The US House of Representatives has passed a healthcare bill, bringing President Trump's pledge to repeal and replace Obamacare a stride closer.
The American Health Care Act (AHCA) passed with a vote to spare, after weeks of cajoling within the Republican party to muster enough support.
It has been opposed by Democrats and several groups representing patients, doctors and hospitals.
The bill next heads to the Senate, possibly in June.
Republicans needed 216 votes in the House and it passed with 217. No Democrats voted in favour.
Its safe passage through the US lower chamber provides the new president with his first legislative victory, three months into his term.
And it marks a remarkable turnaround after the bill was left for dead in March when Republicans were unable to agree on its provisions.
But the speed at which it has been resuscitated since then, with several amendments aimed at winning over Republican rebels, has provoked criticism.
It is not known how much the revised bill will cost, nor how many people will lose coverage, because the nonpartisan Congressional Budget Office (CBO) has not had time to assess it.
Before the latest revisions, the CBO estimated 14 million more Americans would lose insurance in 2018 alone.
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About 20 million Americans gained healthcare coverage under President Barack Obama's 2010 Affordable Care Act, nicknamed Obamacare.
But Republicans viewed it as an overreach of the federal government and said patients had less choice and higher premiums.
What has been the reaction?
There were shouts of "Shame on you!" from protesters directed at congressmen and women as they left Capitol Hill.
Democratic Minority Leader Nancy Pelosi said: "Very sad. One of the biggest transfers of wealth in the history of our country. Their desire to give a tax break for the rich just trumped everything."
But Republicans were jubilant.
The White House Chief of Staff Reince Priebus said it was a "big win for Americans" and would deliver expanded access and lower costs.
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