The revised package now heads back to the House, where Republican leaders hope to approve it and send it to Trump before a self-imposed July 4 deadline. But it faces hurdles.

On July 3, Fitzpatrick was the only Republican opposed to the rule that set up a straight up-or-down vote on the Senate's version of the bill. The near unanimity came after Trump hosted skeptical lawmakers at the White House to answer their questions, worked the phones overnight and cheered the vote through social media.