Senate Democrats hope health care will help them take back control of the Senate in 2020, after it played a major role in Democratic victories across the country in last year. They saw today's vote as an opportunity to highlight their support for the health law’s patient protections and to force Republicans up for reelection to take a difficult vote.

“I’ve been listening to my Republican colleagues say for years and years that though they don’t love everything about the Affordable Care Act, they want to protect people with preexisting conditions,” Sen. Chris Murphy (D-Conn.) told reporters ahead of the vote. “Well, here’s their chance.”

However, several Democratic senators were absent for the vote, contributing to its wide margin of defeat.

Senate Democrats, led by Mark Warner of Virginia, forced the long-shot bid through a procedural mechanism granting Congress the authority to overturn federal rules through a simple majority vote. Even if the resolution had survived the Senate, the Trump administration could have vetoed it.

Collins, a moderate Republican facing reelection next year, was the lone GOP vote in favor of the resolution. She backed a similar Democratic resolution in 2018 aimed at blocking the administration’s expansion of short-term health plans. That attempt narrowly failed, ending in a 50-50 tie.

Senate Republicans dismissed the vote as a political stunt, accusing Democrats of misrepresenting a policy aimed at providing more flexibility. They claimed the rules are aimed at lowering premiums — not dodging benefit requirements.

“States are trying to take advantage of this provision of the Affordable Care Act that says states may have some flexibility in how they spend the money — as long as, the law also says, you don’t jeopardize preexisting condition [protections] for anybody,” said Sen. Lamar Alexander (R-Tenn.), calling Democrats’ resolution a “scary fairy tale.”

No state has applied yet for permission to exercise the greater leeway on Obamacare the Trump administration outlined a year ago.

Administration officials argue that under their watch, the Obamacare markets have improved. Premiums for key plans sold on HealthCare.gov will drop by 4 percent on average next year, marking the second straight year of declines.

But Democrats have seized on studies showing a recent rise in the uninsured rate, including a report published this week that found 400,000 more children lack coverage than in 2016.

“There are only two choices here,” Sen. Bob Casey (D-Pa.) said. “You stand with families or you stand with the Trump administration.”