The House GOP voted to approve a budget that would result in the repeal of the Affordable Care Act, moving one step closer to the full repeal they have threatened. Democrats in the House, including Leader Nancy Pelosi, condemned the decision, saying: "Republicans are feeding their ideological obsession."

The House of Representatives voted nearly straight down party lines today to approve a budget that would pave the way for the repeal of the Affordable Care Act. Nine Republicans peeled away from the crowd to vote no, while five others abstained. No Democrats voted for the measure, leaving the final vote at 227-198.

Republicans plan to use budget reconciliation to “repeal and replace” the immensely popular health care act. Democratic leader Nancy Pelosi (D-CA) calls their work a plan to “cut and run” instead.

A spokesperson for the Democratic Congressional Campaign Committee, Tyler Law, commented:

House Republicans may claim they have plans for simultaneous replacement, but there is no evidence to support this, and the reality is that their fundamentally dishonest approach will come with a steep political price.

Pelosi gave a pointed speech on the floor of the House ahead of the vote, directly going after Speaker Paul Ryan (R-WI).

Thank you, Mr. Speaker. I thank the gentleman for yielding. So proud of him, his leadership as the ranking member on the budget committee. I’m so sorry that the Speaker left the floor, because I have some very good news for him. Clearly, he does not understand what the Affordable Care Act has brought to our country in terms of expanding benefits, lowering costs, and expanding the access of many more people to the promise of our founders of life, liberty, and the pursuit of happiness. A healthier life and the freedom to pursue their happiness.

I understand why the Speaker may want to concentrate on some mythology that he presented about the Affordable Care Act, because he’s not going to focus on what this bill on this floor does today, the Republican budget. It does not create more good paying jobs or raise wages, it does not invest in infrastructure to rebuild our nation. The Republican plan does not invest in the education of our children or the lifetime learning of working people, it does not help Americans find balance between work and family, it does not reduce the deficit — in fact it increases the deficit — and it does not seek to drain the swamp of secret money from our elections.

Instead, the Republicans are feeding their ideological obsession with repealing the ACA and dismantling the health and economic security of hardworking families. We all know that a budget should be a statement of our values. What is important to us as a nation should be reflected in our budget proposal. I always say, show me your values, show me your budget. Well, you heard me say some of what this budget does not do — as we get further into the next stage of the budget, we will see that what their budget does is just broaden, widen the disparity in income in our country, give tax breaks to the high end, and part of their tax breaks to the high end is to repeal the Affordable Care Act so they can eliminate the tax on those who are helping to fund the Affordable Care Act.

Pelosi went on to repeat her “cut and run” warning, saying, “Republicans talk about how they’re going to repeal and replace. Interesting alliteratively, but not realistic in terms of, for six years, they have had a chance to propose an alternative. We’ve seen nothing. But what we have seen is their ‘cut and run.’ They want to cut benefits and run. They want to cut savings and run. They want to cut access and run. They want to cut Medicare and run, Medicaid and run.”

She then went on to outline the very real harm that Americans will suffer if the repeal succeeds, speaking powerfully about her own experience with health insurance:

Now, much has been said about the fact that more than 20 million people now have access to affordable health care.  This is a wonderful and remarkable thing.  But that is only part of the story.  Every American benefits from this who has access to health care.  Most Americans receive their health benefits in the workplace.  And if you do, you now cannot be discriminated against because of a pre-existing medical condition.  You cannot be discriminated against if you are a woman — no longer is being a woman a pre-existing medical condition, which means you paid more if you are a woman.  No longer can the insurance companies levy lifetime limits, just hold you to lifetime limits for a pre-existing condition that you may have or just even the care you are getting on a new basis.  The list goes on and on.

The list goes on and on, and you know how many people have a pre-existing medical condition?  Over 100 million American families are affected by pre-existing conditions.  If your child is born prematurely — I myself have five children.  Long ago, an insurance company said to me, ‘You are at poor risk because you have five children.’  And I said, ‘I thought that was a sign of my strength.  I didn’t know that you were measuring it as a weakness.’  But any excuse will do. Any excuse will do — would have done, but not with the Affordable Care Act.

Indeed, Republicans seem to be rushing forward without much thought to how repealing the ACA will affect their constituents. They have banned the Congressional Budget Office from studying how much, exactly, a repeal of the ACA will increase the deficit. And they still have yet to offer a replacement plan.

And yet, their ideological parade keeps marching forward, promising to pull the rug out from millions of Americans whose lives have been improved by Obamacare.