Sen. John McCain, R-Ariz., leaves meeting of Senate Republicans,on Tuesday, Sept. 19, 2017, on Capitol Hill in Washington.

Sen. John McCain, R-Ariz., announced Friday that he does not support the latest Republican effort to dismantle the Affordable Care Act, dealing a major and potentially decisive blow to the last-ditch attempt to fulfill a seven-year GOP promise.

McCain’s comments came on the same day that Sen. Susan Collins, R-Maine, who like McCain, voted against a GOP repeal bill in July, said she was likely to oppose the proposal, leaving the legislation on the brink of failure.

The Arizona senator joins Sen. Rand Paul, R-Ky., in firmly opposing the plan. Senate Republicans cannot afford to lose any more GOP defections, given their narrow 52-48 majority and the united Democratic resistance to repealing President Barack Obama’s signature health-care law.

In a lengthy written statement, McCain said he “cannot in good conscience” vote for the legislation from Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., which GOP leaders have been aiming to bring to the Senate floor next week. As he has done all week, he railed against the hurried process Senate GOP leaders used to move ahead.

“I would consider supporting legislation similar to that offered by my friends Senators Graham and Cassidy were it the product of extensive hearings, debate and amendment. But that has not been the case,” McCain said. He blamed a looming Sept. 30 deadline that GOP leaders were racing to meet to take advantage of a procedural rule allowing them to pass their bill with just 51 votes.

McCain also said he could not vote for a bill without a complete snapshot of its effects from the nonpartisan Congressional Budget Office, which said earlier this week it could only provide a partial picture by next week. The office said it could not determine the bill’s impact on insurance premiums or project the change in insurance coverage levels it would trigger until a later date.

“I believe we could do better working together, Republicans and Democrats, and have not yet really tried,” McCain said. He added that he took “no pleasure” in his announcement. McCain and Graham are close friends.

In her home state on Friday, Collins signaled that she is edging close to becoming a decided “no.”

“I’m leaning against the bill,” she said at an event in Portland. “I’m just trying to do what I believe is the right thing for the people of Maine.”

Collins has said she is particularly worried that by giving states wide latitude to change the ACA’s current requirements, it could prompt insurers to hike up rates for consumers with costly medical conditions.

“I’m reading the fine print on Graham-Cassidy,” she said, adding that for those with preexisting conditions, “the premiums would be so high they would be unaffordable.”

Paul spokesman Sergio Gor reiterated his boss’s opposition to Cassidy-Graham on Friday.

“Previous partial repeals he voted for left the ‘replace’ fight for another day, enabling him to vote yes,” Gor said. “Graham Cassidy implements Obamacare Lite replacement, which he cannot support.”

Earlier in the day, President Donald Trump tweeted a direct political threat to Paul and all other opponents of Cassidy-Graham.

“Rand Paul, or whoever votes against Hcare Bill, will forever (future political campaigns) be known as ‘the Republican who saved ObamaCare,'” the president wrote.

Paul responded in a series of tweets saying he “won’t be bribed or bullied” into changing his mind, in part, because the legislation does not go far enough in repealing the ACA.

Trump administration officials – including Vice President Pence, who hosted Maine Gov. Paul LePage (R) at his ceremonial office on Friday – have continued to lobby for the measure in the hopes that Congress can pass it by the end of next week.

The Cassidy-Graham bill “is an idea whose time has come,” Pence said, standing with LePage before reporters.

“President Trump and I are absolutely determined to carry this case all across the country and to call on members of the Senate — most especially Senator Susan Collins from the great state of Maine — to join us in giving the people of Maine and the people of America a fresh start on health care reform,” the vice president added.

A spokeswoman for Sen. Lisa Murkowski, R-Alaska, who was the third GOP “no” vote in July, did not immediately respond to a request for comment Friday on where she stands. This week, Murkowski has said she needed to review more data on how her state would be affected before she could make a decision.

Democrats have been fighting against the renewed GOP effort this week. In a statement, Senate Minority Leader Charles Schumer, D-N.Y., said McCain showed “the same courage in Congress that he showed when he was a naval aviator.”

He added: “I have assured Senator McCain that as soon as repeal is off the table, we Democrats are intent on resuming the bipartisan process.”

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