I originally commented on Habib Fanny’s answer, and his response motivated me to write my own answer rather than continue in the comments thread.My comment was to this effect: I thought Habib’s answer was excellent, but I disagree with his conclusion, i.e. that the GOP will successfully repeal and replace the bill. Here’s my reasoning.Nine senators oppose the bill at the time of writing, and it will be difficult to make concessions that win over seven of them. They are:Jerry Moran (Kansas)Shelley Capito (West Virginia)Rob Portman (Ohio)Mike Lee (Utah)Ted Cruz (Texas)Ron Johnson (Wisconsin)Rand Paul (Kentucky)Dean Heller (Nevada)Susan Collins (Maine)As I began researching this answer, I found a great assessment from Five Thirty Eight on this exact question. I highly recommend reading it. So that I’m not covering the same ground, I’ll put my own spin on the same question, using a (very) simplified assessment of political costs and benefits.Simple OverviewEach Republican senator has a choice: support the bill or not. In game theory parlance, they can choose to “defect” or not. Each senator’s incentives depend on the choices of the other senators. Plus, each senator has reasons to conceal and prspecific information about his or her intentions. So: each senator has to make a decision based on the limited information provided.Senators can “signal” their intent, in order to try to get other senators to make decisions by providing information. The issue is that talk is cheap: a senator can say something in public, but it’s not easy for other senators to know if he or she really means that or not.Lastly, I’m following the conventional wisdom: senators‡ primary goal is to get re-elected. Their political futures depend to some degree on their party leadership - which is pushing them toward compliance - but their primary motivation is to appeal to their voters in their home states.(Where does this change? For folks like Ted Cruz, who has presidential aspirations. We’ll come back to that.)Nuts and BoltsThe bill fails if three senators vote against it. There are 52 Republican senators, and if 50 vote for it, Mike Pence can break the tie in favor. So, losing three senators means that the bill won’t pass.The basic calculus facing senators is thus:Factor #1: If the bill is popular or unpopular in their home states, or if it is likely to become so between now and their next election. This isn’t identical with the economic benefits and costs that repeal would create, but it’s strongly related, i.e. if a relatively high percentage of constituents are dependent on Medicaid, a senator is less likely to vote for the bill.#2: The degree of pressure that Senate leadership can exert on them. It’s hard, for both personal and professional reasons, to resist the leadership’s call to “fall in line” and vote for repeal. Plus, Senate leadership can offer to modify the bill to mollify individual senators and their states. (Anybody remember former Senator Ben Nelson and Obamacare?)#3: Personal views. These aren’t always easy to tell - again, “cheap signaling” plays a role here - but they’re not invisible, either.#4: Intangible factors. For example: keeping promises you’ve made in the past. It turns out that politicians actually try hard to keep their promises.#5: What everyone else does. Some senators would like the repeal bill to pass or fail, but don’t want to take the political risks of voting for or against repeal. If you can get your preferred outcome without paying for it, that’s the ideal scenario. The challenge, as mentioned above, is that each individual senator feels this way.There are at least two senators who are very likely to vote against the bill, regardless of what the others do (point #5). Their individual cost-benefit calculations, based on the above, are likely to pra “No” vote.Let’s take a closer look at these two senators:A Closer LookMike Lee (Utah): Mike Lee is a member of the Freedom Caucus. (So is Ted Cruz.) Mike Lee is also pretty steadfast in his positions. (Unlike Ted Cruz).Senator Lee won re-election in 2021. so he doesn’t have to worry about being re-elected for another five years. That’s a lifetime in politics. What happens in 2021 will matter a lot more for his re-election chances.That said‡ Poll: 49% of Utahns say they oppose Obamacare replacement. Only 36% are in favor of the Senate bill. Based on this alone, we would assume Sen. Lee would like to vote against the bill.What about #3 and #4? Here’s an op-ed from the good Senator himself. This could be “cheap signaling”, but Lee has been quite consistent in both his opposition to Obamacare and his desire that “repeal” be an actual, genuine rollback of Obamacare as it stands.Why I could be wrong: Sen. Lee’s op-ed suggests that he really does