On January 12, after a late night "vote-a-rama", the Senate narrowly passed a budget resolution that includes reconciliation instructions that would repeal key portions of the Affordable Care Act (ACA). (See WICs article, "Senate to Consider Budget Reconciliation that Would Start ACA Repeal Process, January 8, 2017.) Senate Democrats pushed against the vote, railing vocally against the Republican action that clears the way for a repeal of the ACA. Only one Republican broke ranks to vote against the bill, Senator Rand Paul (R-KY), saying that Republican leaders need to commit to a plan to replace the ACA after it is repealed. The House is likely to take up the measure on Friday. Speaker of the House Paul Ryan (R-WI) has said that his intention is to pass a replacement bill quickly, but others on the Hill have said that it could take years to bring a replacement bill to fruition. President-elect Donald Trump said in a press conference yesterday that the repeal of the bill should include a quick replacement.