Speaker Paul Ryan Ryan took to the House floor on Friday to promise “a stable transition period so that people don’t have the rug pulled out from under them,” adding that it would be “a thoughtful, step-by-step process.” | John Shinkle/POLITICO House takes major step toward Obamacare repeal The harder work — to actually repeal and replace the law — is still to come.



The House passed a budget Friday that paves the way for repeal of Obamacare — giving GOP leaders a big early win and dealing a huge blow to outgoing President Barack Obama.

It’s one of the final and biggest insults Obama will endure before he turns over the White House to Donald Trump next week. It’s also a sign that Trump, House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell are, haltingly, getting on the same page as they look to gut the Affordable Care Act in the first 100 days of the new administration. Still, the harder work — to actually repeal and replace the law — is still to come.


The House passed the budget on a near party-line vote, 227-198. The action follows Senate passage of the budget, 51-48, which took place in the early hours of Thursday morning after a contentious seven-hour debate. Now that both chambers have passed the budget, Republicans have at their fingertips a powerful procedural tool known as reconciliation, which shields legislation from Senate filibusters and will allow them to ram through repeal with simple majorities.

Republicans have had a somewhat rocky start to their drive to repeal the health law, amid uncertainty over when and how to try to replace it. Democrats have repeatedly slammed the GOP for threatening to unleash chaos on the $3 trillion health system and strip 20 million Americans of health insurance.

“Show us the beef, show us the alternative,” demanded House Minority Whip Steny Hoyer (D-Md.).

Moderate and hard-line Republicans alike have worried openly in recent days about moving to gut the law without having a replacement at the ready. But the House GOP conference ultimately came together in the run-up to the vote.

“I don’t think you want to be a Republican and go home and say I voted against the first step in repealing Obamacare, because I wasn’t sure what the last step would be,” said Rep. Tom Cole, a senior Republican from Oklahoma. “I think that’s a pretty weak position, and I think most of our members know that.”

Rep. Mark Walker, chairman of the conservative Republican Study Committee, said he would vote for the budget and predicted strong support from his colleagues.

“If there’s been one promise that Republicans have run on for the last six years, it is that we are going to do our best to repeal Obamacare, and I think that affirms that promise today,” he said. Walker added that the backing of conservative advocacy groups, which have sometimes clashed with leadership, also solidified support.

President-elect Donald Trump may also have steeled the spines of GOP lawmakers through his voluble Twitter presence. “Congrats to the Senate for taking the first step to #RepealObamacare- now it's onto the House!” he tweeted Thursday. On Friday morning, he proclaimed, “The 'Unaffordable' Care Act will soon be history!”

Trump and GOP leaders have sought to ease members’ concerns by promising to handle repeal and replacement of the law almost simultaneously. Ryan took to the floor to promise “a stable transition period so that people don’t have the rug pulled out from under them,” adding that it would be “a thoughtful, step-by-step process.”

Rep. Mike Coffman (R-Colo.) said a retreat for House and Senate Republicans in Philadelphia later this month will be an important milestone for hashing out the details of any Obamacare replacement plan, and he’s urged stakeholders in his state to offer their suggestions in time for repeal.

House takes major step toward Obamacare repeal

Coffman noted that he met with the Colorado Hospital Association in his office Thursday, which expressed fear about sharp reductions in Medicaid spending if the law’s Medicaid expansion is rolled back. The group is preparing a list of concerns and recommendations that he said he’d relay to colleagues at the retreat. He said he was also concerned about upending the insurance industry with sudden moves.

Fully replacing the law won’t be easy. Even if Republicans are able to agree on a plan, they will not be able to use the reconciliation process, which can address only taxing and spending policy, to completely remake the health system. That would require Democratic votes in the Senate to overcome the filibuster’s 60-vote threshold, and finding support among the minority will be difficult.

Kyle Cheney contributed to this report.