With one vote on Friday, the Republican-led House launched the latest spending battle in Congress -- one that could bring a government shutdown in less than two weeks.
By a 230-189 tally almost strictly on party lines, the House passed a short-term government spending plan that would eliminate all funding for Obamacare.
The measure now goes to the Democratic-led Senate, which is certain to reject the provision that defunds President Barack Obama's signature legislative achievement of his first term.
Even though House Republicans now have voted 42 times to repeal or otherwise undermine Obamacare, Speaker John Boehner and fellow Republicans held a brief victory rally after Friday's action and challenged the Senate to follow their lead.
"The American people don't want the government shut down, and they don't want Obamacare," the Ohio Republican said to applause and cheers. "The House has listened to the American people. Now it's time for the United States Senate to listen to them as well."
In a display of the raw politics of the battle, House Majority Leader Eric Cantor of Virginia called out Senate Democrats facing re-election next year by name, asking how Sens. Mark Pryor of Arkansas, Mary Landrieu of Louisiana, Mark Begich of Alaska and Kay Hagan of North Carolina will vote on the House proposal.
"It's up to Senate Democrats to follow House Republicans and show some responsibility," Cantor said.
Later Friday, Obama accused conservative Republicans of holding the nation hostage by trying to make passing a federal budget and increasing the debt ceiling contingent on defunding health care reforms.
"You don't have to threaten to blow the whole thing up if you don't get your way," Obama said in a campaign-style speech at a Ford plant in the Kansas City, Missouri area, adding that legislators in Washington were focused on politics and "trying to mess with me," rather than helping the middle class.
In legislative jargon, the House passed a continuing resolution that would keep the government funded for the first 11 weeks of the fiscal year that begins October 1. Without some kind of spending measure by then, parts of the government would have to curtail services or shut down.
Conservatives tie Obamacare to budget talks
The controversy involves the provision demanded by the GOP's conservative wing and agreed to by Boehner that eliminates all funding for the 2010 health care reforms popularly known as Obamacare.
Approval by the House set in motion a Capitol Hill showdown that will continue through October, when the nation's debt ceiling must be increased so the government can pay all its bills.
The two-stage process includes the possible government shutdown at the end of the current fiscal year on September 30 if there is no compromise on a spending resolution, followed by a potentially even more rancorous debate over raising the debt ceiling.
Cantor said Friday the House would consider a one-year debt ceiling measure next week that contains other conservative-backed proposals, expected to include postponing implementation of Obamacare for a year and approving the Keystone oil pipeline from Canada.
Obama, however, rejected playing politics with the debt ceiling, which is the limit for how much the federal government can borrow to pay bills it owes.
"This is not a deadbeat nation. We don't run out on our tab," the president said, calling even the threat of not raising the debt ceiling "the height of irresponsibility."
He also made a point of telling the auto workers that raising the debt ceiling "doesn't cost a dime" and "does not add a penny to our deficits."
"All it says is, you gotta pay for what Congress already said we're spending money on," Obama said, adding that "if you don't do it, we could have another financial crisis."
Tea party conservatives who have pledged to fight implementation of Obamacare consider the current budget debate their last major chance to undermine it, because the brunt of the new system takes effect with the start of fiscal year 2014 on October 1.
They demand a halt to funding all programs from the 2010 Affordable Care Act, and they seem indifferent about forcing a government shutdown if that doesn't happen.
"I will do everything necessary and anything possible to defund Obamacare," Republican Sen. Ted Cruz of Texas said Thursday, threatening a filibuster and "any procedural means necessary."
However, more moderate Republicans in the Democratic-led Senate call the defunding effort a waste of time.
Veteran GOP Sen. John McCain of Arizona told CNN on Thursday that because of the chamber's Democratic majority, "we will not repeal or defund Obamacare" in the Senate "and to think we can is not rational."
In addition, the White House said Thursday that Obama would veto the House spending resolution defunding Obamacare if it reaches his desk.