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Mitch McConell has to referee a fight within his own party in order to save one of Republicans main election promises:"Repeal Obamacare."  

Republicans ran on the repeal of the Affordable Care Act, popularly known as Obamacare. Now they are having a hard time coming to a consensus of what a replacement bill would look like. 

Senator Rand Paul of Kentucky has voiced frustration over the direction the GOP bill has taken. A house bill was passed that kept 90% of Obamacare but did allow for people with pre-existing conditions to be charged more. This is seen as politically inconvenient for many Senate Republicans who told constituents just the opposite while running for election in 2016.

"We promised the voters that we'd repeal Obamacare," Paul said. "Instead, we want to repeal sort of a tiny bit of it and replace it with something that looks a lot like Obamacare."

Losing two senators would be a major problem for Senate Majority Leader Mitch McConnell, whose party holds a 52 to 48 advantage in the senate. That would allow no margin of error since one more defection would make it impossible for the Republicans to repeal Obamacare. 

The fight is between moderate forces and more conservative ones in the Republican side of the Senate. Moderate forces would have no problem with the expansion of Medicare. While conservative factions, who have been feeling the pressure form conservative groups, want a full repeal of Obamacare and a replacement that does not allow tax increases that go along with Obamacare. The question then becomes; How do you pay for that?

"There are third rails that they can touch in the bill. They keep Obamacare tax increases, they don't lower premiums: Conservatives will oppose it," said David McIntosh, president of the Club for Growth. "I'm tired of Republicans promising they would repeal Obamacare and then negotiating to keep it."

Many Republican lawmakers do not have a rosy outlook for the success of any future bill that satisfies the conservative wing of the party. Most see that the need to fund Medicaid as the only way to reduce premiums. Others see that the influx of cash into the individual marketplace may be the only way to keep those marketplaces alive and be able to offer affordable coverage to millions of Americans. 

"I don't think it's insurmountable. But I think the passion's going up on each side," said Sen. Shelley Moore Capito (R-W.Va.), who is pushing for more robust Medicaid benefits against conservative opposition. "The heat's definitely rising." 

The Republican Party is in disarray while trying to dismantle one of the signature achievements of the Obama presidency. They seem to be blinded by the need to destroy his legacy. It makes more sense to keep many of the facets of the Affordable Care Act and simply tweak some areas to make it run more effectively. Republicans do not seem to be able to do this. They ran on repealing Obamacare and they are hellbent on delivering that promise regardless of not having an effective replacement. American citizens may end up paying the price.