With the effort to repeal the 2010 health care law on the brink of failure, conservatives are warning that the Republican base will abandon the party. And some are already turning on GOP senators holding up the process.

Three GOP senators have said they would not support moving forward with an effort to repeal much of President Barack Obama’s signature health care law, which would be enough to block the effort. Conservatives, livid with lawmakers reneging on a seven-year promise to undo the law, say not fulfilling that pledge threatens the GOP majorities in Congress.

“If Republicans cannot repeal Obamacare now, they’re going to have to call hospice because their majority is not long for this world,” Tony Perkins, president of the Family Research Council, said on a Wednesday conference call with reporters.

Perkins and leaders of other conservative groups said Republicans will not be motivated to support GOP candidates in future election cycles. They also said the conservative base, unified by the desire to repeal the 2010 law, could back primary challengers against Republicans who vote against moving forward with the bill.

GOP infighting 

Some outside groups are already pressuring those GOP senators likely to vote against moving on to the repeal measure. That vote is expected to occur early next week.

The Club for Growth and the Tea Party Patriots launched a website titled “Traitorous Republicans” that singles out GOP Sens. Shelley Moore Capito of West Virginia, Lisa Murkowski of Alaska, and Rob Portman of Ohio. All three supported a 2015 repeal bill — that Obama vetoed — and that senators could vote on next week. But they are now raising concerns about repealing the health care law without a replacement plan.

FreedomWorks is also launching a “Freedom Traitor Award,” which will be presented next week to lawmakers who vote against the motion to proceed to the bill. The senators will also be given a bust of Benedict Arnold.

The Senate Conservatives Fund announced Tuesday it would recruit and fund primary challengers to those GOP senators. The group has had limited success in unseating Republicans, and only had roughly $360,000 in cash on hand as of May 31, according to Federal Election Commission filings. 

But the fund’s president, Ken Cuccinelli, said this primary effort could be different, since repealing the 2010 health care law has been such a consistent rallying cry for conservatives.

“We intend to harness that,” Cuccinelli said on the Wednesday call. “The incumbents know it.”

Cuccinelli, a former Virginia attorney general, declined to reveal whether his group was talking to potential primary challengers for the most vulnerable GOP senator, Dean Heller of Nevada. But he signaled that was likely.

“[Nevada] is definitely one of those areas where we would always prefer to have a conservative Republican and Heller is not one,” Cuccinelli said.

Pressure is also coming from the Trump administration and political allies.

America First Policies, a group run by former Trump campaign staffers, previously aired an ad knocking Heller for not backing the initial GOP health care bill. The ad was pulled after a backlash from party leaders. The group has since remained quiet, and a spokeswoman said there are currently no additional ads planned.

But Trump made a not-so-subtle jab at Heller during a lunch with GOP senators on the health care effort Wednesday afternoon.

“He wants to remain a senator, doesn’t he?” Trump said, with Heller seated beside him. Heller responded with a laugh and an, “Oh.”

After the meeting, the Republican National Committee also pressured senators to act, tweeting, “.@POTUS is ready to repeal and replace Obamacare. Now, the Senate must do their part.”

Aside from Heller, the senators who have raised concerns about the GOP health care plan are not up for re-election until 2020 or 2022. But conservative leaders said the base would remember their votes.

“This is a vote elections can turn on,” Cuccinelli said. 

Test of conservative cred

For some conservatives, this vote could finally reveal senators who they have long believed were not true conservatives.

“I’m glad this is finally out in the open,” David Bozell, president of ForAmerica, said in an interview. “I hope that these folks stop hiding behind the majority leader, stop hiding behind the procedure, and get on record as to whether they’re going to join with Democrats or honor their promises.”

Some senators were not fazed by the outside groups’ threats.

“My whole focus is just really to the concerns of the people that I represent back home,” Murkowski said Tuesday. “And that’s who I answer to.”

Mississippi Sen. Roger Wicker said it was “not surprising at all” that the Senate Conservatives Fund was threatening to primary Republicans. 

“I think they’ve been doing that for years, with some success, mostly failure,” South Carolina Sen. Lindsey Graham said of the fund’s threat.

Sitting GOP senators would also likely have support from leadership looking to keep its majority.

The Senate Leadership Fund, a super PAC aligned with Senate Majority Leader Mitch McConnell, has demonstrated in the Alabama Senate race that it will aggressively play in primaries and support incumbents. The group declined to comment for this story.

One GOP operative likened the Senate Conservatives Fund’s threat of primaries to “threatening to chop off their nose in spite of their face.” The operative said such primaries could actually help Democrats win Senate seats, since they could produce candidates who cannot win the general election.

Preparing for failure?

Through Republicans face a real possibility of failing to repeal the 2010 health care law, GOP lawmakers aren’t publicly acknowledging the issue could be dead in Congress.

Asked what Republicans would say to voters if they fail, House Freedom Caucus Chairman Mark Meadows simply responded, “It’ll get done.”

“Don’t think that this dies or we don’t continue working on this,” Murkowski said. “This problem doesn’t go away.”

But if they don’t fulfill their campaign promise, Republicans do expect consequences.

“I would anticipate that there would be significant blowback for not finishing what we started several years ago,” South Carolina Sen. Tim Scott said.

Republicans are also hinting at a potential strategy for explaining why they could not succeed: blame Democrats.

On Tuesday morning, McConnell said on the Senate floor that it was “regretful” Democrats would not engage with Republicans on the issue (though Democrats say they are eager to work with Republicans once GOP lawmakers drop the goal of repealing the 2010 law).

A memo recently circulated among Senate GOP chiefs of staff and obtained by Roll Call also detailed messaging that blamed Democrats for the health care stalemate. The memo was compiled by One Nation, a nonprofit also aligned with McConnell, and included data from an early July issue survey of battleground states.

The suggested messaging included, “Our goal is to replace Obamacare with a system that makes healthcare more affordable and give people greater control over their healthcare decisions. Sadly, Democrats have pledged to oppose any replacement plan offered by Republicans.”

But conservatives said voters will still blame Republicans, who control the government, for not repealing the health care law.

“These voters are going to look at the Republicans and say, ‘You pledged, you pledged to put an end to this and all you did was continue funding this. Out you go,’” Brent Bozell, president of the Media Research Center, said on the conservative group conference call. “They’ll throw them out.”

John T. Bennett and Niels Lesniewski contributed to this report.