Speaker Paul Ryan (R-WI) said on Thursday that House GOP leaders and strategists were closing in on a plan to repeal and partially replace the Affordable Care Act with a series of dramatic changes, including revamping and reducing the Medicaid program for low-income Americans, a refundable tax credit to help consumers cover premium costs, and other changes to encourage competition among insurers and bring down costs.

Ryan and other leaders met this morning with rank-and-file Republicans to outline the contours of an emerging plan for using a special expedited budget process called reconciliation to formally repeal Obamacare – effective at some future date — and replacing portions of the law with the Republicans’ more market-oriented provisions. Tom Price, the new Health and Human Services Secretary, attended a portion of the session.

Although Ryan offered only a few clues as to how House Republicans would rewrite the Obamacare legislation, media reports and some health care lobbyists say it will begin with the complete repeal of federal mandates requiring many businesses to provide health insurance to workers and requiring all uninsured Americans to purchase coverage or pay a penalty.

The measure would eliminate all of the Obamacare taxes on insurers, drug companies, medical device manufacturers and other businesses, as well as on upper-income people. Those taxes are projected to generate more than $1 trillion over the coming decade and were crucial to underwriting the cost of Obamacare’s insurance exchanges and subsidies for lower-income Americans.

Repealing all those taxes is a major point of contention between House and Senate Republicans because many…