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United States House Speaker Paul Ryan (Republican of Wisconsin) speaks to reporters after meeting with US Vice President-elect Mike Pence on their plans to repeal the Affordable Care Act (ACA) in the US Capitol in Washington, DC on Wednesday, January 4, 2017. Behind Ryan is US House Majority Leader Kevin McCarthy (Republican of California) Credit: Ron Sachs / CNP - NO WIRE SERVICE Foto: Ron Sachs/Consolidated News Photos/Ron Sachs - CNP (KEYSTONE/DPA/Ron Sachs)