"Senate Republicans are now essentially out of options in the near-term, and shortly after the defeat of the bill Majority Leader McConnell conceded on the Senate floor that they would not be able to repeal the ACA. However, ... the dynamics around the healthcare debate in Washington are volatile, with a variety of proposals being floated by different factions in Congress, and President Trump continuing to make passage of an ACA repeal/replace bill a top priority, threatening a defunding of the ACA's cost sharing reductions to spur action[.]"