The U.S. Senate will start debate on a House bill to repeal and replace the Affordable Care Act after the two U.S. senators from Kansas voted with their fellow Republicans Tuesday to authorize debate on the bill to replace the 2010 health care law.

Vice President Mike Pence delivered the tie-breaking vote after members gridlocked 50-50 on the procedural motion aimed starting debate on legislation that would dismantle the 2010 law championed by President Barack Obama. Two Republican senators voted against the motion.

U.S. Sens. Jerry Moran and Pat Roberts, both Kansas Republicans, stood with Majority Leader Mitch McConnell in a bid to take up the repeal-and-replace approach approved by the House and amend it in the Senate.

Moran had vocally opposed last week a version of a bill replacing the ACA that was being considered in the Senate, which helped temporarily stall work in the Senate. Roberts, however, supported the measure and has promised to vote for GOP vehicles to start the process of taking down the existing health law.

After the Senate bill failed to get enough votes for debate last week, McConnell said in a statement that senators would take up the House version and that the first amendment up for debate would replace the House bill with a full repeal of the ACA. In a statement after his vote Tuesday, Moran said he supported repeal before development of a replacement.

“For years, I have been committed to repealing and replacing Obamacare,” Moran said. ” As I’ve said, I will vote to proceed to and pass a bill that fully repeals Obamacare, puts a two-year expiration date on the damaging law and will allow for the full legislative process I have repeatedly called for – involving all 100 senators – to craft a replacement.”

Moran said the objective would be policy providing greater personal choice, protections for pre-existing conditions, increased access and lower overall costs for Kansans.

President Donald Trump praised senators in a statement following the vote.

“As this vote shows, inaction is not an option, and now the legislative process can move forward as intended to produce a bill that lowers costs and increases options for all Americans,” Trump said.

McConnell and Trump pushed senators Monday to start debate on the health bill. In an appearance with families who have been negatively affected by the ACA, Trump said any senator who voted against the motion would be “telling Americans that you are fine with the Obamacare nightmare.”

Senate Democratic Leader Chuck Schumer, of New York, criticized the approach to repealing the ACA, saying it was an attempt to get the bill into a conference where House and Senate Republicans could make decisions on health care. Schumer urged Senate Republicans to “turn back” and work with Democrats on a health care bill in a floor speech before Tuesday’s vote.

“We know that ACA is not perfect, but we also know what you’ve proposed is much worse,” Schumer said.

John Gibson, chairman of the Kansas Democratic Party, said Moran betrayed hundreds of Kansans who gathered in public forums across the state to caution the senator about how “disastrous it would be for their families if he voted to repeal Obamacare.”

“His decision to vote for a mysterious and reckless plan makes it clear — he has placed the partisan fights of Washington, D.C., over the needs of Kansas families,” Gibson said.

Protesters temporarily disrupted the Senate proceedings on the health care bill. Shouting “Kill the bill” and “shame,” the demonstrators stood in the visitors’ gallery and made their voices heard. They were removed by police.

The Big Tent Coalition — a group of Medicaid recipients, providers and advocates — met at the Kansas State Capitol Tuesday immediately following the vote. Advocates said they were disappointed in Moran’s vote to start debate on the House health care bill, but they hoped that he would vote against cuts to Medicaid.

Rocky Nichols, executive director of the Disability Rights Center of Kansas, said the “North star” advocates want senators to follow is to prevent cuts to Medicaid.

“We want and hope and expect that he will stand by those statements and will protect Medicaid so that there’s no caps, no block grants and none of these devastating cuts,” Nichols said.

At a town hall earlier this month, Moran said he would evaluate health care proposals based on whether they made premiums more affordable, protected those with pre-existing conditions, protected rural health care and paid Medicaid providers adequately without inhibiting job creation or punishing Kansas for not expanding Medicaid under the Affordable Care Act. The previous version of the bill did not live up to those requirements, he said at the town hall. He did not say at the town hall whether he would vote against any health care bill that made cuts to Medicaid.

According to the Alliance for a Healthy Kansas, a pro Medicaid expansion group, Kansas would lose $917 million in Medicaid funding through 2026 under the health care bill that Moran opposed last week. Sheldon Weisgrau, director of the Health Reform Resource Project, said Kansas would have to raise taxes, decrease Medicaid services or make cuts in other parts of the state budget to make up the difference.

“If the Senate bill passes — or really almost of the bills they’re considering pass — Kansans, Kansas health care providers, Kansas schools and the Kansas budget will all feel the pain,” Weisgrau said.

Weisgrau and Nichols both said they were confident Moran would still oppose bills that decrease access or make cuts to Medicaid.

The Congressional Budget Office has projected that both the Senate and House replacement bills would result in an increase in the number of people not covered by health insurance.