A vote on legislation to repeal the Affordable Care Act is supposed to take place within the next day. But the tension that permeated before and after the nail-biter vote was a far cry from the nearly joyful manner in which Republicans have campaigned on their promise to gut Obamacare for years.
The text of the legislation mirrors a bill that the Senate passed in 2015 that President Obama then vetoed.
The two would need to be reconciled and a final bill passed by both chambers before it reaches the president's desk. Rand Paul introduced the amendment - within two years, and come up with a replacement plan in the meantime.
It will be important in this process to hold Republican senators accountable: They can't be for it before they were against it. John McCain (R-Ariz.) and Vice President Mike Pence, voted to proceed on debating the Act, popularly known as Obamacare.
The Senate rejected the plan in a 45-55 vote. This contained a proposal from Sen.
"If there is no longer a requirement for everyone to purchase coverage, it is critical that any legislation include strong incentives for people to obtain health insurance and keep it year-round", the Blue Cross Blue Shield Association said in a statement Wednesday.
Among the provisions Cornyn said could be added in conference with the House is a measure from Sen.
The so-called skinny repeal, however, would also have negative impacts, with 15 million people losing coverage and forcing rates to rise by 20%, according to the CBO. The party's hardline conservatives favored a bill to repeal Obamacare - Sen. They also are using procedural tactics to try to slow down the debate process.
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Senate Majority Whip John Cornyn, R-Texas, said he was not certain the Senate could even pass a stripped-down bill.
The third amendment Republicans have yet to vote on would nix only the individual mandate and the medical device tax imposed by Obamacare. There aren't any men among the Republican Senate caucus that feel the same way.
Though the Senate has yet to release details, the "skinny repeal" plan would likely eliminate the individual mandate, which requires almost all Americans to obtain health insurance or pay a penalty, and the employer mandate, which obligates larger companies to provide affordable coverage to their full-time workers.
If GOP senators manage to get behind a bill, the effort will then move to negotiations with the House in a conference committee. "It's a shell of a bill right now, we all know that", said the Arizona lawmaker. Democrats on Wednesday night released a Congressional Budget Office analysis of the effects of repealing several provisions that could be part of a "skinny" repeal measure.
But first the Senate has to pass a bill, and the "skinny repeal" - which Senate Minority Leader Chuck Schumer called a Trojan Horse created to get the House and Senate into conference - seems to be the preferred choice.
Why has it been so hard for the Senate to reach agreement?
The dramatic vote-a-rama on Thursday would come as McConnell's efforts to rally his troops around a more comprehensive "repeal and replace" bill have been woefully unsuccessful.
The proposal combined the Better Care Reconciliation Act, which Senate Majority Leader Mitch McConnell, R-Ky., has spent weeks crafting, along with two amendments: one for additional funding for opioid programs, proposed by moderate Sen.