Media playback is unsupported on your device Media caption Mazie Hirono said she was one of the lucky ones with health insurance
The latest attempt to repeal the Obama-era healthcare act has failed after a dramatic night in the US Senate.
At least three Republicans - John McCain, Susan Collins and Lisa Murkowski - voted against the bill, which needed a simple majority to pass.
President Donald Trump said the three had "let the American people down".
The so-called "skinny" repeal, which would have scaled back some of the more controversial provisions, is the third failed attempt to repeal Obamacare.
It would have resulted in 16 million people losing their health insurance by 2026, with insurance premiums increasing by 20%, according to the Congressional Budget Office (CBO).
The vote was delayed after Senate Republicans kept a procedural vote open before the actual Obamacare vote while they attempted to persuade their members to vote for the repeal.
Vice President Mike Pence was seen talking to Mr McCain for more than 20 minutes. But Mr McCain then approached a group of Democrats, who appeared happy to see him.
The bill was eventually voted down by 51 votes to 49 in the Republican-dominated Senate.
Senate Majority Leader Mitch McConnell, a Republican, described the result as a "disappointing moment".
Democrat Chuck Schumer said his party was relieved that millions of people would retain their healthcare.
A dagger in Trump's plans - BBC North America Correspondent Anthony Zurcher
The arc of history is long, but it bends towards revenge.
Just over two years after candidate Donald Trump mocked John McCain's Vietnam War record, noting that he prefers heroes "who weren't captured", the Arizona senator stuck a dagger in President Trump's healthcare reform plans.
There were gasps when Mr McCain, after being furiously lobbied by Vice-President Mike Pence, joined two other Republican senators in voting against the so-called "skinny" repeal plan, considered the bare minimum Senate Republicans could agree on.
Instead of a big step toward becoming law - either in its skinny form or after further negotiations with the House of Representatives - the future of Obamacare repeal has been thrown into doubt.
The reality is, for now, there is no minimum level of change on which Senate Republicans can agree. They either have to work with Democrats or resign themselves to stalemate and move on to other topics, like taxes or infrastructure spending.
It will take some time for the scale of this late-night Senate drama to sink in. No one really expected Mr McCain to be the decisive vote, but the man who once had a reputation as a Republican "maverick", now facing a dire brain cancer diagnosis, had at least one more surprise in his pocket.
The bill - officially known as the Health Care Freedom Act - would have eliminated parts of Obamacare - the Affordable Care Act - including the individual mandate requiring all Americans to have health insurance coverage or pay a fine, and the employer mandate, which requires the same of companies with 50 employees or more.
It also would have temporarily repealed a tax on medical devices, defund the US women's group Planned Parenthood for a year and provide more money to community health centres, as well as given states more flexibility in complying with Obamacare regulations.
But the pared-down measure would have left much of Obamacare untouched, including the expansion of Medicaid, a government health programme for the poor that faced deep cuts in earlier proposals.
A requirement that all insurance plans cover essential health benefits, federal subsidies to help consumers pay for insurance as well as taxes on wealthy Americans also would have remained in place.
The stripped down bill came after earlier Senate defeats for proposals to replace Obamacare and then to partially repeal it.
Sen McCain said he had voted against the skinny repeal because it did not amount to meaningful reform and would not have improved care for Americans.
Image copyright Getty Images Image caption Alaska Republican Lisa Murkowski also voted against the repeal
He added that House Speaker Paul Ryan's assurance that the House would be willing to send the bill for further consideration by committee "did not ease my concern that this shell of a bill could be taken up and passed at any time".
There are not thought to be any further plans for a new bill to repeal Obamacare because the skinny repeal was seen as the only measure Republicans could get through Congress.
However, lawmakers could revive the issue and take it up later in the year.
Following the vote, President Trump tweeted: "As I said from the beginning, let ObamaCare implode, then deal."
Media playback is unsupported on your device Media caption 'Trump not thinking about the little people'
Mr Trump's position on healthcare reform has varied - he has spoken out at various points for Obamacare being repealed, repealed and replaced, or being allowed to collapse by itself.
In his statement, Mr McCain said Obamacare was in a state of "collapse", with healthcare premiums "skyrocketing" and providers "fleeing the marketplace".
He criticised the way Obamacare had been passed by Democrats using their Obama-era majority and called for senators to "return to the correct way of legislating" with input from both parties.
"We must do the hard work our citizens expect of us and deserve," he said.
But Texas Senator Ted Cruz insisted the fight was not over.
"Mark my words, this journey is not yet done," he said.
zzzzzzzz414 on July 28th, 2017 at 09:24 UTC »
I'm not sure if it's really being appreciated just how comprehensively the Republicans were just fucked over.
See, the Republicans have been trying to pass these godawful healthcare bills through a process called budget reconciliation, which, among other things, protects the bill from being filibustered in the Senate and only requires a simple majority of 50 votes (rather than 60, which the Republicans don't have).
The thing is, the Senate can only consider one budget reconciliation bill per topic per year. Of course, if the bill dies in committee and never comes to an official vote, it doesn't count- which is why they've been able to keep hammering away at the issue.
This bill, though, was allowed to come to the Senate floor, because the Republicans thought they'd secured the votes. Collins, Murkowski and the Democrats would vote no, everyone else would vote yes, and Pence would break the tie. And then McCain completely fucked them. And it was almost certainly a calculated move; he voted to allow the bill to come to the floor. Had McCain allowed it to die in committee, McConnell could have come back with yet another repeal bill; but he let it come to a vote, and now they can't consider another budget reconciliation bill for the rest of the fiscal year. The Senate needs 60 votes to pass any kind of healthcare reform now.
So now they're caught between a rock and a hard place. Either they concede defeat on the issue and try again later (causing a big, unpopular stink that could damage elections if they try it before the midterms, or risking losing the slim majority they already have if they wait) or they actually sit down with the democrats like adults and write a halfway decent healthcare bill.
This is amazing.
(someone please correct me if any of this is wrong/innacurate)
littlelupie on July 28th, 2017 at 06:43 UTC »
While McCain will get all the coverage, reminder that Mazie Hirono ALSO interrupted her cancer treatment to cast her "no" vote & that Murkowski and Collins have stood up to their party fairly consistently over this.
hoosakiwi on July 28th, 2017 at 06:09 UTC »
The moment that John McCain voted no.
Watch it. The entire room holds its breath. Wow.
Edit: For people wondering why Schumer was waving his arms after McCain voted no, he was doing it to get his caucus to be quiet. It's bad form to make noise like that during the vote and it could be seen as celebratory/gloating....he also didn't want the 3 no votes to get upset about it and change their vote.
Edit 2: If you called your Senators to ask them to vote no, then make sure you call them again to thank them...especially if their names are Murkowski, Collins, or McCain. Hell, even if you didn't call your Senators before the vote, a thank you call can be very impactful.