The vote, which allows the Senate to begin debate on health care reform legislation, was a victory for Trump, who had spent weeks cajoling, strong-arming and warning Republicans to get on board with his effort to overhaul Obamacare.

In recent weeks, several measures have been proposed -- but ultimately collapsed, revealing fissures within the Republican Party on how to reach a goal they have had since the Affordable Care Act was passed in 2010.

But the path forward was no clearer, as the Senate soon after voted down a Republican plan to repeal and replace former president Barack Obama's signature health care reform.

Nine Republicans joined Democrats in rejecting the amendment in the first of several votes expected to repeal Obamacare.

Despite the skepticism of some Republicans over how the effort to dismantle the Affordable Care Act might affect millions of Americans, Trump was thrilled that debate could go ahead.

"This was a big step," he said, calling Obamacare a "disaster for the American people."

McCain, who announced last week he is suffering from brain cancer, cast a critical vote for the measure, leaving senators evenly split and forcing Vice President Mike Pence to break the tie for a 51-50 final count on allowing debate.

All 48 Democrats and independents voted against, along with Republicans Susan Collins and Lisa Murkowski.

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