Washington - President Barack Obama's Republican foes in the US House of Representatives muscled their politically risky budget to passage on Friday, calling it the cure to out-of-control government spending.
In an almost perfect party-line vote, lawmakers voted 235-193 to approve the non-binding blueprint crafted by Republican Representative Paul Ryan and roundly denounced by Obama in a foretaste of the 2012 US elections fight.
"We disagree with their approach," White House spokesperson Jay Carney said after the vote, charging that the Republican plan "places the burden of debt reduction on those who can least afford it" and ends Medicare "as we know it".
"Though our approaches differ, our goal remains the same. Any solution will require Republicans and Democrats working together, and we are committed to that process," Carney said in a statement.
Ryan's budget aims to cut some $4.4 trillion from deficits over the next decade, slash taxes on the richest Americans and corporations, and cut the Medicare and Medicaid health programmes for the elderly, poor, and disabled.
"It's a serious step in the right direction. And I'm really hopeful that the president will take his job as seriously as we're taking ours," Republican House Speaker John Boehner said ahead of the vote.
The measure seemed sure to die in the Democratic-held Senate.
Democrats have pounded away at the Medicare and Medicaid cuts, warning elderly voters who helped Republicans rout them in November elections that enacting the blueprint would destroy the popular health programmes.
"Do you realize that your leadership is asking you to cast a vote today to abolish Medicare as we know it?" Democratic House Minority Leader Nancy Pelosi said in a speech on the House floor.
Ryan's plan aims to limit the potential political damage by keeping benefits intact for people currently 55 years old or over while selling younger voters on the idea that the cuts are the price of saving the popular programmes.
Ryan's plan would privatise the Medicare health programme for older Americans, providing payments directly to private insurance plans, and turn the Medicaid health programme for the poor from a partnership between Washington and the states into block grants from the federal government.
Critics have charged that the Medicare approach is a recipe for cost controls by rationing care, and that the Medicaid plan would starve states of cash if an economic downturn forces more people to seek shelter in that programme.
The two programmes, enacted in 1965, reach nearly 100 million Americans and are critical parts of the fraying US social safety net, burdened by a surge in retirees and swollen by growing ranks of newly poor in the 2008 economic crisis.