House members voted 227 to 198 on Friday to advance repeal of the Affordable Care Act in a budget resolution bill.
The vote was expected and largely along party lines, with nine Republicans voting against. It follows a 51 to 48 vote in the Senate on Thursday.
The budget will allow Republicans to pass any repeal and replacement of ACA with a simple majority vote in a procedural tool known as reconciliation.
It now goes to committees, who are taxed with cutting $1 billion in deficit reduction over the next decade. They have until January 27 to draft reconciliation bills to be consideration by the House and Senate.
At a news conference Wednesday, President-elect Donald Trump said a replacement plan for the ACA would happen at the same time, possibly the same day, as repeal.
During House debate on the measure Friday, House Speaker Paul Ryan, R-Wisconsin said, "This is a rescue mission. This is a necessary move."
House Minority Leader Nancy Pelosi, D-California said, "Republicans are feeding their ideological obsession in repealing the ACA."
House Ways and Means Committee Ranking Member Richard Neal, D-Massachusetts, said in a statement, "Despite Republican rhetoric, the facts are clear: this repeal plan would take away health insurance from nearly 30 million men, women, and children in this country. This job-killing proposal would hurt local hospitals and have a devastating economic impact on communities across the country. It would put insurance companies back in control of Americans' healthcare by cutting consumer protections. And it would enable insurers to deny people coverage simply because they have pre-existing conditions like asthma or diabetes."