The US House of Representatives has approved a budget measure that opens the door for a repeal of the Affordable Care Act, also known as Obamacare. Getting rid of the healthcare mandate was one of President-elect Donald Trump’s top campaign promises.

The Republican majority advanced the repeal through Concurrent Resolution 3, a reconciliation measure setting budget levels for fiscal years 2018 through 2026. These measures are immune to filibusters, and require only a regular majority to pass. The final vote was 227 in favor to 198 opposed, with only 9 Republicans breaking ranks.

Republicans are making ground fast in the battle to repeal #Obamacarehttps://t.co/c9mZguz4NQpic.twitter.com/lhuOendgk6 — RT America (@RT_America) January 13, 2017

The bill has already moved through the Senate, which approved it on Thursday in a 51-48 vote. Senator Rand Paul (R-Kentucky) was the only Republican dissenting.

“My colleagues, this experiment has failed. This law is collapsing as we speak,” House Majority Leader Paul Ryan (R-Wisconsin) said on Friday during the debate on the House floor. “This is a rescue mission,” he added.

Democrats have criticized the Republicans’ push to repeal Obamacare, saying they have no plan to replace it, and will be effectively depriving millions of Americans of their health insurance.

If the ACA is repealed, the wealthiest 400 families would receive a tax cut worth an average of $7 million each. https://t.co/D5qeYQdNsC — Bernie Sanders (@SenSanders) January 13, 2017

Ryan said that the Republicans will outline their replacement strategy at a congressional retreat in Philadelphia, a week after the January 20 inauguration.

“Some of these steps will be taken by Congress; some of these steps will be taken by the incoming Trump administration,” Ryan told reporters on Capitol Hill. “This will be a thoughtful, step-by-step process. We’re not going to swap one 2,700-page monstrosity for another.”

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During a CNN-hosted town hall on Thursday, Ryan faced a tough audience – including a Republican who said he was only alive because of Obamacare, as he couldn’t have otherwise afforded insurance after being diagnosed with cancer at the age of 49.

“Because of the Affordable Care Act, I’m standing here today,” said Jeff Jeans of Sedona, Arizona. “I want to thank President Obama from the bottom of my heart because I’d be dead if it weren’t for him.”

The ACA, which was signed into law in March of 2010, is considered the cornerstone of President Barack Obama’s legacy. Under the law, insurance providers cannot deny coverage based on pre-existing conditions. However, Americans are mandated to purchase health insurance or pay a penalty that the US Supreme Court has ruled to be a tax.

Though Obama famously promised that “if you like your doctor, you can keep your doctor,” many Americans saw their existing health plans vanish once the ACA mandate kicked in, or faced a sharp increase in both premiums and out-of-pocket costs.

In October of 2016, the Obama administration announced a spike in premiums – averaging 25 percent across 39 states – that affected those who used the government health exchanges. The number of participating insurers also dropped from 323 in 2016 to 167.