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J. Scott Applewhite / AP

The Senate has officially taken up legislation to repeal the Affordable Care Act — overcoming a hurdle Republicans weren't sure they could clear just a few days ago. Fifty Republican senators voted to start the debate, with Vice President Mike Pence breaking the tie.

How it happened: Sens. Susan Collins and Lisa Murkowski, sitting next to each other in the Senate chamber, voted against the motion, along with all 46 Democrats and two Democrat-leaning independents. Protesters in the galleries shouted "Kill the bill! Don't kill us!" and "Shame!"

The big moment: The standing ovation for Sen. John McCain as he walked in to vote for the motion.

One tense moment: Sen. Ron Johnson, another Republican who has expressed concerns, had a long talk on the floor with Senate Majority Leader Mitch McConnell before casting his vote. He voted yes, right after McCain.

What's next: Twenty hours of debate, followed by votes on the Senate's repeal and replacement plan and a 2015 bill that would repeal much of the ACA without replacing it. If both fail, all votes will be to amend the House-passed health care bill, which is the vehicle they're technically starting with.

We can't rule out other versions of repeal, either. Even McCain, in a floor speech with all of the senators listening, made it clear he wants changes in the Senate bill: "I will not vote for the bill as it is today."

The bottom line: No one knows if any of the repeal proposals can pass the Senate — but it will be harder for Senate Republicans to give up and shelve the effort now that they've gotten this far.

Go deeper

Biden embarks on a consequential presidency

Photo illustration: Sarah Grillo/Axios. Photo: Joe Raedle/Getty Images

Donald Trump tried everything to delegitimize the rival who vanquished him. In reality, he's set Joe Biden on course to be a far more consequential U.S. president than he might otherwise have become.

The big picture: President Biden now confronts not just a pandemic, but massive political divisions and an assault on truth — and the aftermath of the assault on the Capitol two weeks ago that threatened democracy itself.

Updated 19 mins ago - Politics & Policy

Inauguration Day dashboard

U.S. Capitol and stage are lit at sunrise ahead of the inauguration of Joe Biden. Photo: Patrick Semansky - Pool/Getty Images

President Biden has delivered his inaugural address at the Capitol, calling for an end to the politics as total war but warning that "we have far to go" to heal the country.

What's next: Representatives from all branches of the military escort the 46th president to the White House.

Inaugural address: Biden vows to be "a president for all Americans"

Moments after taking the oath of office, President Biden sought to soothe a nation riven by political divisions and a global pandemic, while warning that "we have far to go" to heal the country and defeat a "virus that silently stalks the the country."

Why it matters: From the same steps that a pro-Trump mob launched an assault on Congress two weeks earlier, the new president paid deference to the endurance of American political institutions.

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