow states to use an existing ACA program, known as 1332, in which they can file for waivers from the Centers for Medicare and Medicaid Services that allow them to scale back the requirements for plans offered by insurers.
But that message may be more of an attempt to pressure Republicans to support the bill rather than an ultimatum, and some aides and outside observers speculated McConnell would pull the bill rather than have it go down in defeat.