Update: The Senate voted down Ryan's bill 40 to 57 Tuesday afternoon. Five Republicans voted against the plan: Lisa Murkowski, Scott Brown, Susan Collins, Olympia Snowe, and Rand Paul. Politico's David Rogers writes that it's a "tell-tale sign of trouble ahead" that there were more moderates voting nay than in a March test vote. And no moderate Democrats defected to vote for the plan, either, though Chuck Schumer didn't vote. The Senate voted on three alternative budgets, and those all failed, too. President Obama's budget, which Democrats argued was outdated, got zero votes.

Rep. Paul Ryan isn't backing away from his plan to overhaul Medicare the day after, even in his estimation, the issue helped swing a special election in a conservative New York district to Democrats. Tuesday night, Ryan posted a second video, complete with sleek infographics, explaining why the program had to be changed. Wednesday morning, he told MSNBC that Democrats were using "Mediscare" tactics, and told the Peterson Foundation Summit that they are "are shamelessly demagoguing and distorting" the Medicare plan by "trying to scare seniors and using this as a political weapon." Republicans have to act now, Ryan said, because "If we wait, if we allow these 'Mediscare' tactics to continue... to inflict paralysis on our system, do you know what happens then? Austerity."

Ryan's Medicare explainer:

Ryan has an unexpected ally in the push to do something now: former President Bill Clinton. ABC News caught the two speaking privately at the Peterson event.

Clinton: I'm glad we won this race in New York, but I hope Democrats don't use it as an excuse to do nothing on Medicare.

Ryan: My guess is it’s going to sink into paralysis, is what’s going to happen.

Clinton: Yeah.

Ryan: And you know the math. It’s just, I mean, we knew we were putting ourselves out there. You gotta start this. You gotta get out there. You gotta get this thing moving.

...

Clinton: If you ever want to talk about it... give me a call

Video of the exchange:

The Senate will vote on Ryan's plan--as well as competing budgets introduced by Sens. Pat Toomey and Rand Paul--on Wednesday afternoon. Ryan's plan was almost certain not to pass because Democrats have a majority, before Republican Senators Olympia Snowe, Susan Collins, and Scott Brown said they won't vote for it. Two other Republican senators--both of whom might hold aspirations for higher office--are strongly backing the plan: Marco Rubio and John Thune. Also suggesting a big margin against: Senate Majority Leader Mitch McConnell is not pushing his colleagues to vote for the bill, even though House Republicans managed to get all but four of their members to vote for it.