mithc mcconnell

J. Scott Applewhite/AP Images

Senate Republicans came out of 20 hours of debate with a stunning failure in their efforts to overhaul the US healthcare system - and Sen. John McCain cast the decisive vote.

Early Friday morning, the Senate voted against a "skinny repeal" plan. Republican senators formed the last-ditch effort, called the "Health Care Freedom Act," after earlier votes on the Senate's healthcare plans failed.

The vote failed with TK voting in favor and TK voting against. Three Republican senators - McCain and Sens. Lisa Murkowski and Susan Collins - voted no.

This vote was to replace the House bill, the American Health Care Act, with the HCFA.

The skinny bill included a series of amendments that would aim to repeal certain unpopular parts of the Affordable Care Act.

The failure leaves Senate Majority Leader Mitch McConnell with no clear options moving forward. The Senate has been grappling for weeks with healthcare overhaul, running through different versions of legislation before settling on a more modest attempt with the aim of moving to a conference with the House of Representatives.

In a surreal scene on the Senate floor, McConnell and Vice President Mike Pence were seen on the Senate floor before the vote speaking with McCain. A previous vote was left open for more than 40 minutes as it appeared Republican leaders attempted to convince McCain, who made a dramatic return to the Senate this week after being diagnosed with brain cancer, to change his vote.

In announcing his vote, McCain came to the Senate floor and loudly said "no" before walking off.

This story is developing.

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