President Donald Trump pressured the handful of Republicansenators who may be planning to vote against Majority Leader MitchMcConnell’s plan to overhaul Obamacare, days before the Senate islikely to begin debate on the measure.

Related: Four GOP senators spurn health plan aimed atunifying party

“I cannot imagine that these very fine Republican Senators wouldallow the American people to suffer a broken ObamaCare any longer!”Trump said Saturday afternoon on his personal Twitter account. Heresent the message from his presidential account.

Trump earlier attacked Democrats for their “slam” on thehealth-care proposal. Yet the measure will live or die in theSenate on Republican support.

Senator Dean Heller of Nevada said Friday he opposes McConnell’splan, becoming the fifth Republican to say he won’t vote for themeasure in its current form. “It’s going to be very difficult toget me to ‘yes,’” said Heller, viewed as the Senate Republican mostat risk in the 2018 midterm election.

The proposal’s cuts to Medicaid and subsidies for individualinsurance coverage are too tough on Nevada residents, Heller saidat a news conference with Nevada Governor Brian Sandoval. Withoutsignificant changes in the proposal, the senator said he’ll votewith Democrats to block it from reaching the Senate floor.

“I cannot support a piece of legislation that takes insuranceaway from tens of millions of Americans and hundreds of thousandsof Nevadans,” Heller said.

Related: Poll: What do you think about the GOP Senate draftof the AHCA?

Sandoval, a Republican who accepted Obamacare’s Medicaidexpansion in his state, said about 210,000 Nevadans gained healthcoverage under the law. “They’re living healthier and happier livesbecause of that decision,” he said.

Wily tactician

McConnell is working to get other Republican holdouts to backthe health-care bill for a possible vote next week, as he begins toseparate those who can be won over with modest changes and thosewho may have unbridgeable concerns.

McConnell, a veteran Senate tactician, may have made someintentional omissions in the “discussion draft” he released onThursday so that senators can be seen securing public victories inreturn for their support. For example, the draft contains only $2billion for opioid-related programs, a number that could easily beboosted to win over Midwestern Republicans.

But other gaps will be much harder to overcome, particularlywith conservatives demanding a fuller repeal of Obamacare andmoderates uneasy about the phaseout of the original law’s Medicaidexpansion.

Only a few hours after the bill was released, four conservativesled by Rand Paul of Kentucky announced they’ll need a host ofchanges to get to “yes.” Two moderates -- Lisa Murkowski of Alaskaand Susan Collins of Maine -- said they want to remove the bill’sone-year halt in funding for Planned Parenthood. Rob Portman ofOhio said it doesn’t provide enough funds for the opioidepidemic.

“The fact we think this bill will spend more next year thanObamacare spends now, that doesn’t sound like repeal," said Paul,who added that he will be negotiating as a team with fellowconservative holdouts Ted Cruz of Texas, Ron Johnson of Wisconsinand Mike Lee of Utah.

‘Really special!’

President Donald Trump backed the measure in a Twitter postingthat said, “I am very supportive of the Senate #HealthcareBill.Look forward to making it really special! Remember, ObamaCare isdead.”

Senator John Cornyn, the No. 2 Republican leader, said he’sstill confident that at least 50 of the chamber’s 52 Republicanswill wind up supporting it in a vote likely to come early nextFriday morning. That’s the number needed to pass the bill, alongwith the tie-breaking vote support of Vice President MikePence.

The plan released Thursday “is sort of a best guess of where theRepublican conference is,” Cornyn told reporters, adding thatMcConnell will massage its contents right up until when heintroduces it as early as Tuesday. “But people have other thingsthey want to see in the bill, and that’s what we’re workingthrough.”

GOP leaders made clear "this isn’t a take-it-or-leave-itproposition," said Senator Marco Rubio of Florida.

The new bill is intended to walk a delicate line in itsrelatively modest tweaks to the measure that passed the House lastmonth.

Senate leaders added funding in the first few years aimed atbringing down premiums and shoring up the Obamacare marketplaces --an attempt to win the votes of moderates. That includes anextra $62 billion allocated over eight years to a state innovationfund, which can be used for coverage for high-risk patients,reinsurance and other items.

On the other end, it would impose longer-term austerity onhealth spending to appeal to conservatives. For example, in 2025,the Senate bill moves to more severe funding caps for the federalcontribution to Medicaid by using the consumer price index, ratherthan a measure of medical inflation that tends to rise morequickly.

Over time, the extra help for states and the exchanges wouldphase out, and cuts to Medicaid and to insurance protections wouldphase in.

Premium spike

While the bill, H.R. 1628, provides far more assistance to thepoor and near-poor than the House bill, it’s still substantiallyless generous overall than the Affordable Care Act. The biggestlosers would be people at 351 percent of the federal poverty level-- a little over $42,000 for an individual -- who would go frompaying a maximum 9.7 percent of their income in premiums to havingno cap at all.

Related: Senate GOP health bill to break with House on keypoints

For older people in that income slice, the spike in premiumswould be enormous, especially in higher-cost states like Alaska. Asingle person aged 60 in Anchorage making 351 percent of poverty iscurrently eligible for a $17,990 subsidy, according to the KaiserFamily Foundation’s calculator. They’d get nothing under the newplan.

The Senate, meanwhile, keeps the House’s tax cuts effectivelyintact -- allowing Democrats to charge that the bill finances taxcuts for the wealthy with reductions in health care.

‘Open to negotiation’

Either way, the draft is certain to undergo some changes. Someprovisions may be stripped out by the Senate parliamentarian. Itwill also be open to amendments when it reaches the Senatefloor.

The angling has already started. The joint statement byPaul and the other three conservatives said they don’t support thebill but are “open to negotiation.”

Related: AHCA continues to bring out thecritics

“There are provisions in this draft that represent animprovement to our current health care system," they said in ajoint statement while adding that it doesn’t "accomplish the mostimportant promise that we made to Americans: to repeal Obamacareand lower their health care costs.”

Cruz handed out a flier with his demands at a ThursdayRepublican caucus meeting. They included letting states designcoverage without needing federal waivers, allowing consumers to buyinsurance across state lines, and allowing insurers that meetfederal mandates to sell other plans that don’t comply.

On the other side, Collins said she and Murkowski probably willtry to strip out language defunding Planned Parenthood on the floorif leaders won’t do it.

“To single out Planned Parenthood which provides services to somany low-income women,” Collins said, “is just wrong.”

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