After Health Care Vote, Uncertainty for Both Sides

WASHINGTON (CN) - Even with Senate Republicans narrowly voting to bring a bill to the floor that would repeal the Affordable Care Act, senators of both parties acknowledged that it is far from assured that they will actually have the votes needed to pass the final legislation.

Republicans won a narrow victory to bring the bill to the floor on Tuesday afternoon, with a 50-50 tie being broken by Vice President Mike Pence on Tuesday afternoon. Sens. Susan Collins and Lisa Murkowski were the only Republicans to vote against the bill, joining with every Democrat.

The bill they voted to advance on Tuesday afternoon was technically the American Health Care Act, which the House passed in May, but the bill figures to change significantly during debate on the bill when senators will be able to offer a string of amendments to the legislation. The first amendment Senate Majority Leader Mitch McConnell brought is identical to a bill that passed both houses of Congress in 2015 that would have repealed the Affordable Care act if not for former President Obama's veto.

The amendment would repeal many provisions of the Affordable Care Act, better known as Obamacare, but would delay the repeal for two years, during which time Republican leadership has said the party would work to develop a new health care plan.

The amendment illustrates the pit falls that could await Republicans as they try to build the legislation on the floor. Three Republicans - Collins, Murkowski and West Virginia Sen. Shelley Moore Capito - said last week they would unequivocally not support a repeal-only legislation while others expressed more vague concerns about it.

But the promise of being able to vote on the repeal legislation was reportedly key to getting Sen. Rand Paul to support the motion to bring the repeal bill to the floor, as he vocally opposed the Republican plan to replace Obamacare as not being conservative enough.

McConnell is expected to also bring a version of that legislation to the floor during the lengthy amendment process, which can last up to 20 hours and is divided between Republicans and Democrats.

But four Republicans have already come out against that legislation, making its passage similarly unlikely.

McConnell insisted there are still many opportunities to overcome the divisions within the party.

"This is just the beginning, we're not out here to spike the football," McConnell told reporters Tuesday after the vote.

Sen. John McCain also cast doubt on the likelihood of Republicans being able to move the bill through the process to final passage, as he used a dramatic floor speech shortly after returning to the Senate for the first time since his brain cancer diagnosis to lament the partisan divide in the Senate and implore his colleagues to try to work together.

"Stop listening to the bombastic loud mouths on the radio, television and the internet," McCain said. "To Hell with them. They don't want anything done for the public good. Our incapacity is their livelihood. Let's trust each other. Let's return to regular order."

McCain also predicted the Republican plan has little chance of surviving a final vote, saying he would not support the bill as it is written.

"I will not vote for this bill as it is today," McCain, who was recently diagnosed with brain cancer, said. "It's a shell of a bill right now. We all know that. I have changes urged by my state governor that will have to be included for my support of final passage of any bill. I know many of you will have to see the bill change substantially  for you to support it."

McCain said that if the bill fails as he predicts it to, then any new health care legislation should go through the committee process like most bills have traditionally. McCain blasted the "closed doors" process McConnell used to craft the bill and called for the Senate to "try the old way of legislating" that involves getting input from lawmakers on both sides.

If McCain were to vote against the bill, the Republican plan to repeal Obamacare would fail, assuming both Murkowski and Collins remain no votes on final passage.

Senate Minority Leader Chuck Schumer similarly predicted doom for the Republican bill, noting the number of Republicans who have expressed at least some level of concern about the legislation.

"Anyone who thinks this is over is sadly mistaken," Schumer told reporters Tuesday. "Leader McConnell has a long way to go before he can get this done. There are many, many Republicans who don't like this bill, who don't want to vote for it. They're under enormous pressure to vote for it but they stretched it out because they're having such trouble."

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