With no votes to spare, Vice President Mike Pence used his Constitutional power to cast a tie-breaking vote in the U.S. Senate on Tuesday, allowing Republicans to begin debate on a House-passed GOP bill that would overhaul the Obama health law, as Republicans scrambled to figure out how to cobble together a plan that could be ultimately approved in coming days by the Senate.
The narrow victory was a big win for GOP leaders and the White House, as President Donald Trump had repeatedly pressed Republican Senators in recent days to keep their promise to act on Obamacare - but this was only an initial victory.
In a speech just before the vote, and after a lengthy closed-door meeting of Republicans, Senate Majority Leader Mitch McConnell implored fellow GOP Senators to stick together, arguing they had promised the American people that they would make dramatic changes to Obamacare.
"They didn't send us here just to do the easy stuff, they expect us to tackle the big problems," McConnell said.
"We can't let this moment slip by,"McConnell declared.
Two Republicans voted against the motion to start debate: Sen. Susan Collins (R-ME), and Sen. Lisa Murkowski (R-AK).
A number of other key GOP moderates voted for debate to begin, but did not guarantee they would support a final product.
In the end, the crucial vote was cast by Sen. John McCain (R-AZ), who was just returning to the Capitol for the first time since being diagnosed with brain cancer; also pivotal was Sen. Ron Johnson (R-WI), who held his colleagues in suspense by waiting an extended period of time before casting a vote in favor of beginning debate.
Johnson though has made clear his frustrations with the process, and with the details of the various GOP plans - it still isn't clear how GOP leaders will find a solution that satisfies him, and several other Senators who voted to begin the health care debate.
Johnson and McConnell spoke for an extended period of time on the Senate floor, mainly just the two of them - while other Senators waited to see what Johnson would decide.
Democrats waited until Johnson and McCain had voted to vote; then each Democrat registered their opposition, to reinforce their stance on the GOP effort.
Just before the vote began, demonstrators in the Senate galleries began chanting, "Kill the bill!" and "Shame!" to the Senators below.
The future of the GOP health care effort was immediately plunged into question with remarks immediately after the vote, as McCain scolded both parties, urging bipartisan compromise on health care.
"If this process ends in failure, which seems likely, let's return to regular order," McCain said, sounding a call for hearings, bipartisan negotiations and cooperation, not a repeat of recent health care efforts led by both parties, the Arizona Republican added.
"We are the not the President's subordinates, we are his equal," McCain added, making clear he is not a guaranteed vote for whatever bill the Senate produces in coming days.
From interviews with Senators after the vote, it is obvious that Republicans have no real idea how the GOP can forge a bill that gets 50 votes - plus the Vice President.
"We got the first step, now we've got to get to the hard work and get this across the line," said Sen. David Perdue (R-GA).
Asked what the details of that new plan would be, Perdue said simply, "Don't know yet."
"It will depend on what's in the final bill, which nobody has any idea as to how that's going to end up," said Sen. Johnny Isakson (R-GA).
So, starting debate was difficult - now comes the tougher assignment of putting together a magic formula that can pass the Senate.