STEVE INSKEEP, HOST:
Well, just before 1:30 this morning, Senate Republicans completed the first step toward repealing the Affordable Care Act. The Senate passed a budget resolution which sets the repeal process in motion. It happened after seven hours of votes on amendments, a ritual senators call the vote-a-rama. NPR's Ailsa Chang reports on the overnight political theater and the substance affecting millions of people lurking somewhere beyond it.
AILSA CHANG, BYLINE: Best guess is the Senate is still several weeks away from repealing the Affordable Care Act. And Democrats went into Wednesday night with a messaging plan - use vote-a-rama to get Republicans on the record about what may come next. Here's how Chris Murphy of Connecticut described the strategy.
CHRIS MURPHY: We're going to figure out what parts of the Affordable Care Act they're going to preserve and what parts they're going to throw out. We're going to use votes tonight to try to divine what this secret replacement plan is.
CHANG: To that, Senate Republicans said whatever.
JOHN MCCAIN: Totally meaningless exercise.
CHANG: Or put another way by Republican John McCain of Arizona.
MCCAIN: Someday, some student of government trying to find the most boring subject ever - they will go back over these votes on vote-a-ramas.
CHANG: What McCain is getting at is this charming Senate tradition, the vote-a-rama, it's a wholly symbolic exercise. Senators are forcing each other to vote on amendments to a nonbinding budget resolution, one after another, for hours and hours. It's political theater, but McCain says he can't remember a single vote-a-rama ever being used against him.
MCCAIN: You can examine people's voting records and run against them. But when it's in a vote-a-rama, which has no impact as far as the lives of any American is concerned, it's ridiculous.
CHANG: But none of that stopped Democrats from making Republicans vote on amendments about Medicaid expansion or funding for rural hospitals or women's access to health care. The other side voted all these down. And Republican Bill Cassidy of Louisiana said he didn't feel one bit uncomfortable.
BILL CASSIDY: It'll be uncomfortable if I have to sleep on a lumpy couch. But I'm a physician who's been on call, and I've slept many times on lumpy couches.
CHANG: But any appearance of Republican unity during vote-a-rama couldn't change the fact that they're nowhere near consensus on how to replace the health care law. President-elect Donald Trump promised in a press conference Wednesday that no repeal would happen without a replacement plan. But Republicans like Susan Collins of Maine say that means repeal can't happen until late February or March.
SUSAN COLLINS: I don't see any possibility of our being able to come up with a comprehensive reform bill that would replace Obamacare by the end of this month.
CHANG: Even so, Democrats know this is a train they cannot stop.
(SOUNDBITE OF GAVEL SOUNDING)
CHANG: As the night drew to a close, all Democrats could do was stage a protest. Senators aren't supposed to give speeches during a vote, but here was Tammy Duckworth of Illinois.
(SOUNDBITE OF ARCHIVED RECORDING)
TAMMY DUCKWORTH: And for all those with pre-existing conditions...
CORY GARDNER: The Senate will be in order. Debate is not allowed during a vote.
DUCKWORTH: ...I stand on prosthetic legs to vote no.
GARDNER: The Senate will be in order.
CHANG: And here was Al Franken of Minnesota.
(SOUNDBITE OF ARCHIVED RECORDING)
AL FRANKEN: I vote no on behalf of the more than 2.3...
GARDNER: Debate is not allowed during a vote.
FRANKEN: ...Million Minnesotans...
GARDNER: Debate is not allowed during a vote. Senate will be order.
FRANKEN: ...Who can no longer be discriminated against...
GARDNER: Senate will be in order, and the clerk will continue the roll.
FRANKEN: ...Because of the ACA.
CHANG: The House expects to take up the budget resolution Friday.
Ailsa Chang, NPR News, the Capitol.
(SOUNDBITE OF BOMBAY DUB ORCHESTRA'S "STRANGE CONSTELLATIONS")