Washington(CNN) Senate Republicans launched their effort to repeal and replace President Barack Obama's landmark healthcare law early Thursday morning, approving a budget blueprint that they've dubbed the Obamacare "repeal resolution."
The Senate voted 51-48 along party lines for the measure, which relies on the same budget process used seven years ago to approve the landmark healthcare law to now attempt to dismantle it.
"This resolution will set the stage for true legislative relief from Obamacare that Americans have long demanded while ensuring a stable transition," Senate Budget Chairman Mike Enzi of Wyoming said, just after 1 a.m. "The Obamacare bridge is collapsing and we're sending in a rescue team."
Kentucky Sen. Rand Paul, one of the most vocal GOP opponents of voting on a repeal bill before coming up with a replacement package, voted against the budget resolution and California Sen. Dianne Feinstein was absent.
Senators were bleary-eyed as they walked quickly to the exits, wrapping up the final vote a little before 1:30 a.m. ET.
Vermont Sen. Bernie Sanders, the top Democrat who led the late-night fight against a repeal, said the protest could be a sign of things to come as the fight stretches on.
"I think it's important for this country to know this was not a usual thing, this is a day which lays the groundwork for 30 million people to be thrown off their health insurance," Sanders said. "And if that happens, many of these people will die."
"We wanted to say no matter how late, we're going to stay and fight and represent our constituents -- there are so many constituencies who will be hurt by this repeal without a replace," said New York Sen. Chuck Schumer.
Democratic senators registered a somewhat subtle, but significant protest in the Senate as they cast their votes -- declaring why they were voting against the repeal, a rare move that rankled Republicans in the chamber.
The House is expected take a swift vote on the resolution, possibly as early as Friday, which will trigger congressional committees to begin crafting a second bill that would roll back major parts of Obamacare. Though it will be weeks before Congress votes on that bill, Thursday still marked a victory for the Republican Party as it moves toward overhauling the country's healthcare system.
President-elect Donald Trump congratulated the Senate for its actions Thursday.
"Congrats to the Senate for taking the first step to #RepealObamacare- now it's onto the House!" he tweeted.
"Vote-a-rama"
Before Thursday's vote, a political spectacle known as "vote-a-rama" unfolded on the Senate floor.
The largely symbolic exercise -- which began Wednesday evening and stretched into wee hours of Thursday -- was ripe for theater. However, the tone was largely subdued, missing some of the fire of voting marathons in previous years.
Democrats still used the late-night drill to publicly defend the Affordable Care Act and chastise their colleagues across the aisle for starting the process of overhauling a law that gives health insurance to some 20 million Americans. Republicans, meanwhile, stressed the harmful impact of the law and the urgent need to do away with it.
Senators introduced more than 160 amendments to the budget resolution, which led to a marathon session of impassioned speeches and roll call votes. Although these votes were non-binding and the budget resolution doesn't require the president's signature, the process helped crystallize the Democratic Party's top priorities as it looks to defend the major pillars of Obamacare.
The most important amendments for Democrats were aimed at preserving what they argue are popular provisions of Obamacare.
Democratic Sen. Tammy Baldwin of Wisconsin pressed a measure to allow young adults to stay on their parents insurance until age 26. "It will block Republican efforts that would weaken dependent coverage," Baldwin said in a brief but forceful floor speech before the vote.
But Republicans -- many of whom have expressed interest in maintaining the provision when they eventually replace Obamacare -- nevertheless blocked the Baldwin amendment, arguing it wasn't applicable to the underlying budget resolution.
Democrats also sought to protect measures dealing with pre-existing conditions and reproductive healthcare services for women.
Divided but some common ground
At times, the evening also showed that Republicans and Democrats share some common goals -- even if the two political parties are bitterly divided on the merits of Obamacare.
Earlier in the night, West Virginia Sen. Joe Manchin, a moderate Democrat who has called on Republicans to work in a bipartisan fashion on repealing and replacing Obamacare, emphasized the importance of preserving coverage for patients in rural areas.
No matter what happens to Obamacare, Manchin said: "We are going to make sure that we protect our rural hospitals and rural clinics."
But on the same topic, Republican Sen. John Barrasso of Wyoming argued that it was because of Obamacare that rural hospitals have shuttered.
Trump's nominees and their confirmation hearings
Vice President Mike Pence, right, administers the oath of office to Dan Coats, the new director of national intelligence, on Thursday, March 16. Coats was accompanied by his wife, Marsha. He was confirmed by the Senate the day before.
Coats speaks on Capitol Hill before his confirmation hearing in February.
The former US senator from Indiana was the US ambassador to Germany in the first term of George W. Bush's administration.
