By Deirdre Fulton / Common Dreams

Early Thursday, Senate Republicans took the first step toward repealing the Affordable Care Act (ACA), or Obamacare, overcoming a slew of Democratic amendments meant to defend popular parts of the law and setting the stage for tens of millions of Americans to lose their health insurance.

The 51-48 vote, taken around 1 a.m., advances a budget resolution that instructs committees to write legislation stripping the health care law of its funding and spending provisions. It allows Congress to consider repeal legislation through the budget reconciliation process, requiring only a simple majority of 51 votes rather than the 60-vote supermajority required for most major bills and blocking the possibility of a Democratic filibuster.

Sen. Rand Paul of Kentucky was the only Republican to join all Democrats in voting no.

Indeed, The New York Times reports:

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.

One by one, Democrats rose to voice their objections. Senator Maria Cantwell of Washington said that Republicans were “stealing health care from Americans.” Senator Ron Wyden of Oregon said he was voting no “because healthcare should not just be for the healthy and wealthy.”

Watch below:

The Huffington Post notes: “Budget resolutions don’t need presidential signatures, since they are basically internal congressional messages to committees. But they still require approval from both chambers, which means this one still needs a yes vote from the House”—a likely, but not certain, next step that could happen as soon as Friday.

Democrats presented multiple amendments during the late-night “vote-a-rama,” seeking to ensure continued access to coverage for people with pre-existing conditions, prevent any changes to Medicare or Medicaid, and allow young adults to stay on their parents’ health insurance plans until they turn 26. Despite their popularity with the American people, Senate Republicans voted down each of those measures—a disconnect that wasn’t lost on observers inside and outside the chamber.

As Ed Kilgore wrote for New York magazine:

Republican senators are now on record as having rejected opportunities to keep Medicare, Medicaid, and [Children’s Health Insurance Program, or CHIP] off the cutting-room floor; to make it possible to import prescription drugs from Canada; to prevent erosion of women’s health services and support for rural hospitals; and perhaps most tellingly, to protect Medicaid funding for the 32 states that accepted the option of expanding that program under the Affordable Care Act.

The budget resolution instructs House and Senate committees to come up with repeal legislation by January 27, though there is no Obamacare replacement at the ready and despite President-elect Donald Trump saying during his Wednesday press conference that repeal and replacement should happen “essentially simultaneously.”

In fact, Politico calls that goal “technically almost impossible.”

The news outlet explained:

Republican leadership aides were quick to say after Trump’s news conference that they’re all on the same page, even though they had earlier planned for a swift vote on repeal (although delayed until sometime in the future) and then an extended debate over the replacement.

But a quick repeal and replace of Obamacare on the scale the president-elect outlined is complex and arduous—and politically rife for accusations that Republicans are recklessly repealing a law with scant time for debate.

On top of that, Trump indicated that his administration would introduce its own health care plan—which could either speed up the process of coalescing around a bill or drive a wedge between the Hill and the new White House. Trump didn’t spell out what his plan would include.

Sen. Brian Schatz (D-Hawaii) called the Republicans’ action “shocking, reckless, and immoral”:

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