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Carolyn Kaster / AP

It ain't over until it's over, and there's still some chatter bouncing around Capitol Hill about last-minute shenanigans or a Hail Mary on the Senate floor. And President Trump is sure to put some serious pressure on the moderates this afternoon when all of the Republican senators lunch with him at the White House.

But unless something dramatic changes, Washington appears to be about done with the repeal-and-replace phase of the debate over the Affordable Care Act. The next phase, though, could be just as hard.

  • The Trump administration — including the president himself as well as the IRS and the Department of Health and Human Services — has some tough decisions to make about whether to torpedo the ACA (and, in the process, people's health care), or suck it up and try to make the law work.
  • Trump clearly prefers the former, but the career staff at HHS and the IRS have been doing this work for years now. It's not realistic to expect everything to grind to a halt.
  • Congress, too, will turn to a smaller-scale but still critically important debate over piecemeal efforts to stabilize states' insurance markets.
  • A handful of GOP senators sincerely want to offer some help — including Sen, Lamar Alexander, the chairman of the HELP Committee, who said yesterday he'll begin holding hearings on the health of the individual market, no matter how the Senate vote shakes out.

In the meantime:

  • The Senate will vote early next week on a procedural motion to begin debate on the health care bill, Majority Leader Mitch McConnell said yesterday.
  • At least three Republicans — Shelley Moore Capito, Susan Collins and Lisa Murkowski — have said they'd oppose the latest vehicle, a 2015 bill that would repeal most of the law but delay the effects of repeal for two years.
  • That means the vote — either on a procedural motion or the proposal itself — would fail even with Sen. John McCain in town.
  • It didn't take long for moderates to back away from the 2015 bill. Even though they voted for it before, it's now pretty clear that the Senate would have a hard time coming up with a replacement plan, even with another two years to think about it.

Flashback: Right after the election, Axios' Caitlin Owens talked to one senior GOP Senate aide who said, re: the 2015 repeal bill: "We're not going to use that package. We're not dumb."

Twitter remembered this quote better than we did, but we followed up on Tuesday to ask the same aide about Senate Republicans deciding to, in fact, vote on the 2015 repeal bill: "Repeal and 2015 are pathologically stupid and it's criminal for Trump and conservatives to put us in that position."

Go deeper

"Atmospheric river" swings Northern California from drought to flood

Satellite view of the bomb cyclone swirling off the coast of the Pacific Northwest and the atmospheric river affecting California on Oct. 24. Photo: CIRA/RAMMB

A series of powerful "atmospheric river" storms are delivering historic amounts of rainfall across parts of drought-stricken California and the Pacific Northwest — triggering widespread power outages and flooding.

Why it matters: The strong atmospheric river, packing large amounts of moisture, is causing Northern California to whiplash from drought to flood.

Updated 3 hours ago - World

Saudi dissident claims MBS said he could get "poison ring" to kill king

Saudi Crown Prince Mohammed bin Salman attending the Saudi Green Initiative Forum, via video link, in Riyadh, Saudi Arabia on Saturday. Photo: Royal Court of Saudi Arabia/Handout/Anadolu Agency via Getty Images

A former senior Saudi intelligence official who worked with the U.S. on counterterrorism alleged to "60 Minutes" in an interview broadcast Sunday that Crown Prince Mohammed bin Salman discussed in 2014 killing the kingdom's then-monarch.

Why it matters: The claim by the exiled Saad al-Jabri, whom Saudi authorities describe as "a discredited former government official," that the crown prince, known as "MBS," allegedly said he could obtain a "ring from Russia" to carry out the attack, is one of several serious but unproven allegations he made on the CBS show.

“You blew it”: GOP activist turns on corporations over vaccine mandates

The chairman of the American Conservative Union said on "Axios on HBO" he accepts "Joe Biden is my president, and I want him to succeed," but predicted Republicans retake the House and Senate in 2022 — with greater than 50% odds Donald Trump runs in 2024.

The big picture: In a joint interview with his wife, Mercedes, Matt Schlapp also refused to share their vaccination status. And he told corporate America "you blew it" by embracing vaccine mandates and liberal social stances that have alienated GOP voters and politicians.