After seven years of GOP promises to get rid of Obamacare — and seven months into Donald Trump's presidency — Republican leaders in the Senate set a vote on Tuesday that could keep the process alive or sink it.
The confusing rules, under which GOP lawmakers have chosen to attack the 2010 Affordable Care Act, require the Senate to start with a vote on whether to debate the repeal-and-replace version that narrowly passed the House back in May, said Sen. John Barrasso, an orthopedic surgeon for more than two decades and often a point person on health care in the Senate.
"We're using the budget process, so you have to pick up what passed the House. That's the starting point," Barrasso told CNBC's "Squawk Box" on Tuesday morning. The Wyoming Republican is also chairman of the Senate Republican Policy Committee, the fourth-ranking position in the Senate GOP leadership.
Budget reconciliation allows for passage of a final bill with only 50 votes and a tiebreaker from Vice President Mike Pence.
"Republicans will offer amendments. Democrats will offer amendments. Some to improve the bill; some may want to ... kill the bill. But ultimately, you get the final amended product and then vote up or down on what that final product looks like," he said.
Arizona Sen. John McCain, who was recently diagnosed with an aggressive brain tumor, returns to Washington on Tuesday to give Republicans a crucial vote in support of a motion to proceed.
"I am so delighted that John McCain is coming back," Barrasso said. "You talk about somebody with courage, and with character, and with credibility, I mean that is John McCain."
With only a four-seat majority, Senate Republicans face a razor thin margin of success.
However, Barrasso was hopeful. "I'm confident. I'm committed. We're going to meet today at noon. The vice president will be joining us, and then we will vote after lunch."
Senate Majority Leader Mitch McConnell from Kentucky has failed repeatedly to come up with a bill that can satisfy both conservatives and moderates in his Republican conference.
Two different versions of repeal-and-replace legislation fell short of votes before coming to the Senate floor, leading to a retreat on July 17 to seek passage of a repeal-only bill that cleared Congress when Barack Obama was in office. But the repeal-only effort also died as three GOP senators announced their opposition last week.
The vote on a motion to debate represents a last-ditch effort for Republicans to prevent their own divisions from pushing their health-care ambitions into oblivion — an urgency that could be felt in tweets early Tuesday morning from President Trump, who campaigned on ditching Obamacare.
— The Associated Press contributed to this report.