President Donald Trump made a last-ditch plea to U.S. Senate Republicans on Monday to "do the right thing" and fulfill seven years of campaign promises to repeal and replace former President Barack Obama's signature healthcare law.
The Senate will vote on Tuesday on whether to open debate on an overhaul of the law, with Senate Majority Leader Mitch McConnell promising an open amendment process and a "robust" debate.
"To every member of the Senate I say this: The American people have waited long enough.
There's been enough talk, and no action. Now is the time for action," Trump said on Monday at the White House.
Standing in front of families who he said had been hurt by the law popularly known as Obamacare, Trump said, "So far, Senate Republicans have not done their job in ending the Obamacare nightmare."
"Any senator who votes against starting debate is telling America that you are fine with the Obamacare nightmare," he said. "There is still time to do the right thing."
Republicans have been under heavy political pressure to make good on their longstanding campaign promises to gut the 2010 law, which they view as a government intrusion in the healthcare market.
But the party is deeply divided between moderates concerned the Senate bill would eliminate insurance for millions of low-income Americans and conservatives who want to see even deeper cuts to the Obamacare legislation.
Senate Republicans have been unable to reach consensus on an approach, with McConnell failing to secure enough votes for either a repeal and replacement of Obamacare or a straight repeal.
Republicans hold a 52-48 majority in the 100-member Senate.
With Democrats united in opposition, McConnell can only afford to lose two Republican votes.
The Republican effort also has been complicated by the absence of Senator John McCain, who has been diagnosed with brain cancer and is in his home state of Arizona weighing treatment options.
"The question for every senator, Democrat or Republican, is whether they will side with Obamacare’s architects, which have been so destructive to our country, or its forgotten victims?" Trump said.
While Trump has repeatedly called on Republicans to repeal and replace Obamacare, he has shown little interest in the policy specifics.
Trump last week initially suggested he was fine with letting Obamacare collapse, then urged Republican senators to hash out a deal.
His remarks on Monday were among the lengthiest statements he has made regarding healthcare.
"Obamacare is death. That's the one that's death," Trump said.
"And besides that, it's failing so you won't have it anyway."
A Senate Republican aide on Monday said the Senate will vote this week on whether to begin debate on the healthcare bill passed in May by the House of Representatives.
If that procedural vote succeeds, the House bill would then be open for amendment on the Senate floor.
If the Senate approves a motion to begin debating a healthcare bill, McConnell will determine which proposal has the most Republican support and move forward to a vote, Republicans said.
The nonpartisan Congressional Budget Office has estimated the Senate's replacement bill could lead to as many as 22 million fewer Americans being insured.
A plan to repeal Obamacare without replacing it could cost 32 million Americans their health insurance by 2026, CBO estimated.
At the same time, premiums on individual insurance plans would rise 25 percent next year and double by 2026 if Obamacare is repealed, CBO said.
Uncertainty over the future of healthcare has left health insurance companies and U.S. states as well as hospitals and doctors unclear about future funding and coverage.
Public opinion polls also show Americans worried about potential changes to the healthcare system.