(Story updated at 4:09 p.m. ET)
Debate about the pace of repealing and replacing the Affordable Care Act continued Thursday as lawmakers cautioned about moving too quickly while still launching the effort to repeal in the first week of the new session.
It took nearly seven hours of votes and many objections from Democrats, but a budget that could dismantle the ACA as early as next month received the simple majority, 51-48, it needed to pass the Senate.
"We have a responsibility to step in and provide relief from this failing law," House Speaker Paul Ryan, R-Wis., told reporters Thursday. "And we have to do it all at the same time so that everybody sees what we're trying to do."
Ryan said there are no "hard deadlines" for a replacement in tandem with the repeal effort, underscoring the difficulty for Congress despite the president-elect's call to both repeal the law and replace it with legislation to "get health care taken care of in this country."
The House is expected to take up the non-binding legislation on Friday. The bill would be used to strip funding mechanisms from the ACA.
But some Republicans have asked to delay repeal of the ACA until a replacement plan is set to cover the up to 30 million people who received insurance because of ACA provisions or its Medicaid expansion.
President elect Donald Trump Wednesday urged swift action for a concurrent repeal and replacement. On Thursday, he used Twitter to congratulate the Senate.
Trump could choose to push the plan proposed by his HHS Secretary nominee, Tom Price, a Republican surgeon from Georgia, who as a member of the Health Subcommittee of the House Ways and Means Committee, put forward his own replacement plan in the form of the Empowering Patients First Act.
It involves age-adjusted tax credits to help people buy insurance as well as increased reliance on health savings accounts and high-risk pools at the state level. It would allow people to opt out of Medicare, Medicaid or Veterans Affairs benefits and receive the tax credit to buy an individual plan. Critics say the plan would fail to keep pace with inflation and force higher out-of-pocket costs like deductibles and co-payments. The legislation has not been scored by the Congressional Budget Office.
Given his legislative history, Price might also concentrate on state reform efforts that offer state governments more flexibility in determining how to use federal funding to cover Medicaid beneficiaries.
Price has also touted the healthcare plan spearheaded by House Speaker Paul Ryan, which has many of the same elements.
Lawmakers have delayed his confirmation hearing to February instead of the tentative Jan. 18 date. This and cautions from healthcare industry leaders worried about the massive shakeup ACA repeal would cause have led lawmakers from both parties to try to temper the movement.
Republicans plan to get legislation voiding Obama's law and replacing parts of it to Trump by the end of February, House Majority Leader Kevin McCarthy, R-Calif., said Wednesday. Other Republicans have said they expect the process to take longer.
Some GOP senators have discussed a phase-in of three years or longer to give lawmakers more time to replace Obama's overhaul and make sure people now covered by that law can adjust to a new program.
For many elements of a new health care law, Republicans are likely to need 60 votes and Democratic support, and at this point the two parties aren't even talking.
Some more moderate House Republicans were unhappy, too, including Rep. Tom MacArthur, R-N.J., a leader of GOP centrists in the House Tuesday Group. He said he would oppose the budget because there was too little information about the replacement, including whether people receiving expanded Medicaid coverage or health care subsidies under the existing law would be protected.
"We're loading a gun here," MacArthur said. "I want to know where it's pointed before we start the process."
Kentucky Sen. Rand Paul, unhappy that the measure endorsed huge budget deficits, was the sole Republican to vote against it.
Sen. Susan Collins (R-Maine) said she wants at least to see "a detailed framework" of a GOP alternative health care plan before voting on repeal. She said Republicans would risk "people falling through the cracks or causing turmoil in insurance markets" if lawmakers voided Obama's statute without a replacement in hand.
Separately, Sen. Bernie Sanders (I-Vt) has teamed up with top Democratic leaders to organize about 50 rallies this weekend to trumpet support for the law.
The Associated Press contributed to this report.
