Everybody knows that’s going to fail,” said Senate Finance Committee Chairman Orrin G. Hatch (R-Utah), who led a raucous, five-hour hearing on the bill Monday afternoon. “You don’t have one Democrat vote for it. So it’s going to fail.”McConnell thanked Sens. Bill Cassidy (R-La.) and Lindsey O. Graham (R-S.C.), the bill’s authors, but suggested that their work had stalled out. He thanked other lawmakers and committees of jurisdiction, as one might do at the official conclusion of a legislative push.“I’d like to thank each of these committees, their chairs, their members and their staffs for their hard work to provide the American people with a better way than Obamacare and its years of failures,” McConnell said.

Senator Collins delivered a scathing assessment of the bill in a statement, saying the fourth version that the senators had produced in an effort to win new votes “is as deeply flawed as the previous iterations.”

Neither a series of last-minute changes over the weekend nor the CBO’s preliminary analysis managed to shift any votes in the bill’s favor.The report also estimated a $1 trillion loss of federal funding for Medicaid by 2026.