A political summit in Washington hosted on television by President Barrack Obama has ended without appearing to have broken a deadlock delaying his health reforms.
Mr Obama outlined his reform plan but Republicans said it was not acceptable and called for a fresh start.
Republicans renewed their call to start over in a bid to draft bipartisan legislation. They say the United States cannot afford Mr Obama's plans.
Senator Mitch McConnell said it was "pretty clear" that Democrats and Mr Obama want to revive a healthcare bill passed by the Senate last December, but now stalled in Congress.
Democrats no longer have a majority of 60 seats.
The BBC reports the meeting began at 10am on Thursday and lasted seven hours. Participants debated controlling costs, insurance reforms, deficit reduction and expanding coverage.
However, they clashed on a range of technical and philosophical differences.
The House of Representatives and the Senate passed separate healthcare bills at the end of last year.
But efforts to merge them and sign a bill into law collapsed last month when Republicans won a special election in Massachusetts.
The victory deprived Democrats of their majority of 60 seats in the Senate.
Mr Obama issued his own version of a healthcare plan on Monday; which was rejected by Republicans.
The White House has signalled it may end up driving through a bill using a procedure called budget reconciliation, which needs only a majority vote.