The Republican plan backed by President Donald Trump to overhaul the US healthcare system has cleared its first hurdles in Congress, but its chances for passage looked uncertain and top Republicans scrambled to bring disgruntled conservatives aboard.
In the face of opposition by Democrats, healthcare providers and many conservatives, two House of Representatives committees approved the legislation that would undo much of the 2010 Affordable Care Act, popularly known as Obamacare, moving it closer to a vote before the full House.
Despite unified Democratic opposition, the Energy and Commerce Committee voted 31-23 to back the plan after marathon proceedings lasting 27 straight hours. Hours earlier, the tax-writing Ways and Means Committee voted 23-16 before dawn to approve it after working 17 straight hours.
House Speaker Paul Ryan sought to bolster support among conservatives in his own party, Senate Majority Leader Mitch McConnell said fellow Republicans must get in a "governing mode" while Mr Trump denied the bill was in trouble.
"Despite what you hear in the press, healthcare is coming along great. We are talking to many groups and it will end in a beautiful picture!" the Republican President said on Twitter.
While Republicans have been itching for seven years to dismantle Democratic former President Barack Obama's signature domestic policy achievement, the party has failed to coalesce behind the plan unveiled on Monday by House Republican leaders.
Republicans control the White House and both houses of Congress for the first time in a decade, but passage of the legislation was not a foregone conclusion.
Conservative lawmakers and lobbying groups have lambasted it as too similar to Obamacare. They have sharply criticised its proposed tax credits to coax people to buy private insurance on the open market as an unacceptable new government entitlement program and have called for a quicker end to the Obamacare expansion of the Medicaid healthcare program for the poor.
The measure is the first major legislative test for Mr Trump and his fellow Republicans amid questions about whether they can govern effectively after years spent as an opposition party under Mr Obama.