Washington: US Senate Republicans have voted in favour of a floor debate on their efforts to re-write healthcare policy, with Vice President Mike Pence breaking the tie.

The Senate on Tuesday decisively rejected a Republican proposal to repeal-and-replace Obamacare as Senator John McCain returned from Arizona to applause from fellow senators to cast a critical vote for Republicans.

The floor debate will on Wednesday morning continue to overhaul the Affordable Care Act, even though there are no guarantees the votes are there to eventually pass the bill.

The vote came as Senate Majority leader Mitch McConnell and President Donald Trump dared their fellow Republicans to block their seven-year campaign promise to repeal and replace Obamacare.

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