Republicans on Wednesday were unable to garner the votes necessary to pass a measure to repeal large portions of the 2010 health law with a two-year delay.

Seven GOP senators joined with Democrats to sink the proposal, 45-55. The failure highlights the continued struggle Senate Republican leadership is facing in coalescing their conference around one health care proposal. Sens. Lamar Alexander of Tennessee, Shelley Moore Capito of West Virginia, Susan Collins of Maine, Dean Heller of Nevada, John McCain of Arizona, Lisa Murkowski of Alaska and Rob Portman of Ohio voted no. 

Sen. Rand Paul, a Kentucky Republican, voted to proceed to the underlying health care reconciliation measure after being assured that this amendment would be the first in line.

“I’ve led the fight to vote on a full, clean repeal of Obamacare, and am pleased the Senate has heeded my call to vote on what we already passed in 2015,” Paul said. “Republicans promised to repeal Obamacare, and as we move forward in this process, I urge them to join me in supporting a clean repeal of as much of this disastrous law as possible.”

The Paul proposal that went down was a mirror image of the 2015 repeal measure Congress passed but was vetoed by then-President Barack Obama.

Senate Majority Leader Mitch McConnell has been working behind the scenes to try to craft a compromise “skinny” bill that would likely repeal the individual and employer mandates and remove an excise tax on medical device manufacturers includes in the health law, lawmakers say.

It remains to be seen whether the Kentucky Republican can gather the 50 votes necessary to pass such a measure under the fast-track budget procedure known as reconciliation, with the assistance of Vice President Mike Pence.

“We’re trying to explore the way forward and to me that seems to have a lot of benefits,” Senate Majority Whip John Cornyn of Texas said on Wednesday. “All we’re looking at is a way to get to that conference quick.”

Among the provisions Cornyn said could be added in conference with the House is a measure from Sen. Rob Portman of Ohio that would add an additional $100 billion to a stability fund that would help states transition individuals off of Medicaid.

The Senate also voted on a motion from Democratic Sen. Joe Donnelly of Indiana that would have sent the House-passed repeal and replace measure to the Senate Finance Committee for revisions.

That motion failed, 48-52.

Niels Lesniewski contributed to this report.