"If Republicans won’t relent and debate their health care bill in the open for the American people to see, then they shouldn’t expect business as usual in the Senate," said Senate Minority Leader Chuck Schumer of New York.

Progressive groups have been calling on Democrats to fight harder to prevent Majority Leader Mitch McConnell from passing a health-care bill before a weeklong July 4 recess. Health-care bill opponents want to hammer Republicans at home during the break in an effort to kill the proposal later in the month.

Investigations into Russian election meddling and Trump’s firing of FBI Director James Comey have crowded health care off the front pages.

“The relentless pace of mind-blowing revelations on Russia have been a disaster for Donald Trump but also an opportunity for Mitch McConnell,” said Ben Wikler, Washington director for the liberal group MoveOn.org.

Related: Trump calls GOP health care bill 'mean'

McConnell’s attempt to craft an Obamacare replacement behind closed doors has also muted public focus on the coming debate, which groups say could help him get enough Republican support to pass the measure. Senate Democrats have said they’re hatching a broader strategy to put more focus on Republican health-care legislation that polls have shown is unpopular with the public.

Grassroots campaign

When the House was debating the health care bill earlier in the year, a significant grassroots campaign against the measure nearly derailed it, as Republican lawmakers were bombarded by hostile questions and large crowds in town halls back home.

Related: Study finds support for ACA provisions -- mostly

The Obamacare replacement passed by the House last month includes deep cuts to Medicaid and other health expenditures. The nonpartisan Congressional Budget Office says it would cause 23 million more Americans to be without health insurance by 2016. A May 16-22 Kaiser Family Foundation poll found that 55 percent of Americans have an unfavorable view of it.

“I think it’s time that we start focusing all of our attention on health care,” said Senator Chris Murphy, a Connecticut Democrat. “This is a red-alert moment. This bill is speeding to the floor.”

So far, McConnell lacks a final measure and is struggling to gain support in a chamber where Republicans have just 52 votes and no Democrats will support it. Senate Republicans plan to use an expedited procedure to pass a health plan with as few as 50 votes, plus a tie-breaker from Vice President Mike Pence. That would bypass the usual 60-vote threshold and keep Democrats from blocking the measure.

Republicans are seeking a more modest version of the House bill, H.R. 1628. It would cut Medicaid by $834 billion over a decade, repeal $664 billion of Obamacare’s tax increases on the wealthy and the health care industry, and end requirements that individuals get health insurance and that most employers provide it. It would replace Obamacare subsidies with tax credits based primarily on age, and let states get waivers from some of the Affordable Care Act’s consumer protections.

Medicaid expansion

Senate Republicans are weighing a slower phase-out of Obamacare’s Medicaid expansion, better protection for people with pre-existing conditions, and tax credits based on income as well as age. They also must navigate abortion policy. Restrictions on abortion funding in the House bill are opposed by at least two Senate Republicans -- Susan Collins of Maine and Lisa Murkowski of Alaska -- but if stripped out could thwart House approval of a final measure.

Related: Two studies look at Medicaid expansion pros, cons

The clock is ticking. Senate Republican leaders have said they want to move on to other issues after their August recess, including a tax-code overhaul, a debt-ceiling boost and next year’s spending bills.

Groups opposed to getting rid of Obamacare, including the labor union SEIU, NARAL Pro-Choice America and the Indivisible Project, are planning in early July to try to turn just enough Republicans against replacing the 2010 Affordable Care Act. Ezra Levin, co-executive director of the Indivisible Project, says his group is planning sit-ins at senators’ offices, letters to the editor and -- if any Republicans hold public town hall meetings -- a heavy presence of their advocates.

“All we need are three Republicans to drop off and we can kill it,” said Levin, whose organization was created to defeat Trump’s agenda and works through a network of over 5,800 local grassroots groups. He said his group is targeting 11 Senate Republicans, including Bill Cassidy of Louisiana, Dean Heller of Nevada, Rob Portman of Ohio and Collins and Murkowski.

Blocking action

The groups say they’ve urged Senate Democrats to block Senate committees and the full Senate from conducting routine business by refusing to provide unanimous consent to move work along, a tactic they’re now poised to use. If McConnell puts a bill on the Senate floor using the fast-track process to avoid a filibuster, they want Democrats to delay debate by offering numerous amendments.

Related: AHCA passage may mean job loss

So far, Democrats have had a tough time getting their message out as the Russia investigations are dominating news coverage and reporters are talking primarily to Republicans in a health debate that relies only on their votes. Democrats have gotten sparse attendance at press conferences to highlight the House bill’s impact on Obamacare’s insurance exchanges, Medicaid funds for opioid treatment, and women’s health.

The top Democrats on the Senate committees that would hold hearings if the GOP scheduled them -- Ron Wyden of the Finance Committee and Patty Murray of the health panel -- made pointed remarks about the secretive process at meetings last week. Then both panels moved right back to other routine work.

‘Cut out’

Wyden of Oregon complained that even his committee’s chairman, Orrin Hatch of Utah, was being “cut out” of discussions and that the process had become a “charade.” Now that the House measure has come to the Senate, Wyden said that McConnell has “committed to rushing the bill to a partisan vote on the floor with no review, no hearings, and no accountability to the American people.”

Schumer sent a conciliatory letter to McConnell Friday, calling the majority leader “Mitch” and asking all Senate Republicans to meet with Democrats next week to talk about health-care policies both parties can support.

“Our health care system affects every single American and one-sixth of our economy,” Schumer wrote. “We believe we all owe it to our constituents to pursue any bipartisan potential legislation because it profoundly impacts so many American lives.”

Republicans fired back shortly afterward with a release titled, “Does All-Out War Sound Bipartisan?” listing quotes from Schumer and other Democrats promising to do everything they can to defeat the emerging GOP measure.

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