Historically, Republicans have controlled their RINOs by insisting that they vote with the party on critical bills or other votes. The rest of the time there is a tacit understanding that they can vote against, because their votes are not needed.
This is one of those votes where at least some of the RINO votes are needed. There's something badly wrong with the leadership and with party discipline if they can't call in those chips.
Part of the problem lies with Frist and his predecessor, no doubt; but part of the problem also lies with Bush as the de facto head of the party.
For example?