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Lazaro Gamio / Axios

We still don't know — no one knows — how the Senate's health care process is likely to end. But it's now well under way. And as the lopsided defeat of the Senate repeal-and-replace plan last night showed, there could be plenty of surprises ahead.

Here's where things stand as we barrel toward some kind of conclusion tomorrow night.

  • The Senate last night voted down a modified version of Republicans' larger repeal-and-replace bill, the Better Care Reconciliation Act. But BCRA is not necessarily dead. Last night's version included provisions that haven't been scored or reviewed by the parliamentarian.
  • Another, simpler version — like the most recent one scored by the Congressional Budget Office — could still come up later in the process, a senior GOP aide told us.
  • Technically, last night's vote was procedural, but it's extremely reasonable to take that vote as a proxy for the policy itself.
  • The next vote, scheduled for early this afternoon, will be on the updated version of the 2015 repeal-only bill. That, too, is expected to fail.
  • All signs point to a vote-a-rama Thursday night, perhaps into Friday morning.

The hot new thing: "Skinny repeal." If neither BCRA nor straight repeal looks to be gaining any traction, the next option in the rotation appears to be a bill that would repeal small parts of the ACA — like the individual mandate and a tax or two.

  • The goal here wouldn't necessarily be to settle for that outcome, but to pass something that would trigger a conference committee with the House. Normally designed as a way to hammer out specific differences in House and Senate bills, a conference here would function more like another opportunity to write another bill — albeit under many of the same restrictions.
  • House Republicans aren't sure yet how they feel about this option. They're waiting to see what — if anything — the Senate actually sends them. But anything that keeps the process alive would be a good thing, a senior House GOP aide told Axios' Caitlin Owens.

Go deeper

Schumer's m(aj)ority checklist

Senate Minority Leader Chuck Schumer. Photo: Tasos Katopodis/Getty Images

Capitalizing on the Georgia runoffs, achieving a 50-50 Senate and launching an impeachment trial are weighty to-dos for getting Joe Biden's administration up and running on Day One.

What to watch: A blend of ceremonies, hearings and legal timelines will come into play on Tuesday and Wednesday so Chuck Schumer can actually claim the Senate majority and propel the new president's agenda.

The dark new reality in Congress

National Guard troops keep watch at security fencing. Photo: Kent Nishimura/Los Angeles Times via Getty Images

This is how bad things are for elected officials and others working in a post-insurrection Congress:

  • Rep. Norma Torres (D-Calif.) said she had a panic attack while grocery shopping back home.
  • Rep. Jim McGovern (D-Mass.) said police may also have to be at his constituent meetings.
  • Rep. Adam Kinzinger (R-Ill.) told a podcaster he brought a gun to his office on Capitol Hill on Jan. 6 because he anticipated trouble with the proceedings that day.
Off the Rails

Episode 3: Descent into madness ... Trump: "Sometimes you need a little crazy"

Photo illustration: Sarah Grillo/Axios. Photos: Tom Williams/CQ-Roll Call, Chip Somodevilla/Getty Images

Beginning on election night 2020 and continuing through his final days in office, Donald Trump unraveled and dragged America with him, to the point that his followers sacked the U.S. Capitol with two weeks left in his term. This Axios series takes you inside the collapse of a president.

Episode 3: The conspiracy goes too far. Trump's outside lawyers plot to seize voting machines and spin theories about communists, spies and computer software.

President Trump was sitting in the Oval Office one day in late November when a call came in from lawyer Sidney Powell. "Ugh, Sidney," he told the staff in the room before he picked up. "She's getting a little crazy, isn't she? She's really gotta tone it down. No one believes this stuff. It's just too much."

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