THE BURNED OVER DISTRICT

Desperately trying, like Pickett's Charge at Gettysburg, to snatch victory from the jaws of defeat. The latest monster, the Cassidy-Graham bill would distort and destroy the ACA in a way guaranteed to enrich their good old buddies at the expense of millions of Americans. Business as usual for the Republicans.

Just when the effort to repeal the Affordable Care Act appeared to be dead, a last-ditch push to obliterate the law could be nearing a showdown vote in the Senate, and a handful of Republicans insist they are closing in on the votes.

The leaders of the latest repeal effort, Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, say their drive is gaining momentum. But it is still a long shot. Under their bill, millions could lose coverage, Medicaid would see the same magnitude of cuts that earlier repeal bills extracted, and insurers in some states could charge higher premiums to people with pre-existing conditions.

Already, Senator Rand Paul, Republican of Kentucky, has said he will not vote for the measure because it leaves too much of the Affordable Care Act in place.

And Senator John McCain, Republican of Arizona, who cast the deciding vote that killed the repeal effort in July, expressed misgivings that the Senate would try again to pass a bill that had not been examined by committees with expertise — and with no Democratic support.

Senators Susan Collins of Maine and Lisa Murkowski of Alaska, Republicans who steadfastly opposed previous repeal efforts, have not said where they stand. But the new bill holds the same provisions that they opposed this summer: deep cuts to Medicaid and a temporary elimination of federal funding to Planned Parenthood.

Mr. Graham and Mr. Cassidy express a sense of urgency. If the Senate does not vote by the end of next week, it will become nearly impossible to repeal the law because the drive to kill the Affordable Care Act will lose the procedural protections that allow it to pass the Senate with a simple majority, rather than the 60 votes that would otherwise be needed.

Sens. Collins and Murkowski need to hear support for a NO vote. And even a pusillanimous scumbag like Dean Heller needs to hear from the people.