((L-R) U.S. House Speaker Paul Ryan and U.S. Senator Mitch McConnell address the media during the 2017 "Congress of Tomorrow" Joint Republican Issues Conference in Philadelphia, Pennsylvania, U.S., January 26, 2017.REUTERS/Mark Makela)

Once again, it appears that the Republican attempt to repeal and replace Obamacare is dead for now.

The Better Care Reconciliation Act lost the support of two more Republican senators on Monday night, effectively crushing the bill's chances of passage.

Unlike after first failure in the House and misstep in the Senate, GOP leadership has responded with a distinct change in tactics this time. Instead of going with a simultaneous repeal and replace, Senate Majority Leader Mitch McConnell said he would look to advance a bill that repeals all of Obamacare's funding in two years while Republicans work on a replacement.

Despite the tactic being modeled on a 2015 repeal bill that passed both the House and Senate with little Republican resistance, the prevailing view is that the attempt will also fail to gain enough GOP support to pass the upper chamber. In fact, two members — Susan Collins of Maine and Shelley Moore Capito of West Virginia — have already come out against this strategy.

So despite frequent promises over seven years to repeal President Barack Obama's signature healthcare law, there looks to be a good chance that much of its structure will remain in place.

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The dilemma for Republicans is simple, a GOP strategist and former Senate leadership aide told Business Insider: this time it's for real.

"The difference between 2015 and now is that Republicans are shooting with real bullets," a GOP strategist told Business Insider last week. "When you're doing that these senators want to make sure there aren't big coverage losses in their states and they're not hurting constituents."

Essentially, everyone expected the 2015 repeal bill to be vetoed — so they didn't have to worry about the Congressional Budget Office's projection that 32 million fewer people would have coverage in 10 years than under the current system.

Republicans didn't have to worry about getting pegged with any market instability or damage to the healthcare system. Now that they're in power, the vote isn't symbolic anymore. And their bill was deeply unpopular with the American public.

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