The US Senate Republicans failed to overturn the healthcare law known as Obamacare early on Friday, in a stinging blow to President Donald Trump that effectively ended the Republican Party's seven-year quest to repeal the 2010 Affordable Care Act.
Three Republicans crossed party lines to join Democrats in a 49-to-51 vote to kill the bill.
Republican senators John McCain, Lisa Murkowski, and Susan Collins voted against the plan.
"This is clearly a disappointing moment," Senate Majority Leader Mitch McConnell said on the floor after the vote.
Senate Republicans decided to vote on the pared-down "skinny" proposal to repeal portions of Obamacare after failing to reach consensus on a more comprehensive measure since the US House of Representatives approved their bill in May.
The Affordable Care Act, known informally as Obamacare, brought insurance to 20 million previously uninsured Americans and was the signature domestic achievement of former Democratic President Barack Obama.
Republicans believe that the law is too costly and represents undue government interference in healthcare.