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The Senate returns to Washington on Monday with its GOP leaders determined to vote this week on their years-long quest to demolish the Affordable Care Act, even though the goal remains mired in political and substantive uncertainties. Central questions include whether enough Senate Republicans will converge on any version of their leaders’ health-care plan and whether significant aspects of the legislation being considered can fit within arcane parliamentary rules. (Goldstein, 7/23)

The Senate will move forward with a key vote this week on a Republican health bill but it's not yet known whether the legislation will seek to replace President Barack Obama's health care law or simply repeal it. Sen. John Thune of South Dakota, the third-ranking Republican, said Senate Majority Leader Mitch McConnell will make a decision soon on which bill to bring up for a vote, depending on ongoing discussions with GOP senators. (7/24)

Some senators said Majority Leader Mitch McConnell (R., Ky.) has told them they would know before the vote whether they would be asked to allow debate on some version of a bill to repeal and replace the Affordable Care Act, or legislation that would repeal the ACA with a two-year expiration date. GOP leaders’ current strategy is to lean heavily on lawmakers to at least vote to allow debate on the bill, in the hopes that amendments and other tweaks could yield an agreement. (Andrews, Armour and Peterson, 7/23)

The two leading options are a repeal-only bill or an updated version of the Senate’s repeal-and-replacement measure. But there has not been a breakthrough on either, despite senators holding a late-night meeting on Wednesday to try to revive the replacement bill. (Sullivan, 7/21)

The uncertainty so close to a major vote is feeding a growing sense of chaos on Capitol Hill, where GOP senators are openly fretting about the lack of information about legislation that could leave anywhere from 22 million to 32 million more Americans without health insurance. "I don’t even know what we’re proceeding to next week," said Maine Sen. Susan Collins, a centrist Republican who has called on her party’s leaders to take a more measured approach to fixing the current healthcare law. (Levey, 7/21)

Almost all Republicans still say they want to get to "yes." But that path has remained stubbornly elusive, as the GOP confronts estimates that its bill will leave millions more Americans without health insurance. (Litvan and Dennis, 7/21)

Talking is no longer working. It's time to vote. Senate Majority Leader Mitch McConnell is taking the rare step of forcing his members to take a tough vote on an Obamacare repeal bill, H.R. 1628 (115), that is on track to fail, making them own their votes. (Haberkorn and Kim, 7/21)

The day-to-day uncertainty over the Republican health care effort is causing angst among the supporters of the next high-priority health policy item on the Senate’s agenda: a bill to renew crucial Food and Drug Administration funding authorizations before they expire in September. The bill would give the FDA the ability to collect about $1.4 billion in fees from the prescription drug and medical device industries, money which pays the salaries of employees who review product applications. If the fee collection authority is not renewed before Sept. 30, those employees could be furloughed. In the meantime, the FDA would start making plans for reducing staff and would begin notifying affected employees. (Siddons, 7/21)