The latest whip count on the Senate health insurance reform bill is out, and it doesn't look good for Majority Leader Mitch McConnell and the Republicans.

The Hill nose count shows that, in addition to all 47 Democrats in opposition, two Republican senators are unalterably opposed: Rand Paul and Susan Collins.  That means that McConnell must round up every single remaining Republican senator to reach 50 votes and count on Vice President Pence to break the tie.

There are 23 fence-sitting Republicans who could go either way.  Here are some of them:

Sen. Shelley Moore Capito (W.Va.) – Capito said she does not know if she'll vote to advance the new bill. "We have another meeting this afternoon on the Medicaid cuts," she said Thursday. "I need to really look at it, look at the score, I still have concerns." She has expressed concerns the first bill did not do enough to combat opioid abuse and cut Medicaid too deeply. Capito told Politico during the July Fourth recess that she will kill the repeal bill if it comes down to her. "If I have to be that one person, I will be it."

Sen. Bill Cassidy (La.) – Cassidy won headlines when he talked about how the bill needed to pass a "Jimmy Kimmel test" on whether it would prevent children with pre-existing conditions from getting coverage. Cassidy on Thursday said he was not sure if he would vote to advance the revised bill. Cassidy has worked with Collins on alternate legislation.Sen. Shelley Moore Capito (W.Va.) – Capito said she does not know if she'll vote to advance the new bill. "We have another meeting this afternoon on the Medicaid cuts," she said Thursday. "I need to really look at it, look at the score, I still have concerns." She has expressed concerns the first bill did not do enough to combat opioid abuse and cut Medicaid too deeply. Capito told Politico during the July Fourth recess that she will kill the repeal bill if it comes down to her. "If I have to be that one person, I will be it."

Sen. Bob Corker (Tenn.) – Corker was undecided on the first bill.

Sen. Steve Daines (Mont.) – "I look forward to hearing directly from Montanans on this legislation," Daines said about the first bill.

Sen. Joni Ernst (Iowa) -- Ernst did not take a position on Senate Republicans' first ObamaCare repeal and replace plan, and said she was polling her constituents to gauge their feelings on the bill.

Sen. Jeff Flake (Ariz.) – Flake is up for reelection in 2018. He said he would "thoroughly read and review it" after the first bill's release.

Sen. Cory Gardner (Colo.) – "If we can have opportunities to make the bill better, then by all means let's take every chance and (all the) time we can," he said of the first bill, according to the Denver Post.

I believe most of these votes are very gettable, with two or three conservatives and another two or three moderates who may be leaning against the bill.

This is where President Trump will be able to do the most good.  Trump demonstrated some skills in herding House Republicans together to support Obamacare reform.  His challenge in the Senate is more serious because his margin for error is so slim.  But the president has shown he is willing to lean on reluctant lawmakers to get his agenda passed.  Expect the president to start working the phones over the weekend in anticipation of a vote on health care reform next week.