WASHINGTON -- Just nine House Republicans dissented from the party line Friday and opposed a budget resolution designed to repeal the Affordable Care Act.

And only one is from New Jersey: Rep. Tom MacArthur.

The resolution passed, 227-198, with every House Democrat voting no. The Senate approved it earlier in the week, 51-48, over unanimous Democratic opposition.

Repealing the health care law without a replacement would cause 194,000 New Jersey residents to lose the coverage they gained under the law's Medicaid expansion, 205,242 residents the tax subsidies they received to help them buy insurance, and 211,881 N.J. seniors the extra help they now have to buy prescription drugs.

"I think we're going too fast," said MacArthur (R-3rd Dist.). "These are real people's lives."

Passing the measure allows the Senate to eventually repeal the health care law by a simple majority, same as the House, rather than requiring a 60-vote threshold. 

"If you proceed in that direction, you're going to kill the Affordable Care Act and, frankly, I don't believe they will replace it," said Rep. Frank Pallone Jr. (D-6th Dist.), the top Democrat on the House Energy and Commerce Committee. "There are enough of these Freedom Caucus-Tea Party types who will not vote for a replacement because they don't want to provide any support."

President-elect Donald Trump said at his press conference Wednesday that he would have an alternative to the Affordable Care Act at the same time the law is repealed. 

"It will be repeal and replace," he said "It will be, essentially, simultaneously."

Without offering specifics, House Republican Conference Chairwoman Cathy McMorris Rodgers (R-Wash.) said after the vote that the future GOP plan would cover everyone now receiving insurance through the Affordable Care Act.

"No one who has coverage because of Obamacare today will lose that coverage the day it's repealed," she said. "We're committed to a smooth and stable transition for those currently receiving care." 

Even so, congressional Republicans have yet to offer a substitute that would come close to covering the more than 20 million Americans whose health coverage would be in jeopardy if the Affordable Care Act went away.

"I want to get this right," MacArthur said. "I'd rather do it slower. I don't want us to start down a repeal path until we know what the replacement will look like."

The Congressional Budget Office and Joint Committee of Taxation said repeal would grow the deficit by $353 billion over 10 years, excluding any revenues from possible increased economic activity.

The deficit would grow because repealing the bill would provide a $7 million tax cut to each of the richest 400 taxpayers, who have an average income of more than $300 million apiece, according to the Center on Budget and Policy Priorities, a Washington research group.

Not everyone would pay lower taxes. By eliminating the tax subsidies used to hold down the cost of buying insurance, 7 million low- and moderate-income families would pay higher taxes, the center said.

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