Late Tuesday afternoon, the Senate, with the help of Vice President Mike Pence breaking a 50-50 tie, made the vote that was almost straight down party lines.
Sen. Shelley Moore Capito, R-W.Va., voted in favor of moving forward with the debate.
West Virginia's congressional delegation says the state will get another $42 million in federal flood relief.
Capito tweeted a week ago she would not support a go-for-broke approach "without a replacement plan that addresses my concerns" about devastating cuts to Medicaid funding for her West Virginia, a state with a greater share of its population covered by the program than any other. Joe Manchin, who voted against debating the health care bill. "This funding is welcome news, as it will help us continue recovery efforts, and help many West Virginians rebuild".
In a release, West Virginians for Affordable Health Care said this vote could potentially sever the Medicaid lifeline for hundreds of thousands of West Virginians - more than 180,000 stand to lose coverage.
Although the West Virginia Senator had been critical of the Senate bill in the past, her statement from Tuesday indicated that Capito wants to play ball with her fellow Republicans instead. Medicaid enrollment increased by almost 62 percent from 2013 to 2016, and three in ten people in the state use Medicaid.
The decision to debate the bill, though not unexpected, is a far cry from what some GOP lawmakers have been saying for weeks while McConnell has pushed to repeal the ACA without a replacement. In fact, earlier this week, Capito was still being named alongside Susan Collins of ME and Lisa Murkowski of Alaska as GOP senators who oppose the existing legislation's failures to address Medicaid, Planned Parenthood, and opioid epidemic-related concerns. Republicans have campaigned on repealing the Affordable Care Act, but have been unsuccessful numerous times despite majorities in both chambers of Congress.
West Virginia Center on Budget and Policy Executive Director Ted Boettner said in a release, "This vote shows disregard for the well-being of West Virginians as well as their concerns about affordable and accessible health care, and maintaining Medicaid expansion".
"I don't think we should be repealing", Manchin said. "It's critically important in this state".