Early on Thursday morning, in a 51-48 vote, the Senate took the first concrete step toward dismantling Obamacare, when it voted to instruct key committees to draft legislation repealing Barack Obama’s signature health insurance program. Republicans needed a simple majority to clear the repeal rules, instructing committees to begin drafting repeal legislation, through the upper chamber, with the vote falling largely along party lines.

Rand Paul was the lone Republican to vote against the budget resolution because it didn’t balance. Paul said in a statement after the vote that while he supports nixing ObamaCare “putting nearly $10 trillion more in debt on the American people’s backs through a budget that never balances is not the way to get there.”

Meanwhile, no Democrat supported the repeal rules. Instead, Democrats rose one by one from their seats on the Senate floor in protest to state why they were voting against the resolution. In dramatic fashion, Bernie Sanders warned that if the GOP resolution moved forward Americans would die.

“Up to 30 million Americans will lose their health care with many thousands dying as a result,” he said. “Because when you have no health insurance and you can’t go to a doctor or a hospital, you die.”

Sanders also mocked the Republican effort saying the GOP have never united around an alternative to Obamacare. “They want to kill ACA but they have no idea how they are going to bring forth a substitute proposal,” declared Senator Bernie Sanders of Vermont.

Dianne Feinstein who had surgery to install a pacemaker, missed the hours-long “vote-a-rama” session that began Wednesday evening. Lawmakers were able to use the hours-long voting block to force a vote on any amendment to the budget resolution. Some 180 amendments were filed.

As the Hill adds, the late-night passage of the budget resolution comes despite deep divisions on when and how to replace ObamaCare, which were on full display. Lawmakers spent more than six hours on the Senate floor and voted on more than 19 amendments, none of which were successfully added to the resolution.

But Republicans managed to avoid what was expected to be the top fight of the night, when a group of five GOP senators dropped their push to delay the ObamaCare repeal legislation. Lawmakers had wanted to push the deadline for committee repeal proposals from Jan. 27 to March, which they argued was needed to give lawmakers extra time to lock down details on a replacement bill and work with the incoming Trump administration about next steps.

Sen. Bob Corker (R-Tenn.), one of the Republicans backing the amendment, said the decision was a result of a “very thoughtful discussions” within Republicans and recognizing that the Jan. 27 date is a “placeholder.”

 

Sen. Rob Portman (R-Ohio) added that “we have assurances from leadership that this date is not a date that is set in stone.”

 

But Sen. John Cornyn (R-Texas), McConnell’s deputy, had warned that pushing back the date could create a “jam” on the Senate floor with GOP lawmakers wanting to tackle an ambitious agenda with President-elect Donald Trump’s first 100 days.

The resolution now goes to the House of Representatives, which is expected to vote on it this week. Scrapping Obamacare, albeit without a ready replacement, has become a top priority for most Republican majorities in both chambers and Republican President-elect Donald Trump. Republicans have said that the process of repealing Obamacare could take months, while developing a replacement plan could take far longer, according to Goldman as much as two years. However, they are under pressure from Trump to act fast; he said on Wednesday that the repeal and replacement should happen “essentially simultaneously.” It remains unclear just how that will happen.

Trump said during a press conference on Wednesday that repeal and replace legislation would occur near simultaneously if not at the same time. “It’ll be repeal and replace. It will be essentially, simultaneously. It will be various segments, you understand, but will most likely be on the same day or the same week, but probably, the same day, could be the same hour,” he said.

At the same time, Democrats continued to warn that if Republicans break ObamaCare they will own any political backlash and roil the insurance market. Minority Leader Chuck Schumer (D-N.Y.) appealed to Republicans earlier Wednesday, urging them to back down from the healthcare fight. “If Republicans go forward with this plan, they may mollify their base, but they will ostracize and hurt the American people, and ultimately lose in the court of public opinion,” he said.

Democrats forced votes on a myriad of amendments aimed at blocking legislation that would  “make America sick again,” a new Democratic slogan on the GOP plan to repeal ObamaCare without a replacement.

Some 20 million previously uninsured Americans gained health coverage through the Affordable Care Act, as Obamacare is officially called. Coverage was extended by expanding Medicaid and through online exchanges where consumers can receive income-based subsidies. On the other hand, premiums for Obamacare members have exploded in recent year, leading to widespread anger among middle-class Americans.

* * *

The resolution approved Thursday instructs committees of the House and Senate to draft repeal legislation by a target date of January 27. Both chambers will then need to approve the resulting legislation before any repeal goes into effect. Senate Republicans are using special budget procedures that allow them to repeal Obamacare by a simple majority; this way they don’t need Democratic votes. Republicans have a majority of 52 votes in the 100-seat Senate; one Republican, Senator Rand Paul, voted no on Thursday.

Democrats passed the Affordable Care Act in 2010 over united Republican opposition. Democrats say the act is insuring more Americans and helping to slow the growth in healthcare spending. But Republicans say the system is not working. The average Obamacare premium is set to rise 25 percent in 2017.