This week's edition of The 45th newsletter.

The Republican effort to repeal and replace the Affordable Care Act, known as Obamacare, is dead. On Monday night two Republican senators – Mike Lee (Utah) and Jerry Moran (Kansas) – pulled the plug, saying they would not vote for it. Added to the no votes of senators Susan Collins and Rand Paul, Senate Majority Leader Mitch McConnell admitted that the bill would not pass.

“Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful,” McConnell said in a statement. 

Senate Republicans' fallback plan is to repeal Obamacare and work on a replacement later. A congressional report says that would cause 18 million more people to be uninsured and premiums to spike by 20 to 25 per cent next year.

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