want to see a repeal - he just doesn’t think the bill goes far enough.If the bill moves to the right to appease him/Cruz/Paul - which is the right strategy from a game theory perspective - it’s going to lose Susan Collins for sure, and probably Lisa Murkowski as well. Dean Heller is going to vote against it no matter what (he’s up next). It’s possible that Mitch McConnell can buy off Murkowski with a massive exception for Alaska, and probably one for Rob Portman in Ohio as well. I don’t think it’s likely. But it might be enough to get Mike Lee on board.Dean Heller (Nevada). Dean Heller is running for re-election next year. He is the most vulnerable Republican running for re-election, and he’s doing so in a state that Hillary Clinton won in 2021. The Democrats are desperate for some wins, and they’re going to spend all the $$$ necessary to get some, so his opponent will be very well-funded. And repeal is unpopular in Nevada.If more proof were needed, the stats tell it all. Sen. Heller has a 31/44 split on approval vs. disapproval, in polling today (or almost), he loses a matchup against a generic Democrat, and 51% of voters polled disapprove of the House repeal bill, vs. 31% in favor.Why I could be wrong: I mean, Trump is President, so anything can happen. But barring a massive shift in public opinion in Nevada, no way is Sen. Heller voting for this bill in anything approaching its current form.What About Everyone Else?If I am right and Sen. Lee and Sen. Heller both vote “No”, the Senate could still pass the bill. But that would mean holding onto every other Republican vote.Let me group the other senators into buckets:2021 Wannabes: Ted Cruz and Rand Paul. Both are far-right, and both have presidential aspirations. This makes it difficult to predict their motivations, as they are balancing national appeal with appeal to their voters. That said, I don’t think they’ll vote for this bill unless it moves further to the right. If it does, it risks losing…Moderates. Lisa Murkowski and Susan Collins fit this bill. If the bill goes further right, they probably won’t vote for it. Simple as that. I do say “probably”, as it’s possible they could be enticed by means of a massive dole-out from the GOP leadership for their respective states. If the bill passes, I think that’s how it’s going to happen. But I don’t think it’s going to happen.Similarly, if the bill goes toward the center to attract these two, it will almost certainly lose Rand Paul’s vote. (Cruz might go along with it if he feels it will serve his future ambitions.) Kentucky benefited a LOT from the Medicaid expansion. As the 538 piece points out, Rand Paul knows that. It’s reasonable to suspect that he wants the repeal bill to fail for that reason, but he can’t say so because of his past statements (and possibly because of his ideological bent.)Senators Who Want To Go With the Leadership, But Whose States Will Suffer A Lot From Repeal: Rob Portman and Shelley Moore Capito. Portman is close with Mitch McConnell, but Ohio’s got a serious problem with opiods, and Governor Kasich hates the repeal bill. Portman’s in a tough spot. Likewise with Sen. Capito, because West Virginia is going to get hammered if the bill goes through. She’s another great example of someone who probably wants this bill to fail, but doesn’t want to be on record saying so.People I Know Nothing About: Ron Johnson and Jerry Moran. I don’t have a clue what they’ll do.SummaryA closer look at the incentives suggests that Mike Lee and Dean Heller aren’t going to vote for this repeal bill. Sen. Lee isn’t facing electoral pressure, and his state doesn’t like the bill, so he’s free to “vote his conscience” with an eye to his voters. He’s been consistently saying that the bill doesn’t go far enough, and I don’t think he’ll change his tune.Sen. Heller is the opposite. Political exigencies will ensure that he does not vote for repeal.Can the GOP hold onto the other seven votes? It’s possible, but it would require satisfying both the most conservative and the most moderate members of the GOP. That’s tough sledding, especially when folks in Ohio and West Virginia have benefited as much as they have from the expansion of Medicaid.Ultimately, of course, I could be wrong about this. Maybe Mike Lee, in the absence of strong political pressure, comes around. Maybe a large enough aid package for West Virgina, Ohio and Alaska goes through to win those votes. Maybe they strip out the Planned Parenthood amendment and the conservatives don’t revolt. Maybe Ted Cruz and Rand Paul decide that their political futures are best served by voting to repeal, rather than claiming they want to repeal it but also claiming the mantle of ideological purity.Maybe.But I wouldn’t bet on it. I’d bet against it.