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Trumpcare returns to undead zombie state.

Alex Wong/Getty Images

There are now four Republican senators who will not support Senate Majority Leader Mitch McConnell’s health care bill in its current, already-modified form. Most observers had been looking to vulnerable Republicans (like Nevada’s Dean Heller) or senators from states with large Affordable Care Act beneficiary population (like Ohio’s Rob Portman or West Virginia’s Shelley Moore Capito) to put a stake through the heart of the latest incarnation of Trumpcare. In the end, the conservative duo of Kansas’ Jerry Moran and Utah’s Mike Lee issued coinciding statements announcing their intent to oppose moving forward with the bill.

As long as Republicans control Congress and the White House, Obamacare’s insurance expansion and coverage guarantee will be under constant, dire threat, but it has never looked so much like these achievements will survive—vulnerable mostly to intentional mismanagement and administrative sabotage. At the end of the day, McConnell is simply more constrained than his counterpart, House Speaker Paul Ryan, and seems to lack the legislative berth he needs to send a bill to the White House.

McConnell is a savvier and more seasoned legislative tactician than Ryan, but Ryan had two advantages over his Senate counterpart. Ryan enjoyed a nearly two-dozen vote margin for error where McConnell had to assuage 50 of his 52 members. Perhaps more important, Ryan could idly promise his members that the House bill had to pass to keep the process moving—that the Senate would refine it, improve it, build upon it, but the House’s explicit position would never become law.

The House bill, like the Senate bill, failed once after its first contact with reality, thanks to the broad opposition of both wings of the GOP conference. But Ryan was able to buy off conservatives with policy concessions, and then use the promise that the House bill was just a placeholder, to strong-arm moderate Republicans—and still lose 20 votes. That’s how the House bill passed.

McConnell wants to run the same play, but without the flexibility that allowed Ryan to succeed where he is poised to fail. He can try to buy off Moran and Lee, but he can’t then return to Heller, Portman, Capito and others and promise them the House will refine and improve the bill. The Senate is the final stop. When McConnell attempted to appease his moderates with a similar promise—that his bill’s severe out-year Medicaid cuts would never be implemented—the information leaked and support for the bill within his conference softened. This in turns goes to show that he can’t buy off the moderates without losing more than enough conservatives to kill the bill from the other direction.

If Obamacare survives this Congress, it will be because a 52-vote majority isn’t quite large enough to do the odious things we now know, through the text of the Trumpcare bills, Republicans would like to do. That is still too close for comfort.