WASHINGTON — The Senate Republican health care bill released Thursday lived up to its designation as a “discussion draft” after four senators balked at voting for it because it didn’t repeal enough of Obamacare and President Donald Trump called for negotiations.

The 142-page proposal, crafted in secret to the anger of Democrats and some Republicans, also included Medicaid reductions that raised the concerns of Sen. Susan Collins (R-Maine) and other more moderate Republicans.

That response underlined the uncertain path the legislation faces as Senate Majority Leader Mitch McConnell pushes for a vote next week before Congress leaves for the July Fourth recess.

McConnell must secure the votes of at least 50 Republican senators in the face of Democrats’ opposition in order to accomplish the Republicans’ seven-year campaign to repeal Obama’s Affordable Care Act and give Trump a major win.

“We have to act,” said McConnell (R-Ky.), “because Obamacare is a direct attack on the middle class, and American families deserve better.”

Trump said at the White House that “we’re putting in a plan today that’s going to be negotiated.” His spokeswoman Sarah Sanders said Trump “wants to bring stakeholders to the table.”

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Senate Minority Leader Chuck Schumer (D-N.Y.) said, “We live in the wealthiest country on Earth. Surely, surely we can do better than what the Republican health care bill promises.”

The bill does not fully repeal Obamacare. But it would eliminate its taxes, replace its subsidies with tax credits to help people buy insurance, and scrap mandates requiring individuals to buy insurance and employers to provide coverage, according to health care expert Gary Claxton, a vice president at the nonpartisan Kaiser Family Foundation.

The Senate measure also would more gradually phase out federal funds for expanded Medicaid coverage than the House bill passed in May, but would limit the federal funding more over time, putting pressure on states to raise their share of the funding or to cut services.

McConnell said after the Congressional Budget Office scores the bill’s cost he’ll bring it up for debate and amendments next week. Democrats have little power to block the legislation, unless at least three Republicans oppose it.

For that, Schumer is looking to Collins and moderates such as Sen. Lisa Murkowski (R-Alaska) and Sen. Dean Heller (R-Nev.), as well as to conservative Sens. Rand Paul (R-Ky.), Ron Johnson (R-Wis.), Mike Lee (R-Utah) and Ted Cruz (R-Texas).

Paul, Johnson, Lee and Cruz issued a statement Thursday that clouded the bill’s introduction: “Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor.”