Hours after the Senate needed Vice President Mike Pence to break a 50-50 tie to move forward with debate on healthcare, the GOP’s controversial repeal-and-replace plan has come up several votes short of being accepted. Yet this is far from the end for this matter.

The first proper vote, held late Tuesday evening, was on an amendment that is effectively the Better Care Reconciliation Act (BCRA) — the Senate bill that Majority Leader Mitch McConnell introduced earlier this summer, but which has been significantly altered after being criticized by both GOP moderates and hardline conservatives.

Because the Senate Parliamentarian ruled that the BCRA does not meet the standard for budget resolutions — which only require a simple majority to pass — and because the Congressional Budget Office had not yet analyzed the possible long-term effects of some newer tweaks to the bill, supporters of this legislation would have needed 60 votes for the BCRA to survive in its current form.

The 60-vote requirement effectively doomed the vote from the start, as Republicans only control 52 seats in the Senate, and no Democrats have shown any sign of defecting. Nine Republicans did break rank with their party to vote against the amendment, resulting in 57 votes against passage of the amendment. That disparity also means the bill would have failed under the relaxed 51-vote threshold for budget resolutions.

The nine GOP senators who voted against the amendment include the four lawmakers who had previously come out against the BCRA — Susan Collins (ME), Lisa Murkowski (AK), Jerry Moran (KS), and Mike Lee (UT). They were joined by Sens. Rand Paul (KY), Bob Corker (TN), Tom Cotton (AR), Lindsey Graham (SC), and Dean Heller (NV).

The Senate then adjourned for the evening, planning to continue debate Wednesday morning. Lawmakers are expected to take up several proposals and amendments in the coming days, with the expectation that by the end of the week they will have finally drafted legislation that somehow pleases hardline conservatives — who want to see deep cuts to programs like Medicaid and repeal of taxes associated with the Affordable Care Act — and moderate Republicans, who are concerned that slashing these programs will lead large numbers of their constituents without access to affordable, quality insurance and healthcare.

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