Backers of the American Health Care Act budget measure ran into some Republican resistance today at the House Budget Committee meeting.

Related: White House wooing of GOP holdouts on health plan may backfire

The committee took an upside down approach to reviewing the framework for efforts to de-fund the Affordable Care Act: It started a markup session in Washington by voting on whether to forward the measure to the House Rules Committee for further work.

The committee then voted on proposed amendments. Technically, any amendments approved were non-binding recommendations to the Rules Committee to amend the proposal.

Members voted 19-17 to support the AHCA measure.

All Democrats who participated voted against the measure.

Three Republicans — Mark Sanford of South Carolina, David Brat of Virginia and Gary Palmer of Alabama — crossed party lines to vote against it.

The three Republicans who voted against it are all members of the House Freedom Caucus, a group for Republicans with an interest in limiting the role of the federal government.

The vote could be a sign that the AHCA proposal will face soft Republican support in the Rules Committee and on the House floor. But there were signs the Freedom Caucus might side with AHCA if the measure were about to fail.

When the committee moved on to considering proposed amendments, most of the votes appeared to be entirely, or almost entirely, along party lines.

Rep. John Faso, R-N.Y., said he saw a lack of specifics in Democrats' AHCA effect certification proposals. (Photo: House Budget)

Rep. John Faso, R-N.Y., said he saw a lack of specifics in Democrats’ AHCA effect certification proposals. (Photo: House Budget)

AHCA amendment proposals

Palmer, for example, proposed an amendment that would give states the ability to set work requirements for adult, able-bodied Medicaid enrollees. Committee members backed that amendment 21-13.

Palmer said when he introduced the amendment that the ACA Medicaid expansion program has given states a perverse incentive to favor low-income able-bodied adults over elderly and disabled people, by paying 100 percent of the cost of cover the Medicaid expansion enrollees and a lower share of the cost of covering elderly and disabled people.

The expansion funding formula has pushed 582,000 elderly and disabled people onto Medicaid waiting lists, Palmer said.

“The work requirement would help states focus their limited resources on the truly needed,” Palmer said.

Democrats accused supporters of the work requirement provision of painting an unfair picture of low-income adults, and of trying to impose a requirement that could lead to severe hardship for people who were on Medicaid because they were caring for loved ones.

Democrats proposed a number of amendments, all rejected, that would require the secretary of the U.S. Department of Health and Human Services to certify that AHCA would improve health coverage and health coverage access before the provisions could take effect.

Rep. John Yarmuth, D-Ky., said one introducing one of the HHS certification amendments that the AHCA measure “is not a health care bill.”

“It gives $600 billion in tax cuts for the wealthy paid for in the worst possible way,” Yarmouth said. “It takes life-saving health care from those in need and gives tax cuts to the rich.”

Rep. Michelle Lujan Grisham, D-N.M., later blasted the government, in general, for helping drug makers and health insurers at the expense of ordinary people.

She said health insurance is regulated only by the states.

“It is a negative basket of accountability,” Lujan Grisham said.

Rep. John Faso, R-N.Y., found fault with the first proposed Democratic certification amendment.

“This motion is just an aspirational proposal,” Faso said. “It doesn’t offer any specifics.”

The committee began streaming video of the session live on the web at 10 a.m. Eastern Daylight Time. At press time, the session was still under way. The committee posted the video here.

Related:

Anthem: Subsidy cash key to saving individual health

CBO sees AHCA cutting $337 billion from the deficit

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