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First GOP health care bill fails, with many more votes to come

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The Senate GOP's Affordable Care Act replacement plan did a face plant on Tuesday night, with nine Republicans and all Democrats voting against it. But it was only the first vote of what's sure to be a long process, and its failure wasn't a surprise.

Why this matters: This was the Senate's best attempt at an ACA replacement, after about two and a half months of closed-door meetings attempting to find something that could bridge the caucus' deep divides. Its failure suggests Senate Republicans won't be able to come together on a replacement plan without Democrats in the future, no matter what happens next.

What's next: A vote on a bill that repeals the Affordable Care Act's subsidies, taxes and Medicaid expansion but leaves in place its regulations. It's expected to be tomorrow at noon.

The version of the bill, the Better Care Reconciliation Act, that the Senate voted down tonight included an agreement by Sens. Ted Cruz and Rob Portman that added $100 billion to help low-income people transitioning off of Medicaid, as well as Cruz's proposal to let insurers sell health plans that don't meet ACA requirements as long as they also sell plans that do.

Since neither of these were scored by the Congressional Budget Office, the BCRA amendment needed 60 votes to pass, meaning it was doomed from the start as Democrats were never going to support it.

Republicans who voted against the bill: Mike Lee, Susan Collins, Bob Corker, Lindsey Graham, Rand Paul, Dean Heller, Jerry Moran, Lisa Murkowski, Tom Cotton.