The tumult around the Affordable Care Act is undoubtedly far from over, but the Republican effort to repeal and replace the landmark piece of healthcare legislation has collapsed in the Senate after marathon sessions and an early morning defeat of the latest, leanest fix.

"It's time to move on," Senate Majority Leader Mitch McConnell said, according to reporting by the Associated Press and others.

The latest — and perhaps final — repeal attempt in the Senate lost by a vote of 51-49, with three GOP senators joining all of the Democrats in voting against the bill.

The Capitol in Washington is seen early Thursday, July 27, 2017, as the Republican majority in Congress remains stymied by their inability to fulfill their political promise to repeal and replace "Obamacare" because of opposition and wavering within the GOP ranks. (AP Photo/J. Scott Applewhite)

After other derivations of ACA-upending legislation were decisively thwarted, the Senate was down to a bill widely known as “skinny repeal.” The bill was so light on specifics that some Republican Senators publicly termed it “a fraud” as a piece of stand-alone policy. Many who supported the “skinny repeal” bill conceded it was little more than a mechanism to bring the two bodies of the legislative branch together to draft a new law together.

Concerns were raised, however, that the conferencing step might not happen.

“There’s increasing concern on my part and others that what the will do is take whatever we pass — the co-called skinny bill — not take it to conference, go directly to the House floor, vote on it, and that goes to the President’s desk with the argument ‘This is better than doing nothing,’” Republican Senator Lindsey Graham said at a news conference where he was flanked by fellow GOP senators John McCain and Ron Johnson.

Hours later, Graham and Johnson voted in favor of the bill, but only after receiving assurance from House Speaker Paul Ryan that the body he controls would not vote on the legislation without first negotiating modifications. Earlier in the day, House leadership suggested they might revoke protocols that would slow their ability to bring the legislation to floor, raising worries they would ram through whatever the Senate delivered.

In a rushed assessment, the CBO estimated that, by next year, the “skinny repeal” bill would have caused 15 millions Americans to leave the insurance pool and the policy purchasers who remained would have seen their premiums jump 20 percent higher.

In opposition to the bill, the full cohort of Democratic senators were joined by their GOP colleagues Lisa Murkowski, Susan Collins, and McCain. While Murkowski and Collins were largely unwavering in their skepticism about the legislation throughout its unorthodox development process — with Murkowski even proceeding in the face of ethically questionable threats against her home state of Alaska by the White House — McCain’s defection was something of a surprise. Earlier in the week, his dramatic return to the Senate while still recuperating from brain surgery was instrumental to the procedural vote that allowed the repeal efforts to proceed.

With characteristic directness and brevity, President Donald Trump took to Twitter to lament the results of the vote, saying the senators who opposed the legislation “let the American people down.” He also repeated his intention to “let ObamaCare implode” as a strategic measure to eventually get the healthcare reform he promised on the campaign trail.