The wild Senate health care debate is hurtling toward an unpredictable finish

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In the next day or so, Senate Republicans are expected to take their first vote in a health care crusade that has consumed Congress for the past six months.

Nobody knows what they’re voting on. Nobody knows if it can pass. Nobody is even sure if the Senate’s plan to repeal and replace Obamacare, as a policy, can even work.

It is a bewildering state of affairs — and health insurance for millions of poor and middle-class Americans hangs in the balance.

Every path forward that Senate Majority Leader Mitch McConnell has floated appears to lack the necessary support of 50 Republicans. Nevertheless, Senate leaders are promising to vote within the next 36 hours, without a workable bill, a final Congressional Budget Office score, or perhaps even the votes to pass anything.

“Mitch McConnell is Doc Brown — ‘Where we’re going, we don’t need roads,’” a Republican health care lobbyist quipped on Monday morning, referencing the cinematic classic Back to the Future.

Confusion and uncertainty are the order of the day. But this, as best as we can tell, is what’s going on.

1) Nobody knows which health care bill the Senate is trying to pass

Senate Republicans currently have two health care bills.

One is the Better Care Reconciliation Act, the repeal-and-replacement plan that Republicans have been discussing and drafting in private for the past two months. That’s the health care bill you’ve been hearing about for most of the Senate debate. That bill would overhaul Medicaid, end Medicaid expansion, scale back assistance for people buying private coverage, and roll back some of Obamacare’s regulations. The result would be, according to the CBO, 22 million fewer Americans with insurance in 2026.