The Senate Hosted the First Major Fight Over Obamacare Late Last Night

At about 1:30 AM Thursday, the Senate voted 51 to 48 (Democrat Diane Feinstein of California was absent because she was recovering from surgery) to pass Concurrent Resolution 3, the official name for the first of several steps in the GOP's chosen strategy to repeal the Affordable Care Act, a.k.a. Obamacare.

This resolution didn't do anything to damage the ACA by itself. Nor are the Republicans who passed it unified about how exactly Obamacare should be repealed or what will eventually replace it. Instead it was a budgetary actionthat could empower Congress to gut Obamacare with minimal resistance. Utilizing parliamentary rules surrounding this process, Democrats sought to initiate a "vote-a-rama" Wednesday night that would force Republicans to go on record choosing, in vote after vote, not to safeguard popular, even life-saving, elements of Obamacare down the line. But after a seven-hour voting marathon, the Democrats were only successful in generating a few sound bites. Despite the lack of fireworks, last night marked a major stepin the most consequential congressional battle of the year, with Republicans determined to make good on their promises to repeal Obamacare, and the Democrats equally determined to preserve their party's signature policy achievement.

The budget resolution process, initiated last Tuesday by Senate Budget Committee chairman Mike Enzi, a Wyoming Republican, is parliamentary arcana: Basically it calls for deficit reduction by a certain date and lays out a roadmap for how to achieve it—in this case in large part by stripping core elements of Obamacare. Senate Republicans favor the process because it's filibuster-proof—repealing the ACA by standard methods would require 60 votes, which the GOP has little hope of getting, whereas this procedure only requires 50 of the Senate's 52 Republicans to line up. (Democrats like California Representative Nancy Pelosi have labeled this strategy an act of cowardice.)

But before the resolution could move to the House (which will presumably also pass it, after which the real work of repeal will begin), parliamentary procedure opened it up to 50 hours of debate—and an unlimited number of votes on amendments. These amendments wouldn't even necessarily have been binding; they were just a chance for Democrats, by naming them and seeing them rejected, to voice their concerns to the public that an Obamacare repeal could mean the scrapping of policies like those that forced insurance companies to cover people with preexisting conditions and the defunding of women's health services.

As Democratic Senator Jon Tester of Montana told McClatchy, "It's great messaging." The vote-a-rama was also part of a larger Democratic blitz, including a five-hour Monday night Senate floor protest by 24 Democrats and nationwide demonstrations in favor of key elements of the ACA planned for Sunday. The passage of the ACA was a drawn-out mess that cost some supporters their seats in Congress—it appears that Democrats want the same kind of fight this time, only in reverse

Democrats duly loaded down the resolution, proposing the vast majority of the 189 amendments that were proposed. Many were near duplicates of one another and most boiled down to symbolic bids at blocking legislation that would reduce the level or quality of healthcare coverage, end popular elements of the ACA, or allow a repeal of Obamacare without a replacement in sight. Virginia Senator Tim Kaine's Amendment 8, "to prohibit legislation that makes America sick again," was archetypal.

A few, like Vermont Senator Bernie Sanders's Amendment 19 "to prevent the Senate from breaking Donald Trump's promise that 'there will be no cuts to Social Security, Medicare, and Medicaid,'" seemed designed to drive a wedge between the GOP and the president-elect.

But the Senate voted on, and rejected, just 19 amendments (17 by Democrats), compared to 101 in a 2013 vote-a-rama and 40 in 2015. (Five other amendments, including 8 and 19, were killed over previous days and five more were withdrawn on the floor.) The mood was subdued, and the GOP remained united. The only senator to break ranks was Kentucky Republican Rand Paul , who voted against the resolution—he's long insisted that the GOP not repeal the ACA until a replacement is prepared.

Democrats reportedly closely tracked who voted against what, likely for use as ammunition in protecting the ACA and in future campaigns, and some of the amendments at least sounded bad, with the GOP voting not to promise to protect Medicaid and Medicare or ensure that people under 26 could be covered by their parents' health insurance, among other items.

Chris Condeluci, a GOP consul to the Senate Finance Committee during the 2010 Obamacare debates, doubts these votes signify much. Many senators likely voted against amendments they believe in because adding them would bog down the process—and right now speed is the priority. These votes weren't outright rejections either, he said, but sidesteps, "saying [each amendment was] not germane for the purposes of this budget resolution." Senators will have plenty of time to describe what they want to see in an ACA replacement in the coming debate. Even when it came to possible attempts to needle the GOP-Trump relationship, like Sanders's amendment, Condeluci told me, "I don't think it'll play."

Republican Senator Cory Gardner of Colorado echoed Condeluci, telling the Morning Consult, "I'm sure the political strategists are over here trying to figure out the votes that can be used in the political process. But the voters of people's states understand they're just playing politics."

The most prominent amendment actually may have divided the Democrats more than the Republicans. Proposed by Sanders and Minnesota's Amy Klobuchar, this amendment was designed to suggest US residents be allowed to order medication from other countries where pills are cheaper, particularly Canada. A dozen Republicans supported it, but it was defeated anyway thanks to 13 Democrats going against it—most notably New Jersey's Corey Booker. The argument against the policy is that foreign-bought medications might not meet FDA standards, but that's hardly going to satisfy progressives angry at how much influence the pharmaceutical industry seems to have bought.

The other intriguing amendment, put forth by five moderate Republicans, attempted to ensure there was a good ACA replacement by slowingdown the timeline for drafting repeal legislation—but it was withdrawn before a vote. GOP leadership reportedly assured the senators that the January 27 deadline for repeal legislation is a placeholder and that the party will be prioritizing replacement plans and interim steps to prevent chaos after repeal.

"That's the only significant amendment that I, at least, had a reaction to," Condeluci told me.

In the end, the vote-a-rama wasn't nearly as dramatic as many had hoped. It was just another venue for Democrats to voice their dissatisfaction about the repeal rolling through Congress right now—as they explicitly did over procedural objections in the last 13 minutes of the night.

This wasn't going to be the hill anyone died on. Several GOP senators are worried about repealing Obamacare without a replacement, and negotiations over a replacement are bound to be fraught. This first pitched ACA battle was conducted in the dead of night during a busy news week—expect the next rounds to be fought when a lot more people are paying attention.

Follow Mark Hay on Twitter.