The Senate GOP's effort to overhaul the health-care system collapsed this week when multiple Republican senators came out against both the revamped bill and the idea of repealing Obamacare and letting the markets "fail" before replacing it. (Jenny Starrs/The Washington Post)

Monday night brought one of the most embarrassing blows Mitch McConnell has endured in his 2½ years as Senate majority leader.

Two more Republican senators came out against McConnell’s bill to overhaul the Affordable Care Act, effectively dooming the latest version. That forced the Kentucky Republican to confront a difficult question with no good answers: What now?

That didn’t stop McConnell from crafting a 90-word written statement that took some of the Hill’s most seasoned veterans hours to decipher. For this move, McConnell appeared to be issuing a dare.

The effort to “repeal and immediately replace” Obamacare “will not be successful,” McConnell admitted. In its place in the coming days, he would call for a vote to open debate on the House-passed bill — unpopular among most senators — with the aim of amending that bill with the straight-up repeal bill that his more conservative members desire.

He was giving the conservatives the chance to vote on a straight-up repeal. But first they would have to record their vote for a House bill they loathe. There would be no guarantee that the amendment to repeal would pass — and no guarantee that other, less welcoming amendments would fail.

If hard-right conservative senators vote no to starting debate and the effort quickly collapses, McConnell can come back at them and blame them. He is likely to try shifting the blame onto others, and he has given himself a new talking point to counter the “clean repeal” crowd — including President Trump.


Senate Majority Leader Mitch McConnell arrives on Capitol Hill Monday. (AP)

If they vote yes — and enough moderates join them to start the debate — then suddenly they’re back on track, at the table debating legislation that has at least some chance of passing in some form.

But don’t count on the latter scenario ever happening.

Even if the Senate got to a clean repeal vote, it wouldn’t be likely to pass. Moderates are petrified of voting for repeal-only legislation. Even some conservatives suggested Monday that the better idea is to completely start over again with a new effort led by the committees. So why would the conservatives go out on a limb for something that isn’t expected to actually become law? And if they do, why would the moderates join them in voting to proceed to debate on something they don’t like?

Sure, pure repeal passed back in 2015. But the stakes were lower back then. Barack Obama was president, and he wasn’t ever going to sign a bill that undid his signature law. So Republicans were free to vote for it with little on the line.

Now, there’s a lot on the line — which is why moderate Republicans have openly worried that the current Senate bill goes too far in attacking Obamacare. How are they supposed to support an even more aggressive repeal? And if indeed they don’t, they could get some blame for the collapse of the repeal effort.

What’s less clear at this point is McConnell’s longer game. If this doesn’t work out, will he move on to other matters? Follow through on his threats to work with Democrats on narrower changes, which were seen as ways to try to pressure conservatives not to let this fail? We’ll find out soon.

There are no longer any good outcomes for McConnell — politically speaking. There are bad ones and less bad ones. And putting the onus on other senators means there will be more blame to go around when all of it comes to an end.