Sen. Bill Cassidy (R-La.) speaks with media at the Senate subway following a meeting with Senate Majority Leader Mitch McConnell (R-Ky.) on Capitol Hill. (Michael Reynolds/European Pressphoto Agency/EFE/Rex/Shutterstock)

Senate Republicans have made a calculated decision: Better to fail again trying to repeal the Affordable Care Act than not to try at all.

That bet, made out of fear rather than a sense that victory is any nearer than it has been all year, can be traced to this year’s August recess — the five-week stretch back home that immediately followed the Senate’s previous failed attempt to overhaul the nation’s health-care laws. The late-summer break, distant as it already feels to many of us, remains fresh in some lawmakers’ minds.

It did not entail the kind of high-profile clashes at town halls that Democrats faced eight years ago as they began drafting the Affordable Care Act — or that House Republicans confronted at the start of the year, when their repeal effort took shape. Nevertheless, according to GOP senators and aides, Republicans faced an unrelenting barrage of confrontations with some of their closest supporters, donors and friends. The moments occurred in small gatherings that proved even more meaningful than a caustic town hall — at meetings with local business executives, at church, at parks.

It didn’t matter if those friends and allies were big-time supporters of President Trump or part of the “Never Trump” crowd of purist conservatives opposed to his hostile takeover of the GOP. By August, those two wings came together in their sheer, utter contempt toward a Republican-controlled Congress that could not back up its most basic promise, to repeal Obamacare. Trump’s hectoring via social media egged them all on.

That’s the driving reason behind Senate Majority Leader Mitch McConnell’s decision to at least “consider” holding votes next week on new legislation to repeal the ACA. Stuck in what might become the greatest damned-if-he-does, damned-if-he-doesn’t moment of his political career, McConnell (R-Ky.) is, for now, siding with those clamoring for another vote to repeal the health law.

“I think we failed in August, and to me, as long as that’s out there, we have to continue to show the American people we are not going to walk away from this,” Sen. Thom Tillis (R-N.C.) said Wednesday.

All the more remarkable is the lack of evidence that the bill’s chances are any better this time around than they were in July. In fact, some Republicans openly expect another defeat. Yet they still believe that trying again is the only option.

In a call with Iowa reporters Wednesday, Sen. Charles E. Grassley (R-Iowa) said he could cite "10 reasons this bill shouldn't be considered" on policy merits alone. On top of that, McConnell is still short of the votes to approve the proposal — "and I don't see those other one or two votes coming," Grassley said.

Why consider a bill that is bad on policy and won’t pass?

“Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign,” Grassley said.

Tillis and Grassley are part of an outspoken majority in the GOP caucus who want to go full-speed ahead, consequences be damned.

Who’s for and against the Cassidy-Graham bill

A small but influential bloc of GOP senators, meanwhile, has argued behind closed doors, to no avail, that another failed repeal effort would be more catastrophic for their standing, both with supporters back home and with Trump.

One of the leading proponents of the new legislation, Sen. Lindsey O. Graham (R-S.C.), is a master salesman and a telegenic communicator. But in more than 23 years in Congress, Graham has shown little health-care expertise. His bill is being rushed to the Senate floor without much vetting because it faces a Sept. 30 witching hour to retain special privilege under Senate rules to pass on a simple majority.

The doubting Republicans are not optimistic about Graham’s chances for success. Sens. Rand Paul (R-Ky.) and Susan Collins (R-Maine) seem opposed, leaving no vote to spare in the path to the bare minimum of 50 votes.

These lawmakers declined to speak publicly out of deference to McConnell, and they spoke on the condition of anonymity to discuss internal GOP deliberations. Their private discussions were confirmed by aides.

Sens. Lisa Murkowski (R-Alaska) and John McCain (R-Ariz.), along with Collins, cast decisive votes against the July proposal. Unlike most of their colleagues, who faced heated confrontations, Murkowksi basked in the media glow of statewide applause for her vote. Her governor has said the new proposal would leave thousands of Alaskans without insurance. Reversing course is not easy.

And a longtime friendship with Graham does not guarantee that McCain will switch his vote after the national adulation he received following his “no” vote in July, which came shortly after his brain cancer diagnosis. Some longtime GOP advisers wonder if McCain is keeping his powder dry so another Republican will be the decisive public voice opposing his close friend.

Meanwhile, another consequence looms: The spotlight was supposed to shift next week to the one issue where there has been some measure of progress and unity — the effort to rewrite the code for businesses and individuals by reducing taxes by $1.5 trillion. Instead, tax negotiators already know they will be overshadowed by health care.

“Everything gets in the way of tax reform, and we’re just going to have to be prepared to bulldoze through,” Sen. Orrin G. Hatch (R-Utah), chairman of the Finance Committee, said Wednesday.

And all of it comes at another critical political juncture: Tuesday’s special election GOP primary in Alabama.

Sen. Luther Strange (R), appointed to his seat on an interim basis after Jeff Sessions became attorney general, has McConnell’s full financial backing in the face of a strong challenge from Roy Moore, a conservative icon and former chief justice of the Alabama Supreme Court. In addition, McConnell’s allies have succeeded in getting Trump and Vice President Pence to go all-in for Strange.

By the middle of next week, McConnell might pull off the victory for Strange and have the votes lined up to pass the ACA repeal, which would be his best week as leader since Trump took office.

Losses on both counts, however, would all but guarantee another round of recriminations that could stall momentum on taxes. Those outcomes also could embolden more conservative insurgent challengers to Republican incumbents in the 2018 midterm elections.

It doesn’t sound like anything McConnell would have wished for. It might, however, be a situation that other Senate Republicans forced him to plow through even if it ends in another embarrassing defeat.

“This should be important to continue to message to the American people,” Tillis said, calling for repeated repeal votes even if they keep losing. “We’ve got to keep that in the narrative, and one way you do that is you go to the Senate floor and take a position on a strategy for fixing a failed system.”

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