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Gage Skidmore / FoterWhen the Senate took the first of many steps in the Obamacare repeal process this week, Sen. Rand Paul (R-Kentucky) was the only Republican to vote in opposition.

But it's important to understand that what happened this week wasn't a straightforward Obamacare repeal vote, and Paul wasn't voting to keep the law in place. He was voting out of objection to the GOP's debt-laden budget plans.

The vote was the first step in a long and convoluted budget process that Republicans are hope to use as a vehicle for repealing major components of the law. That process, known as reconciliation, is complex and convoluted, and it will take weeks if it goes swiftly, but could easily take much longer.

After the Senate adopts a budget resolution, the House must follow with its own. Then the two must come together, either through a conference process or by adopting the same measure. From there committee instructions are drawn up, and the process splits into two tracks again, with relevant House and Senate committees putting together their own reconciliation bills, each of which must be debated in multiple committees and then passed by the full body, and then unified again, likely requiring yet another conference process. Only then can the bill be sent to the president's desk. (A Roll Call infographic helpfully lays out the basics here.)

Ultimately, there's no guarantee that this process will actually end with the repeal of the health law.

So what we saw this week wasn't the main event. If this were a dinner party, it wouldn't be the meal. It wouldn't even be setting the table. It would be more like deciding that perhaps there should be a meal several weeks or months down the road, with no final agreement about what might be on the menu.

Paul's no vote was an objection to the budget itselfwhich adds to the national debt and provides no clear path to budget balancenot to repealing the health care law.

Here's how he explained it:

"As a physician, I cannot wait to repeal Obamacare and replace it with a health care system that relies on freedom to provide quality, comprehensive, and affordable care," Paul said in a statement, reports the Lexinton Herald-Leader. "But putting nearly $10 trillion more in debt on the American people's backs through a budget that never balances is not the way to get there. It is the exact opposite of the change Republicans promised, and I cannot support it, even as a placeholder.Not only are we not cutting spending, but we are also proposing an increase at an exponential pace. There is no reason we cannot repeal Obamacare and pass a balanced budget at the same time."

This isn't the only objection Paul has raised to the GOP's plans this year. He has also been among the most vocal GOP legislators in opposing Republican leadership's "repeal and delay" strategy on Obamacare, which would repeal the law but leave it in place for several years while the GOP worked out a replacement plan. It looks as if Paul is deliberately taking steps to distance himself from the party and its leadership in order to preserve a measure of independence.

Paul isn't the only Republican to trash the GOP's budget plans either.

The House is expected to vote on its own budget resolution today, and Rep. Justin Amash (R-Michigan) says he's voting no because the plan would add far too much to the debt. "By nearly every measure," he wrote last night, the current proposal "is the worst budget I've seen as a congressman."

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Rand Paul, Justin Amash Trash the GOP Majoritys Debt-Ridden ...

Sen. Rand PaulRand PaulFreedom Caucus wants more ObamaCare repeal details before budget vote Overnight Healthcare: GOP leaders defend plan to delay ObamaCare replacement Schumer flubs Dems ObamaCare protest slogan MORE (R-Ky.) said Friday that President-elect Donald TrumpDonald TrumpDeVos confirmation hearing delayed Trump pick Monica Crowley faces more plagiarism accusations: report Sanders, Trump supporter spar over small business regulations MORE agrees with his proposal to repeal and replace ObamaCare at the same time, rather than roll back the law with no plan to move forward.

I just spoke to @realDonaldTrump and he fully supports my plan to replace Obamacare the same day we repeal it. The time to act is now. Paul tweeted.

I just spoke to@realDonaldTrumpand he fully supports my plan to replace Obamacare the same day we repeal it. The time to act is now.

Paul wrote in an op-ed earlier this week that it would be wise to vote on a replacement plan for the Affordable Care Act as the law is repealed.

"If Congress fails to vote on a replacement at the same time as repeal, the repealers risk assuming the blame for the continued unraveling of Obamacare. For mark my words, Obamacare will continue to unravel and wreak havoc for years to come," he wrote.

On Wednesday, Paul said he would vote against a budget resolution that paves the way for lawmakers to repeal ObamaCare because it is not balanced.

