Repealing and replacing ObamaCare, a popular Republican campaign issue for the past seven years, has been far less urgent as a legislative issue. Just goes to show that talk is cheap. Empty promises from Republican congressional candidates running for reelection, meaningless bills for show only, passed by Congress knowing they would never become law after being shredded by the Obama veto pen.

Now with once-in-a-generation control of the executive and legislative branches, an opportunity to lead and govern, the GOP can’t seem get their heads out of their nether regions to do something of significance. Simple things like what they have been promising their constituents.

Why is the clock ticking? Come September 30, Republicans will no longer be able to repeal ObamaCare with only 51 Senate votes based on Senate rules on reconciliation. On October 1, less than two weeks away, 60 votes will be needed to advance any legislation. Tick tock.

Sure, the Senate can change the rules, but don’t hold your breath waiting for that. The Senate already failed on their first repeal attempt in July. They created the September 30 deadline through the budget resolution passed in January. Back when they were basking in the light of Donald Trump’s electoral coattails. The proverbial dog chasing the car finally catching it and asking itself, “What now?”

Republican senators have a bill they are hoping to pass before the deadline in a few weeks. Sponsored by Senators Cassidy, Heller, Johnson and Graham, the bill ends ObamaCare subsidies and mandates, both employer and individual. It gives block grant dollars to the states to spend at their discretion for Medicaid recipients.

Not the repeal promised to voters, but at this point the best we can hope for. Far better than doing nothing, which has been the GOP Senate’s track record so far this term.

If this bill fails to launch, then it’s back to the filibuster and 60 votes necessary to pass anything. Good luck getting a handful of Democrats on board with anything short of single-payer. Which, based on recently uncovered video, Senator Bernie Sanders in 1987 admitted, “would bankrupt the nation.”

So what? We are $20 trillion in debt with well over $100 trillion in unfunded liabilities. Congress and previous presidents have already bankrupted the nation. Bernie’s plan would cost $32 trillion over ten years, chump change compared to our unfunded obligations. Fire up the printing presses at the Bureau of Engraving and Printing. Print more money. Borrow it from China. Whatever.

Back to the Senate bill. The Congressional Budget Office needs to analyze and score the bill before it can be considered. Can they do that in less than two weeks? Have they even started? Tick tock.

What if all GOP senators aren’t on board? Senator Rand Paul isn’t, as it doesn’t provide enough of an ObamaCare repeal. Then there are the three stooges who voted against the “skinny repeal” last July, Senators McCain, Murkowski, and Collins. McCain might vote for this bill, as his BFF Lindsey Graham is a cosponsor. Then again, Senator Maverick might slight his pal just to stick it to his non-BFF President Trump. Too close to call at this point. And unlikely to gain any Democrat senators, except perhaps a moderate like Joe Manchin.

The CBO will likely score the bill badly. Their assumption is that if individuals are not forced by the government, via the muscle of the IRS, to purchase insurance, they won’t. This leads to all persons formerly falling under the individual mandate scored incorrectly by the CBO as "uninsured" without mandates under the new bill. When in reality, most will find alternative insurance more suited to their needs when essential benefits and other insurance mandates disappear.

The clock is ticking. If the Senate can drag something across the finish line, the House can hopefully tweak and improve it, getting something to President Trump’s desk for signature. If not, then Republicans can campaign for reelection in 2018 touting their empty promises and legislative impotence. Tick tock.

Suppose the President gives up on his party’s legislative incompetence and has another dinner with his new pals Chuck and Nancy? Who knows what might emerge from the Democrat swamp? Not single-payer and certainly not a repeal. The current trajectory of ObamaCare is unsustainable and everyone knows it. The President promised to fix it. If his political partners, the GOP, can’t muster the will to do their jobs, Trump will find new partners.

September 30 is less than two weeks away. Will the Republicans make good on their longstanding promises to repeal and replace? Or will they continue to fiddle while Rome burns, facing a hostile electorate in 2018? All because they don’t approve of President Trump’s “tone and demeanor”?

A recent Politico-Harvard poll found, “More than 80 percent of Republican voters think repealing and replacing ObamaCare should be an ‘extremely important priority’ for Congress.”  Clearly their constituents want this fixed. As does their President. The time for talk and excuses is over. The clock is running. Can the GOP Congress deliver? Tick tock.

Brian C Joondeph, MD, MPS, a Denver based physician and writer. Follow him on Facebook,  LinkedIn and Twitter.