The stage is now set for a battle over specific provisions in the healthcare legislation passed into law last March now that Senate Democrats turned aside a bid by Republicans to repeal it. The vote was along party lines, with 47 Republicans voting for repeal and 51 voting against it.
GOP leaders, who have pledged to go after the law "piece by piece," have not indicated what part of the overhaul they will target first. With funding for the federal government set to expire in four weeks, the next battleground could be crucial legislation to keep the government operating from March to September.
Short of shutting down the government, Republican leaders are working to peel off enough Democrats in the Senate to pass legislation taking out pillars of the healthcare law, such as the controversial mandate or the funding needed to expand coverage to tens of millions of Americans.
Republicans are also considering proposals to allow states to opt out of parts of the law, as many GOP governors have said they want to do.
The GOP repeal proposal did not win over a single Democrat; 50 Democrats and one independent voted against it. Sens. Mark R. Warner (D-Va.) and Joe Lieberman (I-Conn.) missed the vote. Even Democrats from conservative states who face reelection in 2012 rejected a repeal, though many have said they are interested in modifying the law.
"Who wants to go backward and tell 220,000 Nebraskans they can't have health insurance?" Sen. Ben Nelson (D-Neb.) told reporters in his home state.