Senate Republican leaders failed Wednesday in their latest attempt to repeal the Affordable Care Act.

After the Senate on Tuesday rejected a replacement to the Affordable Care Act offered by Senate leaders, Obamacare opponents turned to an option that would immediately have repealed mandates that people buy insurance and that larger employers offer it, but would have delayed implementation of other aspects until 2020.

Seven Republican senators — Arizona’s John McCain, Maine’s Susan Collins, Nevada’s Dean Heller, Alaska’s Lisa Murkowski, Ohio’s Rob Portman, Tennessee’s Lamar Alexander, and West Virginia’s Shelley Moore Capito — broke ranks with their GOP colleagues and joined unified Democrats in voting “no.”

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The latest defeat leaves Republicans with limited options as the multi-day debate continues. GOP leaders now will turn to a proposal to repeal just a few provisions of current law, which would at least allow a House-Senate conference to keep the process moving.

Senate Majority Leader Mitch McConnell (R-Ky.) noted during the floor debate that the proposal is the same as a bill that nearly every Republican senator voted for in December 2015.

“We’ll consider many different proposals throughout this process from senators on both sides of the aisle,” he said. “Ultimately, we want to get legislation to end the failed Obamacare status quo through Congress to the president’s desk for his signature.”

The amendment needed only a simple majority due to a parliamentary maneuver tying it to the budget. But that meant certain parts of Obamacare — such as protections for people with pre-existing conditions and requirements that all plans include a variety of services — would have remained.

Sen. Rand Paul (R-Ky.), one of the sharpest voices for complete repeal, offered the proposal as a compromise. Internal opposition prevented Republican leaders from moving on that plan early this month. Paul said that Obamacare’s problems — rapidly rising premiums and fewer insurance choices — will only grow worse.

“Republicans made a promise,” he said. “We made a promise to the American people to repeal it. There may be some Republicans today to say, ‘I’m not voting to repeal any longer. Things have changed.’ The problem is, we are not going to get towards the solution if we don’t begin to repeal.”

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Paul said the proposal would have included a two-year window during which the Senate could continue working toward a solution.

“Over that two years, my guess is that we will have impetus from the other side to actually begin to negotiate,” he said.

Paul advocated for one of his favorite ideas — allowing people to form buying cooperatives in order to take advantage of the purchasing power that people enjoy when they receive group insurance from their employers.

Currently, Paul said, half of the 27 million people without insurance cannot afford it.

“Why is it too expensive? Because Obamacare dictates about 15 different things that every insurance policy’s got to have. Vision, hearing, pregnancy, you name it. It’s all on there.”

“Why is it too expensive?” he said. “Because Obamacare dictates about 15 different things that every insurance policy’s got to have. Vision, hearing, pregnancy, you name it. It’s all on there.”

Democrats argued the repealing the law would hurt the poor by cutting funds that the Affordable Care Act made available for states to expand Medicaid.

“We’re here to say that we have got to stop this war on Medicaid,” Sen. Maria Cantwell (D-Wash.) said. “Throughout this process, it is clear there are many on the other side of the aisle who just want to cut or gut Medicaid.”

Sen. Mike Enzi (R-Wyo.) countered that Medicaid is on an unsustainable path.

“This will be the first time in a generation that we’ve even attempted to rein in any of these programs and put them on a sustainable path, the ones that are threatening to bankrupt our country, without pulling the rug out from under people,” he said.

Sen. Ron Johnson (R-Wis.) said health reform is needed to help people like one Colby family, who he said had to sell their house to afford runaway health insurance premiums. He said average premiums on the Affordable Care Act exchanges have more than doubled, adding that the alternative that the Senate rejected Tuesday would have resulted in significantly lower premiums after a decade than under current law.

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But Johnson said prices would have been significantly lower even than that had Obamacare not so badly distorted the individual insurance market.

“This is the damage done by Obamacare,” he said. “And this, I am very sad to report, we have not done enough to address.”

The repeal-and-delay proposal that went down Wednesday also included a provision that would have strengthened the ban on using taxpayer funds for abortion.

“If we fail to stand for those who stand for themselves, then the words of our founding documents, the words inscribed in the words of this building and the truths that we each hold in our hearts mean nothing,” Sen. Luther Strange (R-Ala.) said.