Donald Trump, US president asked Republican senators not to leave town for their August recess without passing a health care reform plan that makes good on seven years of promises to repeal and replace President Barack Obama's Affordable Care Act.

Trump told the lawmakers that Republicans are "closer than people understand" on getting health care reform done and "have to pull through."

He added: "We are in this room to deliver on our promise. We have no choice, we have to repeal and replace Obamacare. We can repeal it but the best is repeal and replace and let's get going. I intend to keep my promise and I know you will, too. Inaction is not an option and frankly, I don't think we should leave town unless we have a health insurance plan, unless we can give our people great health care because we are close, we are very close."

"There is a large majority in our conference that want to demonstrate to the American people that they intend to keep the commitment they made in four straight elections to repeal Obamacare," he said.

"I think we all agreed it is better to vote to repeal and replace. But we could have a vote on either and if we end up voting on repeal only, it will be fully amendable on the Senate floor and if it were to pass without any amendment at all, there is a two-year delay before it kicks in."

The top Republican added that while it is "pretty obvious we have had some difficulty in getting 50 votes to proceed," he intends to "vote on the motion to proceed next week."

He added: "So the takeaway from what I am telling you is no harm is done by getting on the bill."

"I am ready to act," Trump said. "I have pen in hand, believe me, I am sitting in that office, I have pen in hand. You never had that before."

The meeting was held after Senate Majority Leader Mitch McConnell's backup plan to gut the Affordable Care Act was knocked off course by four senators who said they wouldn't go along with the bill. It marked the second-time McConnell hit a roadblock in less than 24 hours.