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J. Scott Applewhite
Costumed as the grim reaper, a protestor opposed to the Republican health care bill waits prior to a hearing by the Senate Finance Committee on the Graham-Cassidy health care repeal, on Capitol Hill in Washington, Monday, Sept. 25, 2017. (AP Photo/J. Scott Applewhite)

WASHINGTON (AP) — President Donald Trump lashed out at "so-called Republicans" Tuesday for deserting the party's latest attempt to repeal the Obama health care law as Senate leaders tried to decide whether to even hold a roll call that was virtually certain to fail.

Trump didn't name any of the four GOP senators who've said they're against the doomed measure. But Vice President Mike Pence singled out one of them: Maine Sen. Susan Collins, who announced her opposition a day earlier, essentially assuring the proposal's defeat.

"We are certainly disappointed that Sen. Collins has chosen to vote against the Graham-Cassidy bill," Pence told radio station WGAN-AM in Portland. The measure is sponsored by GOP Sens. Lindsey Graham of South Carolina and Louisiana's Bill Cassidy.

"At some point there will be a repeal and replace," Trump said when reporters asked if he wanted the Senate to vote on the measure this week. "But we'll see whether or not that point is now or will be shortly thereafter. But we are disappointed in certain so-called Republicans."

Trump's attack was the latest instance in which he's derided fellow Republicans during this year's up-and-mostly-down GOP drive to deliver on their pledge to demolish President Barack Obama's health care law. He lambasted dissident House Republicans before that chamber approved its version of the bill in May and has blasted Majority Leader Mitch McConnell for allowing the measure to collapse in the Senate.

Because of their narrow majority and unified Democratic opposition, Republicans can lose just two GOP votes and still push the legislation through the Senate. A vote or a decision by McConnell, R-Ky., to forego a roll call must come this week because procedural protections against a bill-killing filibuster by Democrats expire Sunday.

McConnell must choose whether to satisfy conservatives insistent on fighting to the bitter end against a law they despise or other Republicans who see little point in yet another defeat. GOP senators planned to discuss their next steps at a Tuesday lunch.

"There are people who have needs they feel politically," Sen. Bob Corker, R-Tenn., told reporters. He added, "I think we know the outcome, so you all can show up in the balcony if you wish. Maybe we ought to do it to entertain you."

The GOP bill would transform much of "Obamacare's" spending into grants that states could spend on health programs with few constraints. McConnell contrasted that with a proposal by Sen. Bernie Sanders, I-Vt., to create a national system of government-run health insurance that has won backing from some Democrats and distance from others.

"It's an important debate for our country. It's one that we'll certainly continue," McConnell said.

To resuscitate their push, Republicans would need to change opposing senators' minds, which they've tried unsuccessfully to do for months. Collins told reporters that she made her decision despite a phone call from Trump, who's been futilely trying to press unhappy GOP senators to back the measure.

GOP Sens. John McCain of Arizona, Rand Paul of Kentucky and Texas' Ted Cruz have said they oppose the measure. Cruz aides said he was seeking changes that would let him vote yes.

Sen. Lisa Murkowski, R-Alaska, remains undecided. Murkowski, who voted against the failed GOP bills in July, has said she's analyzing the measure's impact on her state, where medical costs are high.

In the Senate, even GOP leaders concede their latest repeal effort has little chance.

"It's going to be a heavy lift," said South Dakota Sen. John Thune, the No. 3 GOP Senate leader.

The crash of the Senate repeal effort has frustrated Republicans in the House, who approved their version in May after initial failures.

"Let's see what the Senate throws us," said Rep. Blake Farenthold, R-Texas. "Something's better than nothing and right now we've got nothing."

The collapse marks a replay of the embarrassing loss Trump and party leaders suffered in July, when the Senate rejected three attempts to pass legislation erasing Obama's 2010 statute.

Republicans pinned their last hopes on the measure by Cassidy and Graham. It would end Obama's Medicaid expansion and subsidies for consumers and ship the money — $1.2 trillion through 2026 — to states.

Collins announced her decision shortly after the nonpartisan Congressional Budget Office said "millions" of Americans would lose coverage under the bill and projected it would impose $1 trillion in Medicaid cuts through 2026.

The Maine moderate said the legislation would make "devastating" cuts in the Medicaid program for poor and disabled people, drive up premiums for millions and weaken protections Obama's law gives people with pre-existing medical conditions.

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GOP leaders revised the measure several times, adding money late Sunday for Alaska, Arizona, Maine, Kentucky and Texas in a clear pitch for Republican holdouts. They also gave states the ability — without federal permission — to permit insurers to charge people with serious illnesses higher premiums and to sell low-premium policies with big coverage gaps and high deductibles.


Associated Press congressional correspondent Erica Werner and writers Ken Thomas and Marcy Gordon contributed to this report.