Ryan's words mirrored those of President-elect Donald Trump, who insisted at a Wednesday news conference that the law is "imploding as we sit", and who is urging Congress to pass both a repeal of Obamacare and a replacement within weeks.
"We want that fixed", he said. But growth will be a thing of the past if the Medicaid expansion is cut, he said.
Congressional Republicans say they will repeal Obamacare and replace it with a plan that doles out fixed tax credits and unleashes market forces to entice people into health coverage, instead of relying on President Obama's "individual mandate" to force people into the marketplace.
Trump labeled Obamacare "a disaster" during his campaign, but has not provided alternatives for 23 million Americans now benefitting from law. Republicans have voted more than 60 times to repeal the ACA in the last six years.
Democrats have argued that gutting the law that mandates individuals buy health insurance and employers provide it would leave millions uninsured.
Two women hold up signs directed at Donald Trump during a Toronto rally against the Republican candidate's campaign
The question, then, is what does going forward look like?
President Trump has called Obamacare an "incredible economic burden", and claims that it has "tragically but predictably resulted in runaway costs, websites that don't work, greater rationing of care, higher premiums, less competition and fewer choices". Simply put, the law has not solved the problem of skyrocketing medical prices, although it has helped curb the growth in costs. Five states have one insurer, while 13 have just two.
"The people of our state show compassion for their fellow West Virginians, and they don't think it's responsible or compassionate to pull the rug out from people who are insured thanks to the ACA", said Renate Pore, interim executive director of WVAHC, in a release.
Nobody's tried harder than Trump himself, who repeatedly promises cheaper and better coverage without explaining how he'd make that happen.
Donald Trump's pick to be the next federal Health and Human Services secretary, Tom Price, o... In two of the counties in Sean Duffy's 7th District, Vilas county residents enrolled in subsidized private exchanges at almost 2½ times the rate of Wisconsin as a whole, and in Taylor County, a 7th district county that voted 3-to-1 for Donald Trump, health care consumers signed up for the ACA at rates much higher than average in Wisconsin.