New Energy Secretary Rick Perry speaks at his swearing-in ceremony in Washington on Thursday, March 2. The former Texas governor
was confirmed by a Senate vote of 62-37.
Perry is sworn in before his confirmation hearing in January.
During his testimony, Perry cast himself as an advocate for a range of energy sources, noting that he presided over the nation's leading energy-producing state. He also said he regrets once calling for the Energy Department's elimination.
Ben Carson is joined by his wife, Candy, and his granddaughter Tesora as he is sworn in as the secretary of housing and urban development on March 2. The renowned neurosurgeon and former presidential candidate
was confirmed by a vote of 58-41.
Carson greets Tesora prior to testifying before the Senate Committee of Banking, Housing and Urban Affairs in January.
In his opening statement, he noted that he was raised by a single mother who had a "third-grade education" and made the case that he understands the issues facing the millions of people who rely on HUD programs.
New Interior Secretary Ryan Zinke signs an official document after he was
confirmed by the Senate on Wednesday, March 1. The former congressman from Montana was joined by his wife, Lolita, as well as Vice President Mike Pence, US Sen. Steve Daines and Montana Attorney General Tim Fox.
Zinke, a former Navy SEAL, is sworn in before
his confirmation hearing in January. He pledged to review Obama administration actions that limit oil and gas drilling in Alaska, and he said he does not believe climate change is a hoax.
Pence swears in new Commerce Secretary Wilbur Ross as Ross' wife, Hilary, stands by on Tuesday, February 28. The billionaire
was confirmed by the Senate by a vote of 72-27.
Ross, center, waits to be introduced by US Sen. Marco Rubio, right, at his confirmation hearing in January. At the hearing, Ross said he wants countries that resort to "malicious" trading tactics to be "severely" punished. He
pointed the finger at China, which he called "the most protectionist country of very large countries."
Supreme Court justice Samuel Alito swears in Scott Pruitt as the new administrator of the Environmental Protection Agency on Friday, February 17. Holding the Bible is Pruitt's wife, Marlyn, and they were joined by their son, Cade. Pruitt, the former attorney general of Oklahoma,
was confirmed by the Senate 52-46.
Pruitt testifies at
his confirmation hearing in January. Pruitt said he doesn't believe climate change is a hoax, but he didn't indicate he would take swift action to address environmental issues that may contribute to climate change. He said there is still debate over how to respond.
Pence shakes hands with Mick Mulvaney after swearing him in as the new director of the Office of Management and Budget on Thursday, February 16. Mulvaney's wife, Pam, looks on. Mulvaney had been a congressman since 2011.
Mulvaney testifies before the Senate Budget Committee in January. He
didn't back off his views that entitlement programs need revamping to survive -- and he didn't back away from some of his past statements on the matter. President Donald Trump, during his campaign, pledged not to touch Social Security or Medicare.
McMahon speaks during her confirmation hearing. She stepped down from her WWE duties in 2009 and ran for the Senate in 2010 and 2012.
Pence watches David Shulkin, the new secretary of the Veterans Affairs Department, speak at his swearing-in ceremony on February 14. Shulkin was confirmed by
a unanimous vote in the Senate.
Shulkin speaks at his confirmation hearing. He was
the VA's undersecretary for health, a position in which he oversaw more than 1,700 health care sites across the United States.
Mnuchin arrives for his confirmation hearing in January. Mnuchin, a former Goldman Sachs banker,
faced policy questions about taxes, the debt ceiling and banking regulation.
Pence shakes hands with Health and Human Services Secretary Tom Price -- who was accompanied by his wife, Betty -- after a swearing-in ceremony on Friday, February 10. Price, a former congressman from Georgia,
was confirmed 52-47 in a middle-of-the-night vote along party lines.
Price testifies at his confirmation hearing in January. Price
confronted accusations of investing in companies related to his legislative work in Congress -- and in some cases, repealing financial benefits from those investments. Price firmly denied any wrongdoing and insisted that he has taken steps to avoid any conflicts of interests.
Trump watches as Pence administers the oath of office to Attorney General Jeff Sessions in the White House Oval Office on Thursday, February 9. Sessions, one of Trump's closest advisers and his earliest supporter in the Senate, was confirmed
by a 52-47 vote that was mostly along party lines. He was accompanied to the swearing-in by his wife, Mary.
In his
wide-ranging confirmation hearing, Sessions pledged to recuse himself from all investigations involving Hillary Clinton based on inflammatory comments he made during a "contentious" campaign season. He also defended his views of the Supreme Court's Roe v. Wade ruling on abortion, saying he doesn't agree with it but would respect it.
Pence swears in Education Secretary Betsy DeVos next to her husband, Dick, on Tuesday, February 7. Pence
cast a historic tie-breaking vote to confirm DeVos after the Senate was divided 50-50.
