Although President Trump claimed on "Fox and Friends" on June 25 that the health care challenge was not about the votes, in fact that is exactly what congressional politics comes down to. And neither the President nor McConnell had the votes that they needed to get this problematic bill through the chamber. Many Republicans don't want to be the ones responsible for taking away basic health care coverage from millions of Americans.
Now the battle will turn back to the grass roots as senators and legislators travel back home for the July Fourth break. At the same time that Senator McConnell will keep wheeling and dealing, trying to dole out some of the savings promised in the bill as a way to win over votes, opponents of the Republican legislation will be heading back to key states for what promises to be a fierce battle.
In short, grass roots opponents have a historic opportunity over the next week to save the Affordable Care Act before the senators return to Washington on July 10. Unlike Speaker Paul Ryan, who was able to win on his health care vote the second time around by making the legislation more appealing to conservatives and pressuring moderates into adhering to the party line, Senator McConnell doesn't have that option.
There is no wiggle room, with a majority of 52 and no support from the Democrats. If he moves this bill any further to the right, he won't be able to get the fifty votes that are necessary to pass this bill (combined with Vice President Pence as a tie-breaker). The moderate Republicans won't sign on. Yet he can't adjust the legislation to appeal to the moderates since the Senate conservatives -- and the Freedom Caucus in the House -- won't agree to those kinds of changes. The slim majority creates a very narrow, almost nonexistent path to victory.
This means that opponents of the bill can emerge victorious if they create pressure on Republicans like Susan Collins and Dean Heller in the next few days. The grassroots has the potential to overcome anything that horse trading can do to salvage such a deeply flawed bill.
Following the playbook of the progressive "Indivisible" organization that took form after the election, a group of former Democratic congressional staffers who mimicked the tactics of the Tea Party to save the Affordable Care Act, protesters will need to make their voices heard in all of the purple states so that senators understand there will be steep costs to supporting this legislation.
They will have to engage in the legislative fight of their lives, by calling the offices of senators and emailing their official accounts, appearing at any public events -- such as the Fourth of July parades that will be taking place all over -- and conducting protests at all the events that senators are attending to make clear where public opinion stands on these proposals. Democratic figures such as Bernie Sanders and Al Franken need to do their part to mobilize crowds and energize voters.
Grassroots opposition has been an enormously effective tool in these kinds of congressional battles. During the 1960s, civil rights and anti-war activists changed congressional opinion through ongoing protests. More recently, the Tea Party revealed the kind of havoc they could cause President Obama by keeping up pressure on Republicans to stick to the right and avoid any kind of compromise on issues like spending and immigration. They flooded town hall meetings and incessantly called into the offices of members to make it clear how intense the opposition was in their constituencies on key matters.
Given the disastrous week that Senator McConnell faced and the perilous state of this unpopular health care legislation, opponents have a massive opportunity to shape the outcome. The most damaging force to the health care bill thus far has been basic information about what it would do. The release of the CBO report on Monday was devastating simply because it exposed the details.
If the opponents can keep these facts in front of voters and encourage them to express their opinions, then they can maintain intense pressure on purple state Republican senators. Their decision will determine whether the Affordable Care Act survives, at least for now, and thus whether a pillar of President Obama's legacy will remain intact.