During his State of the Union Address, President Obama pledged to work with  Republicans  to change some elements of the health care law, such  repealing a provision that the president said placed “an unnecessary bookkeeping burden” on small businesses. But the president made it clear he would not accept any major changes to the law. In the GOP response, House Budget Committee Chairman Paul Ryan, R-Wisc., said his party would work to repeal the law and replace it with more “fiscally responsible, patient-centered reforms.” 

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