On Sept. 26, with three Republican senators signaling they would not vote for the Graham-Cassidy healthcare proposal ... all for different reasons ... Sen. Majority Leader Mitch McConnell (R-Ky.) pulled the plug on the latest ACA repeal and replace measure. As the clock ticks down on the window in which Republicans could pass a reform measure with a simple majority, the next steps were not immediately clear. The ability to pass with 50 votes plus the vice presidential tiebreaker under reconciliation expires on Sept. 30. After that time, the Senate reverts to normal rules requiring 60 votes to pass any measure. Sen. John McCain (R-Ariz.) has expressed a hope that the Sept. 30 deadline will push his colleagues toward bipartisan dialogue and solutions.

On Sept. 22, Sen. John McCain (R-Ariz.) announced he cannot, in good conscience, vote for the Graham-Cassidy healthcare proposal. "I believe we could do better working together, Republicans and Democrats, and have not yet really tried," he said in a statement. While McCain also said he might have considered supporting similar legislation had it come to the floor after extensive hearings, debate and amendments, he noted that wasn't the case.

Sen. Rand Paul (R-Ky.) is also a 'no' vote, albeit for different reasons. While Sen. Susan Collins (R-Maine) has only said she is "leaning against" the bill, pundits widely believe she will be a 'no' vote. If that holds true, the measure will not pass when it comes to a vote next week.

Additionally, Sen Lisa Murkowski (R-Alaska) is also believed to be opposed to the proposed legislation, although the bill's authors Sens. Lindsay Graham (R-SC) and Bill Cassidy (R-La.) are said to be lobbying her hard to win over her vote. With McCain and Paul definitely out, the co-authors must hold onto both Collins and Murkowski to have a chance to pass with a tie-breaking vote from Vice President Mike Pence.

Statement from TJC on McCain Announcement:

"A genuine hero in peace as in war, Senator McCain has again shown us what courageous service to country looks like. He has sided with doctors, nurses, health experts and every major charity or child advocacy organization in America, all of whom have opposed Graham-Cassidy as a devastating blow to the health and financial security of the American people. I hope that Senator McCain's example will inspire Senator Alexander and Senator Corker to join him in opposing this terrible bill."

- Michele Johnson, Exec. Dir., Tennessee Justice Center