Health Care Overhaul Collapses as Two Republican Senators Defect

“This second failure of Trumpcare is proof positive that the core of this bill is unworkable,” Mr. Schumer said. “Rather than repeating the same failed, partisan process yet again, Republicans should 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.”

The opposition from Mr. Paul and Ms. Collins was expected, so Mr. McConnell had no margin for error as he unveiled the latest version of his bill. Though Mr. Paul and Ms. Collins rejected it, Mr. McConnell survived through the weekend and until Monday night without losing another of his members — though some expressed misgivings or, at the very least, uncertainty.

Mr. McConnell had wanted to move ahead with a vote this week, but was forced to step back from that plan after Senator John McCain, Republican of Arizona, underwent surgery last week. That unexpected setback gave the forces that opposed the bill more time to pressure undecided senators. On Friday, the health insurance lobby, which had been largely silent during the fight, came off the sidelines to blast a key part of the latest Senate bill, saying it was unworkable, would send premiums soaring and would cost millions of Americans their insurance.

Mr. McConnell has now failed twice in recent weeks to keep his caucus together in advance of a planned vote. He first wanted to hold a vote in late June, only to abandon that plan after running into opposition.

Mr. Lee, one of the most conservative members of the Senate, had championed a proposal that would allow insurers to sell low-cost, stripped-down plans — an idea that ended up being added to the latest version of Mr. McConnell’s bill. But the language that was added to the bill was not quite what Mr. Lee had been advocating, his office said after the bill was released.

Mr. Moran faced pressure in his home state about how the bill would affect Kansas, including its rural hospitals….

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