DeVos, a top Republican donor and school-choice activist,
prepares to testify at her confirmation hearing in January. DeVos
stood firm in her long-held beliefs that parents -- not the government -- should be able to choose where to send children to school, pledging to push voucher programs if she was confirmed.
Trump watches as Pence swears in Rex Tillerson as secretary of state on Wednesday, February 1. Tillerson's wife, Renda St. Clair, holds the Bible. Tillerson, a former CEO of ExxonMobil, was
confirmed in the Senate by a vote of 56 to 43.
Elaine Chao, Trump's pick for transportation secretary, signs the affidavit of appointment during her swearing-in ceremony in Washington on Tuesday, January 31. Chao is joined, from left, by Pence; her father, James Chao; and her husband, Senate Majority Leader Mitch McConnell.
Chao testifies at
her confirmation hearing in January. Chao, who was approved by a 93-6 vote, was deputy secretary of transportation under George H.W. Bush and labor secretary under George W. Bush.
South Carolina Gov. Nikki Haley takes the oath of office as she becomes the US Ambassador to the United Nations on Wednesday, January 25. She is joined by US Sen. Marco Rubio and staffer Rebecca Schimsa as she is sworn in by the vice president.
During her confirmation hearing, Haley rapped the UN for its treatment of Israel and indicated that she thinks the US should reconsider its contribution of 22% of the annual budget. "The UN and its specialized agencies have had numerous successes," Haley said. "However, any honest assessment also finds an institution that is often at odds with American national interests and American taxpayers. ... I will take an outsider's look at the institution."
Mike Pompeo is joined by his wife, Susan, as he is sworn in as CIA director on Monday, January 23. Pompeo, who is vacating his seat in the US House, was
confirmed by the Senate in a 66-32 vote.
Pompeo is sworn in at
his confirmation hearing. Along with Russia, Pompeo said other global threats include Iran's growing influence in the Middle East, ISIS' grip over major urban areas, and the conflict in Syria.
Mattis testifies before the Senate Armed Services Committee. He
emerged from his confirmation hearing with broad support after he took a strong posture against Russian President Vladimir Putin and answered tough questions on women and gays in combat.
Retired Marine Gen. John Kelly signs his confirmation letter on January 20. He is joined by his wife, Karen.
Kelly testifies
at his hearing. He was previously the head of US Southern Command, which is responsible for all military activities in South America and Central America.
"For people in small towns -- the closures that we've already experienced, these closures have had a devastating impact," Barrasso said.
Trump has ratcheted up the pressure this week, calling on his party to act as quickly as possible. Perhaps more significantly, Trump is adamant that Republicans vote on repealing and replacing Obamacare more or less at the same time. This is a significant divergence from the party's initial thinking that it would first vote on repeal before considering replacement options.
Trump's plan
In a news conference in Wednesday, Trump told reporters that a plan will be unveiled soon after his nominee for Health and Human Services secretary, Tom Price, is confirmed. A Georgia congressman, Price is an ardent Obamacare critic and has previously introduced detailed legislation to repeal and replace the law.
"We're going to be submitting -- as soon as our secretary's approved, almost simultaneously, shortly thereafter, a plan. It'll be repeal and replace. It will be essentially simultaneously," Trump said. "Probably the same day, could be the same hour."
Trump appeared to be suggesting that the plan would come from his administration, but a transition spokesman told CNN that he couldn't confirm whether that was Trump's intention.
Even as Republicans advanced the plan to roll back Obamacare, plans to replace were still being formulated. To that end, a small group of relatively moderate Republican senators -- including Tennessee Sen. Bob Corker and Alaska Sen. Lisa Murkowski -- initially pushed a change that would give senators until March to develop a plan to replace Obamacare. But the senators dropped that push as it became clear Wednesday that Republican leaders were moving toward replacing Obamacare as they repeal it.
Vice President-elect Mike Pence met with senators at the Capitol Wednesday. As he exited his meeting with Pence, Manchin said that the incoming VP promised a draft replacement for Obamacare would be available in 30-60 days.
Republicans on the Hill do not yet have a plan for replacing Obamacare, and are considering a series of possible legislative paths to replace what they vote to repeal.
It's also not clear that one comprehensive "replacement" bill will ultimately emerge from GOP lawmakers -- in fact, senior leaders are currently weighing the option of incremental replacement bills.
For example, they are exploring whether replacement measures could be inserted into the "repeal" reconciliation bill, which Republicans hope to vote on by late February or March. Leaders are also looking into whether any replacement or healthcare reform measures could be inserted into reauthorization bills that Congress is expected to take up later this year.