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US House Speaker Paul Ryan (Republican of Wisconsin) speaks to reporters after he and other members of the US House Republican Leadership met 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. From left to right: US Vice President-elect Mike Pence, US House Majority Leader Kevin McCarthy (Republican of California), Speaker Ryan, and US House Majority Whip Steve Scalise (Republican of Louisiana). Credit: Ron Sachs / CNP - NO WIRE SERVICE Foto: Ron Sachs/Consolidated News Photos/Ron Sachs - CNP (KEYSTONE/DPA/Ron Sachs)