Few things in politics are as reliable as Rand Paul’s absolutism, but … he’s not entirely wrong here, either. A last-ditch effort to repeal ObamaCare finally emerged two days ago in the Senate, but it suffers from the same problems as other repeal efforts, as far as the Kentucky libertarian is concerned. Paul says the bill would keep 90% of ObamaCare in place:

I can't support a bill that keeps 90% of Obamacare in place. #GrahamCassidy is not repeal or replace, it is more Obamacare Lite

— Senator Rand Paul (@RandPaul) September 15, 2017

But wouldn’t a devolution of ObamaCare to the states, as Graham-Cassidy supposedly accomplishes, still be an improvement over the current status quo? Paul started off the week by predicting it would actually make things worse:

Sen. Rand Paul (R-Ky.) said he can’t support the newest ObamaCare repeal plan a quartet of senators is pushing, highlighting the hurdles the legislation would need to overcome to pass the upper chamber. …

On Monday, Paul told reporters the proposal would “probably” be worse than doing nothing about the health law. Over the summer, Paul was critical of GOP leadership’s repeal-and-replace bill, advocating for a clean repeal of ObamaCare instead.

There are two problems with clean repeal. One, Republicans from Donald Trump down promised a replacement along with a repeal. That by the way includes one Republican named Rand Paul. Second, Paul got the vote he wanted on clean repeal, and lost 45/54. It’s not going to happen, as much as it should happen, and perhaps his time might be better spent trying to work on a compromise.

This … really doesn’t qualify as helpful:

#GrahamCassidy keeps Obamacare and redistributes money from dem states to republican states.

— Senator Rand Paul (@RandPaul) September 15, 2017

Whoa. This tweet isn't merely criticism from the right. It provides fodder to Dems. https://t.co/txSR25nQkn

— Philip Klein (@philipaklein) September 15, 2017

In truth, though, no one was planning on getting Rand Paul’s vote on ObamaCare repeal. The trick will be getting to 50, with or without him. So far, the prospects may not be a slam-dunk, but there is reason for some optimism, Philip Klein and his team reported today:

Going into this week, not many people in Washington gave Republicans a chance of passing healthcare legislation before the end of the month, when reconciliation language allowing them to pass a bill with a simply majority expires. Even President Trump and congressional leaders had seemingly moved on. But now, it looks like the the bill released by Republican Sens. Bill Cassidy of Louisiana., Lindsey Graham of South Carolina, Dean Heller of Nevada and Ron Johnson of Wisconsin has gained some real momentum. While still an uphill climb, there’s now a non-zero chance of something passing. Cassidy said Friday that more senators have told him they support his proposal to overhaul Obamacare, bringing the total to as many as 49 votes.

Whether this is true or a typical lawmaker exaggeration in the midst of boosting his legislation, a spokesman for conservative Sen. Mike Lee told Daily on Healthcare he was “encouraged” by the latest Obamacare bill because it provided flexibility to states to get around several key Obamacare regulations. Though Lee isn’t fully a “yes” yet, he is at least receptive and is working on some tweaks to the language about state regulatory waivers. The spokesman described the tweaks as “technical” in nature, and not substantive changes that could broaden the waivers in such a way that it would be more likely to scare off centrists. Getting Lee on board would be a huge coup for supporters of the bill, because it was the Utah senator’s opposition that helped kill an earlier proposed healthcare compromise.

In order to qualify under reconciliation, the bill needs a CBO score that shows a substantial savings on deficit spending. While Mitch McConnell has apparently taken himself out of management of the effort for the bill, he has asked the CBO to provide a score, and to expedite it:

Senate Majority Leader Mitch McConnell has asked the Congressional Budget Office to quickly score an Obamacare overhaul bill introduced this week, his office confirmed Friday. …

Supporters hope the bill can be passed through the reconciliation, would need just 50 votes to advance and pass in the Senate, assuming a tie-breaking vote by Vice President Pence. Reconciliation is a budget measure that allows passage with a simple majority rather than the 60 votes needed to block a filibuster. The Senate faces a Sept. 30 deadline to use reconciliation, according to the Senate parliamentarian.

To get to 50, Graham-Cassidy will have to keep all but one other Republican from jumping ship. John McCain offered qualified and preliminary support for the bill, and Lee sounds like he’ll provisionally be on board. That leaves Susan Collins and Lisa Murkowski as deciders. Collins at one point had partnered with Bill Cassidy on a state-based plan, so she may well be open to this approach — assuming that the bill doesn’t defund Planned Parenthood, which the two women bragged about protecting with their no votes on earlier repeal-and-replace efforts.

For now, though, don’t expect any real movement until the CBO score comes back. At that point the Senate will have to act quickly to beat the reconciliation clock.