Senate Republicans voted Tuesday to open debate on repealing Obamacare, dramatically reviving an effort that many GOP lawmakers left for dead just a few days ago.

The vote is a huge political win and turnaround for Senate Majority Leader Mitch McConnell and Republicans who’ve promised for seven years to repeal Obamacare if voters gave them control of Congress and the White House.

Sen. John McCain (R-Ariz.), recently diagnosed with brain cancer, entered the chamber to a standing ovation and cast the 50th Republican vote. GOP Sens. Susan Collins of Maine and Lisa Murkowski ofAlaska broke ranks to oppose the measure, forcing Vice President Mike Pence to break a 50-50 tie.

All Democrats opposed the measure. Underscoring the significance of the vote, many senators sat at their desks for the vote.

The vote is no guarantee that the fractured Republican caucuses can coalesce around a single health care plan. Now that debate has officially started, Republicans in the Senate lack 50 votes on a policy. Moderates oppose repealing Obamacare without a replacement, and conservatives don’t like the idea of significantly replacing it.

The leading idea now is to repeal only a small portion of the health law just to get a bill to a conference with the Senate.

After a series of votes on amendments, Republicans would aim to enact a bill repealing three parts of Obamacare: the individual and employer mandates and the medical device tax, according to Republican sources. It could be expanded or altered depending on where the bulk of the conference is.

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