WASHINGTON — Appeasing clashing Republican interests on national health care will occupy Senate Majority Leader Mitch McConnell over the week-long Fourth of July recess.

McConnell acknowledged Tuesday he needs more time to make mitigating changes to the bill his small team of GOP senators forged in 52 days of secret discussions only to face crippling opposition from his party’s ideological gap.

It may be an unattainable mission given the divide between the moderate and hardcore conservative Senate Republicans over legislation to repeal and replace the Affordable Care Act known as Obamacare.

Moderate Sen. Susan Collins, R-Maine, admitted as much following McConnell’s announcement postponing a vote on the health care bill until after the July 4^th recess that starts Friday and stretches to July 11.

“I have so many fundamental problems with the bill, that have been confirmed by the CBO report, that it’s difficult to see how any tinkering is going to satisfy my fundamental and deep concerns about the bill,” Collins said on CNN.

She referred to the nonpartisan Congressional Budget Office report released Monday that said the Senate bill would increase the number of uninsured by 22 million over the next decade by reducing health insurance subsidies to lower-income Americans and gradually cutting back Medicaid assistance.

Collins and moderate Sens. Shelly Capito of West Virginia and Rob Portman of Ohio want Medicaid left mostly intact instead of being cut by $772 billion. They also seek kinder reductions in federal subsidies to individuals who need them to afford health insurance. This approach has been labeled by critics as Obamacare light.

And it runs smack into the wall of resistance from a clutch of Senate conservatives — Ted Cruz of Texas, Rand Paul of Kentucky, Mike Lee of Utah and Ron Johnson of Wisconsin. They insist on revoking Obamacare’s federal mandates for subsidies and insurance coverage of pre-existing conditions and essential health services such as maternity care and mental health treatment. They prefer the states finance pre-existing medical conditions through high risk pools and let free market competition lower premiums and deductibles with non-mandated coverage options.

That leaves McConnell between a rock and a hard place. If he gives in to moderate interests, he can’t count on conservative votes. And vice versa if he appeases conservatives by completely gutting Obamacare’s mandates.

“We’re going to press on,” said McConnell. “We’re continuing to talk. It is a very complicated subject.”

He said about 50 Republican senators met with President Donald Trump to discuss the subject, and that “one thing I would say is everybody…was interested in getting to yes, interested in getting an outcome because we know the status quo is simply unacceptable, unsustainable and no action is not an option.”

Trump said only that it “will be great if we get it done. And if we don’t, it’s just going to be something that we’re not going to like — and that’s okay. I understand that very well.”

McConnell said his goal is to make changes and then get another, more favorable report from the Congressional Budget Office. He hopes that will get 50 of the 100 senators “in a comfortable place.” That’s the number needed to approve the health care bill, with Vice President Mike Pence casting the tie-breaking vote.

There’s little chance he can convert any of the 48 Democrats in the Senate to help win approval. They’re angry over the bill’s repeal of taxes they say are paid by the rich and that help finance Obamacare. They also object to cuts in subsidies and Medicaid.

No Democrat got an invitation from McConnell to join the closed-door group that met for weeks to create the Republican bill. He said that’s because Democrats were hell bent to prevent repeal of former President Barack Obama’s signature health care law.

Senate Minority Leader Chuck Schumer of New York said Democrats are willing to work with Republicans if they agree to abandon repeal, take tax cuts off the table, conduct negotiations in public and require 60 votes to pass the bill. Conditions that Republicans find unacceptable.

“We’re going to fight the bill tooth and nail, and we have a good chance of defeating it — a week from now, a month from now,” said Schumer.

Liberal Sen. Ed Markey, D-Mass., said Democrats cannot sit back and expect that Republicans can’t close the gap between moderate and conservative factions.

“#Trumpcare is not dead,” Markey posted on Twitter. “We must keep fighting and raising our voices.”

At a news conference earlier in the day, Markey called the Republican bill “a death sentence for those people who suffer from opioid addiction” and that progress to fight the epidemic would “be going out the window.”

Sen David Perdue, R-Ga., told Fox News the GOP remains optimistic. “We’re still so close on this deal,” he said. “If we had another day or two we can get there.”

Perdue said the decision to delay the vote was made when Republicans couldn’t come together after meeting at the Capitol with Pence and White House Chief of Staff Reince Priebus.

Sen. Pat Toomey, R-Pa., a fiscal conservative who was involved in drafting the bill, said he’s hopeful a new CBO analysis will help the legislation’s chances.

The bill, he said in a statement, is “not perfect, but it is a positive step toward repairing the damages caused by Obamacare and putting Medicaid on a sustainable fiscal path.”

West Virginia’s Capito and Ohio’s Portman said in a joint release they’re worried about rolling back Medicaid. Capito said West Virginia has the largest number of people in the nation on the health assistance program.

“As drafted, this bill will not ensure access to affordable health care in West Virginia, does not do enough to combat the opioid epidemic that is devastating my state, cuts traditional Medicaid too deeply, and harms rural health care,” she said.

Portman said he has “real concerns about the Medicaid policies in this bill, especially those that impact drug treatment at a time when Ohio is facing an opioid epidemic.”

Democrat Sen. Amy Klobuchar of Minnesota expressed similar sentiments. She said the bill would “move us backward” to stemming the increase of drug addiction.

Sen. Joe Manchin, D-W.V., referring to Trump’s comments that the House Republican health care bill doesn’t have a heart, said the Senate version “doesn’t have a soul.”

Contact reporter Kery Murakami at kmurakami@cnhi.com.