With Rand Paul's Support (For Now), Republican Health Care Bill Survives First Senate Vote

They had to pass the motion to proceed to the bill to find out what's in the bill.

After weeks of will-they-or-won't-they tension, the Senate pulled together 50 votes (plus a tie-breaking vote from Vice President Mike Pence) on Tuesday afternoon to proceed to debate on the Republican health care bill.

Whether the bill—technically known as the Better Care Reconciliation Act—will pass, or what it will look like when it does, remain unanswered questions.

Sen. John McCain, R-Arizona, who returned to applause on the Senate floor after getting treatment for brain cancer, provided the best indicator of the bill's tenuous status. McCain cast a critical vote in moving the bill forward and, shortly afterward, disparaged the bill and the legislative process used to try to pass it, raising questions about whether he will support the BCRA as it goes forward.

"I voted for the motion to proceed to allow debate to continue and amendments to be offered. I will not vote for this bill as it is today," McCain said. "It is a shell of a bill. We all know that."

Sen. McCain upon returning to the Senate: "Let's trust each other. Let's return to regular order…we're getting nothing done, my friends." pic.twitter.com/O6UW0WhUj4

— ABC News (@ABC) July 25, 2017

Other Republican senators who have been outspoken critics of the GOP health care effort, including Sen. Rand Paul of Kentucky and Sen. Ron Johnson of Wisconsin, voted in favor of motion to proceed. Paul announced his decision to back the initial vote while maintaining that he could oppose the final version of the bill if it did not go far enough to repealing Obamacare.

"If this is indeed the plan, I will vote to proceed and I will vote for any all measures that are clean repeal," Paul tweeted Tuesday morning.

After the vote, Paul released a video statement explaining some of the technical details about the votes to come.

Today we took the first steps to repeal Obamacare. Here's my statement after today's #healthcare vote. pic.twitter.com/ph3VqcYAtv

— Senator Rand Paul (@RandPaul) July 25, 2017

Maine's Susan Collins, and Alaska's Lisa Murkowski were the two Republicans to vote against the motion to proceed. Both have been opposed to the bill during most of the Senate's negotiations over it.

With debate on the health care bill officially open, senators are now free to offer amendments to the bill. The first of what could be dozens of amendments is being debated at this moment. Each will be given a simple up-or-down vote, and votes are expected to run well into the evening.

The major amendments to watch, according to NBC News, will be offered by Sen. Ted Cruz, R-Texas, and Sen. Rob Portman, R-Ohio.

Cruz' amendment is expected to allow for the sale of so-called "catastrophic plans" currently outlawed by Obamacare. Allowing insurance companies to sell those cheaper options has been a major sticking point for some opponents of the Republican effort, including Paul. Portman's amendment is expected to authorize $100 billion in new Medicaid spending, something moderate Republicans have pushed to include in the bill.

Want more on the substance—such as it is—of the health care bill? Check out these links:

• The Senate GOP's New Health Care Bill Is Just Obamacare, But Less of It
• Republicans Are Keeping Their Health Care Bill Secret Because They Can't Defend it on The Merits
• Protecting The Medicaid Status Quo Won't Save Patients

Bottom line: The Republican effort to repeal and replace Obamacare is alive, if barely, for now. After the rest of this evening's votes, we will have a better sense of what's actually in the bill and whether it has a chance to survive a final vote in the Senate, which could come as early as tomorrow.

This is a backwards way to write legislation, to say the least.

"I don't think that's going to work in the end," McCain predicted on the Senate floor Tuesday. "And it probably shouldn't."

Photo credit: Bill Clark/CQ Roll Call/Newscom