The Senate is expected to vote next week on a shell budget resolution that includes guidelines for repealing the Affordable Care Act.

He also told reporters that he would likely ultimately support ObamaCare repeal, even if it does not come with a replacement plan immediately.

Under the GOP repeal guidelines, four committees would have until late January to hand over their repeal proposals.

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Rand Paul: Trump backs plan to repeal and replace ObamaCare ...

Kentucky Sen. Rand Paul is warning Republicans not to repeal Obamacare without voting in a replacement for the health care law on the same day.

I think it's imperative that Republicans do a replacement simultaneous to repeal, Paul said Wednesday on MSNBCs Morning Joe, cautioning that disaster in the form of insurance company bankruptcies and a massive bailout could follow a move to repeal the law without a new one in its place. If they don't, Obamacare continues to unravel.

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Some Republicans, determined to repeal Obamacare quickly now that they have one of their own entering the White House, have advocated repealing the law with a delay period in which they would try to come up with some replacement. If they failed to pass a new law in that time, millions of people who depend on Obamacare for their health insurance could lose their coverage.

Paul, a libertarian-leaning Republican, made clear on Wednesday that he does not agree with his colleagues arguing for a repeal-and-delay strategy.

We need to think through how we do this, and it's a huge mistake for Republicans if they do not vote for replacement on the same day as we vote for repeal, Paul said.

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Rand Paul warns Republicans not to repeal-and-delay Obamacare ...

President-elect Donald Trump may be joining the growing ranks of Republicans in Washington who are getting cold feet aboutplans to rush through a vote to repeal Obamacare without a plan to replace it.

Trump called Sen. Rand Paul (R-Ky.) this weekend to discuss Pauls push to convince the rest of the GOP not to vote later this week on a budget resolution that includes a framework for a vote to repeal the Affordable Care Act without a replacement plan. Paul said he spoke with Trump for approximately 15 minutes Friday and the two agreed on the need for replacement.

The only hitch: Republicans dont have one yet.

He showed willingness and openness and was interested in getting a replacement that could be passed as part of repeal, Paul said. Now, were trying to get a bill out there this week.

Paul said Trump didnt give additional details on what he would like to see in a replacement plan. Republican leaders have insisted in recent weeks that they are working on a plan that will help those who receive coverage through the Affordable Care Act to buy insurance on the private marketplace, but like Trump, few have offered any specifics.

Trump said Monday that he had no concerns about the lack of a plan or growing worries about repeal.

Not even a little bit. Thats going to all work out, Trump said Monday outside of Trump Tower in New York.

House Speaker Paul D. Ryan (R-Wis.) insisted to reporters last week that Republicans do have a plan just not one that is ready to be released this week.

We have plenty of ideas to replace it, Ryan said. Youll see, as the weeks and months unfold, what were talking about replacing it how we can get better choices with lower prices by not having a costly government takeover of health care, which is causing all this problem in the first place.

A growing number of Republicans have raised concerns in recent daysabout aggressively gutting major portions of the health-care law including eliminating penalties for people who do not have insurance and the federal subsidies that help people buy insurance in the coming months. Leaders have said those changes would not go into effect for several years to give committees time to pass a replacement.

Some Republicans, including Paul, have floated bits and pieces of a potential replacement, but there is widespread disagreement over who should be on Medicare and Medicaid and whether it is possible to promise that everyone who is insured under Obamacare will be able to find coverage under a GOP plan.

My view is that replacement should try to get insurance for as many people as possible, Paul said. The administration likes to say that 20 million people are covered now. Well, 85to 90percent of that number got Medicaid. Many were already qualified for Medicaid. So a lot of debate goes into these numbers.

Others,such as Sen. Bill Cassidy (R-La.), have pitched plans that allow states more leeway. His plan would allow individual states to retain exchanges and would include a tax credit to help people buy insurance on the private market. Cassidy said Monday that he wants to move quickly to repeal onerous parts of the health-care law, such asthe requirement for individual health coverage, as long as there is a plan and timeline for completing a replacement.

As long as we have a sense of where were going, Im okay with that, Cassidy said.

