WASHINGTON — The House cleared the way on Friday for speedy action to repeal the Affordable Care Act, putting Congress on track to undo the most significant health care law in a half-century.

With a near party-line vote of 227 to 198, the House overcame the opposition of Democrats and the anxieties of some Republicans to approve a budget blueprint that allows Republicans to end major provisions of President Obama’s health care law without the threat of a Democratic filibuster in the Senate.

President-elect Donald J. Trump, Speaker Paul D. Ryan and other Republican leaders now face a much bigger challenge: devising their own plan to ensure broad access to health care and coverage while controlling costs. While their party is far from a consensus on how to replace the health care law — under which more than 20 million Americans have gained health insurance — they will need votes from Democrats in the Senate to enact a robust replacement plan.

Republicans have argued that Americans have been crushed by soaring premiums and other unintended effects of the law, which was adopted without any Republican votes.