The US House of Representatives on Friday joined the Senate in passing a critical measure that marks the first major step toward repealing outgoing President Barack Obama's landmark but controversial health care reforms.
The House's near party-line vote of 227 to 198 approved a budget blueprint which provides Republicans, who control both chambers of Congress, with a framework for dismantling the Affordable Care Act.
But one week before Republican President-elect Donald Trump takes office, a sense of urgency has swept over Washington about what his party will put forward as a replacement for the law, with Democrats warning of disastrous consequences should Republicans act too hastily.
"This resolution essentially fires the starting pistol... for repealing Obamacare," said Representative Bill Johnson, an Ohio Republican.
"This is a critical first step to deliver relief to Americans struggling under this law," House Speaker Paul Ryan told fellow members, describing as a "rescue mission" the latest effort to unwind Obamacare.
"This experiment has failed," and "we have to step in before things get worse."
The Senate passed the resolution Thursday. It received no Democratic support in either chamber, highlighting the intensely partisan fight that lies ahead.
The resolution provides Republicans with a powerful tool, called reconciliation, which allows repeal legislation to proceed through the 100-member Senate with a simple majority, protected from a Democratic filibuster that requires a 60-vote threshold to overcome.
Trump made repeal of the law a central plank of his insurgent campaign, and he sounded triumphant ahead of the vote.
"The 'Unaffordable' Care Act will soon be history!" he tweeted early Friday.
Days earlier he said the Republicans ought to repeal and replace Obamacare quickly and "simultaneously."
During a Thursday town hall style event Ryan said he was on board, and that he envisioned action on a plan "within the first hundred days."
'Cut' and run?
Unwinding Obamacare will be a monumental task. Republican leadership is moving carefully, stressing it does not want to "pull the rug out from anyone" who might lose coverage if there is no replacement plan on offer.
But there is debate among Republicans about how—and how fast—to proceed.
Charlie Dent, one of nine House Republicans who voted against the resolution, expressed "reservations" about quickly repealing parts of Obamacare without a credible replacement at the ready.
"I think the repeal plan needs to be fully developed and better articulated prior to moving forward," he told CNN.
The White House touts Obamacare as a success, saying more than 20 million Americans have gained health insurance through the law.
The Affordable Care Act forbids insurance companies from denying health care due to pre-existing conditions, abolishes lifetime caps on care, and allows children to stay on their parents' plans until age 26, three provisions that have proved popular nationwide.
Ryan insists the Republican plan that moves forward will include its own versions of such provisions.
Democrats warn that scrapping the law could result in tens of millions of Americans losing coverage.
"They want to cut benefits and run. They want to cut access and run," House minority leader Nancy Pelosi said of Republicans, and accused Ryan of peddling "mythology" about the law.
House Democrat Hakeem Jeffries offered harsher criticism about Republican efforts to swiftly dismantle the reforms, despite not formulating a viable replacement plan in the last six years.
"All you have is smoke and mirrors, and the American people are getting ready to get screwed," Jeffries said on the House floor.
Explore further: US Senate takes first step toward unraveling Obamacare