Senate Republicans have released several bills in recent weeks in support of their goal of repealing and replacing the Affordable Care Act (“ACA”). This afternoon, the Senate narrowly approved a procedural step that allows the chamber to begin consideration of measures to achieve that goal. Republican Senators Susan Collins of Maine and Lisa Murkowski of Alaska voted with the Democrats against the motion to proceed and Vice President Mike Pence broke the resulting 50-50 tie.

Today’s vote allows debate to move forward on a range of healthcare legislative options. The next step for proponents of the repeal effort is to agree on what, if anything, will replace the ACA. It remains to be seen if any of the legislative proposals (including straight repeal with no immediate proposal to replace) put forward so far will be able to draw enough votes to pass the closely divided Senate. One possibility may be a “skinny repeal” bill limited to repealing the individual mandate, employer mandate, and medical device tax. If passed, this bill could be approved by the House as-is, but would more likely move to conference with the House.