The Senate is expected to vote this week on a budget measure that includes instructions for committees to write repeal legislation by the end of the month. But some Republicans are raising concerns that a replacement may never happen if it is delayed.

I think the vast majority of people believe were better off doing both at one time. The question is, can you really make that happen?Sen. Bob Corker (R-Tenn.) said Friday.

But it is far easier for Congress to pass a repeal bill than it is for itto pass any kind of replacement. Republican leaders are relying on special budgetprocedures to repeal Obamacare without the threat of a blockade by Senate Democrats.

Budget legislation can pass the Senate with a majority of 51votes rather than the normal 60 needed for almost everything else. There are 52 Republicans in the Senate, ensuring that a unified GOP can actwithout the help of Democrats.

But passing a replacement is another story. Any new health-care legislation would be subject to normal Senate rules meaning Republicans would need votes from at leasteight Democrats to get the new bill passed.

Were possibly creating a boxed canyon for ourselves by potentially repealing without replacing, Corker said. On the other hand, I realize the difficulties of getting the other way you need 60 votes, right? And I dont see a lot of appetite by Democrats to sit down and try to work some things through.

Democrats have said that they are not interested in helping the GOP dismantle President Obamas health-care law.

Show us what they are going to replace it with, not just one senator, said Senate Minority Leader Charles E. Schumer(D-N.Y.) on Monday. Or they abandon repeal.

Sean Sullivan contributed to this report.

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Rand Paul: Trump open to passing Obamacare replacement ...

The estimate from the Committee for a Responsible Federal Budget includes the repeal's effect on the economy. Video provided by Newsy Newslook

Sen. Rand Paul, R-Ky.(Photo: Pablo Martinez Monsivais, AP)

WASHINGTON Sen. Rand Paul voted Wednesday against the first step in repealing the Affordable Care Act because the underlying budget proposal increases the federal debt over 10 years.

Paul, a Kentucky Republican with a history of casting protest votes, was the only GOP senator opposed. After the 51-48 vote in the Senate, the budget resolution, which includes the mechanisms to start repealing the 2010 health care law in addition to general spending levels for the federal government over the next decade, will be debated for the next week.

Paul announced his opposition earlier in the day on MSNBC.

I wont vote for a terrible budget just to repeal Obamacare, Paul said.

Pauls opposition illustrates that even strong Republican critics of the Affordable Care Act have concerns over how to kill it without doing damage to the health insurance market, consumers and the larger American economy.

The proposed Republican budget a key piece to the repeal effort increases the federal debt by more than $9trillion over 10 years, Paul said.

If I have to weigh the two problems, I actually think the debt is a more important problem than Obamacare, Paul said.

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Paul is so far the lone Republican dissenter in the Senate, but some of his fellow deficit hawks are also protesting the projected debt increase.

Sens. Mike Lee of Utah, Marco Rubio of Florida and Ted Cruz of Texas said they supported the 2017 budget resolution in order to repeal the Affordable Care Act, but they want the spending levels to be revisited in the 2018 budget.

Our votes in favor of the Obamacare Repeal Resolution do not indicate in any way our support for the revenue, and deficit numbers therein, nor for the use of those numbers as the basis for future federal budgets, they wrote to Republican leaders.

Paul is also part of a growing Republican sentiment to have an alternative health insurance plan ready to immediately replace the repealed law.

If they dont, Obamacare continues to unravel and there are many health care experts and analysts predicting bankruptcy for insurance companies and a massive insurance company bailout within six months of repeal, Paul said.

If the Affordable Care Acts mandate for individuals to buy health insurance is repealed, for example, there will not be enough healthy people buying insurance to keep the plans solvent.

It will be a huge mistake for Republicans if we dont vote for a replacement the same day as the repeal, Paul said.

Paul took to the Senate floor Wednesday afternoon to defend his vote and criticize the GOP for taking control of the House, Senate and White House and proposing a budget that doesn't dramatically cut federal spending.

"It's not a popular stand that I take today," Paul said. "The debt threatens the very foundation of our country."

Paul said he plans to introduce his own budget proposal, as in past years, that balances within five years.

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Sen. Rand Paul using Obamacare repeal to protest debt