Senate GOP leaders are bearing down Tuesday in their push to pass a health care bill this week, a day after brutal budget estimates dealt a blow to their proposal.

The senators are expected to come together at lunchtime Tuesday to discuss the path forward for the plan and whether they should open official debate on it. Notably, Vice President Mike Pence is expected to attend.

On Monday the Congressional Budget Office estimated that the plan could leave 22 million more Americans without health insurance in the next 10 years. A Georgia analyst said that could translate to 680,000 Georgians. The office also found it could shave $321 billion off the budget deficit.

The massive number of potentially uninsured people immediately lost one Republican vote, and the bill’s backers can only afford to lose two. Sen. Susan Collins of Maine tweeted that she wouldn’t even vote to open the plan for official debate. Instead, she said, the two parties should work together to fix the Affordable Care Act, the current system known as Obamacare.

If backers of the bill lose a third Republican senator, they will not have the votes to pass it. News reports say at least five have balked at voting for the bill in its current form. Others have been quoted criticizing it.

GOP leaders are negotiating hard now with their colleagues on the fence, and Pence is expected to join the effort as Tuesday wears on.

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