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Senate Republicans took their first major step toward repealing the Affordable Care Act on Thursday, approving a budget blueprint that would allow them to gut the health care law without the threat of a Democratic filibuster. The vote was 51 to 48. During the roll call, Democrats staged a highly unusual protest on the Senate floor to express their dismay and anger at the prospect that millions of Americans could lose health insurance coverage. (Kaplan and Pear, 1/12)

Republicans needed a simple majority of votes to clear the repeal rules, instructing committees to begin drafting repeal legislation, through the upper chamber, with the vote falling largely along party lines. Sen. Rand Paul (R-Ky.) voted against the budget resolution because it didn’t balance, while no Democrat supported the repeal rules. (Carney, 1/12)

The House is slated to vote on the measure on Friday, though some Republicans there have misgivings about setting the repeal effort in motion without a better idea of the replacement plan. Trump oozed confidence at a news conference on Tuesday, promising his incoming administration would soon reveal a plan to both repeal so-called Obamacare and replace it with legislation to "get health care taken care of in this country." (Taylor, 1/12)

The budget resolution, S. Con. Res. 3, sets a Jan. 27 target for writing the first Obamacare replacement bill. A group of five Republicans proposed changing that target to March 3, but they withdrew the amendment late Wednesday after GOP leaders reassured them that there was no practical difference because missing the deadline doesn’t carry a penalty. (Dennis, 1/11)

“The Senate just took an important step toward repealing and replacing Obamacare by passing the resolution that provides the legislative tools necessary to actually repeal this failed law while we move ahead with smarter health-care policies,” Senate Majority Leader Mitch McConnell (R., Kentucky) said in a statement after the resolution passed. (Peterson and Andrews, 1/12)

Democrats said repealing the law will strip millions of Americans of insurance, leave people with pre-existing medical conditions unable to find coverage, and increase the nation's budget deficit by $353 billion over the next 10 years as the tax and fee provisions that pay for Obamacare are gutted. "Ripping apart our health care system — with no plan to replace it — will create chaos," said Sen. Patty Murray of Washington, the senior Democrat on the Health, Education, Labor and Pensions Committee. "If Republicans repeal the Affordable Care Act, it’s women, kids, seniors, patients with serious illnesses, and people with disabilities who will bear the burden." (Kelly, 1/11)

Senate Democrats made a late-night show of resistance against gutting the Affordable Care Act by forcing Republicans to take politically charged votes against protecting Medicare, Medicaid and other health-care programs. The measure narrowly passed without the support of any Democrats. The hours-long act of protest culminated in the early hours of Thursday when Democrats made a dramatic display of rising to speak out against the repeal measure as they cast their votes. The Democrats continued to record their opposition over their objections of Senate Republicans. (Snell and DeBonis, 1/12)

Democrats sought to drive a wedge between Senate Republicans and President-elect Donald Trump by pushing multiple amendments to curb the skyrocketing cost of prescription drugs. ... Democrats also forced Republicans to balk at supporting popular provisions in the health law. Sen. Bob Casey (D-Pa.) offered an amendment to prevent discrimination against people with pre-existing conditions; Sen. Kirsten Gillibrand (D-N.Y.) tried to block “legislation that makes women sick again” by stripping women’s health care services provided under Obamacare. Both proposals went down to defeat, 49-49. (Weyl, 1/12)

Before adoption of the budget blueprint, Sen. Bernie Sanders, I-Vt., the ranking member on the Budget Committee, took a final shot at the budget resolution and Republican efforts to repeal the health care law without a clear replacement. “If they do that, up to 30 million Americans will lose their health care, with many thousands dying as a result. Because you have no health care and you can’t go to a doctor or a hospital, you die," Sanders said. "They have no alternative proposition. They want to kill [the Affordable Care Act], but they have no idea how they’re going to bring forth a substitute proposal.” (Shutt and McCrimmon, 1/11)