"We want to do this at the same time, and in some cases in the same bill," Ryan said during a town hall in Washington sponsored by CNN and moderated by Jake Tapper. "So we want to advance repealing this law with its replacement at the same time."
Ryan said Republicans are moving "as quickly as they can" to repeal and replace the Affordable Care Act, but said he doesn't yet have a date, and it will take "a little bit of time" to do so.
"We're working on this as fast as possible," he said, adding that the GOP will act "definitely within these first 100 days" of Trump's presidency.
At the outset of the town hall, Ryan didn't say that the government has an obligation to insure every American.
"I clearly think there's a role for the government in health care, no doubt about it," the Wisconsin Republican said.
He added that he supports elements of the health care law -- including that "people with pre-existing conditions, no matter how much money they make," should have access to insurance.
But, he said, "The law is collapsing, and so we've got to rescue people."
Ryan faces a tough balancing act as he leads the House at the outset of Trump's administration. He's attempting to hold together an unruly set of Republicans that includes Trump loyalists who want to see the President-elect's populist policies swiftly enacted, fiscal hawks who fret about the price tag of those policies and moderates still leery of the President-elect. Meanwhile, Democrats appear set to deny the GOP even limited support on any major initiatives.
Ryan, who waited weeks to even endorse Trump after he clinched the GOP nomination, also now knows his party's electoral fate is largely tied to his ability to help Trump succeed. And he remains committed to his own, much more detailed policy platform, years in the making. Ryan had long sought a Republican president to sign his entitlement reforms and budget cuts into law -- but hadn't counted on this Republican president.
'Do you think that I should be deported?'
Ryan was asked point-blank by a woman whose parents brought her to the US as an undocumented immigrant at age 11, and who has remained in the country for 21 years since: "Do you think that I should be deported?"
"I can see that you love your daughter and you're a nice person who has a great future ahead of you, and I hope your future's here," Ryan responded.
Trump has pledged to repeal Obama's executive actions that allowed undocumented immigrants brought into the country as children and their families to remain in the country without fear of deportation.
Ryan said lawmakers are talking with Trump's transition team about those immigrants -- and said Trump's focus is on violent criminals and building a US-Mexico border wall.
"That's the problem he wants to focus on. This is not the focus. And so what we have to do is find a way to ensure that you can get right with the law," he said. "We have to figure out how to fix this, but to do that, people need to have confidence that our laws are being followed, people know who's coming and going and we need to have a secure border."
"What we have to do is figure out how to have a humane solution to this very legitimate, sincere problem, and respect the rule of law," Ryan said.
Tapper asked Ryan if Republicans would seek a law barring the federal government from using information submitted by those allowed to remain in the US through Obama's executive actions to deport those individuals.
Ryan responded that though some fear a deportation force, "it's not happening."
Tapper responded that Trump had actually talked of creating a "deportation force" on the campaign trail.
"I know, I know," Ryan said, laughing. "But I'm here to tell you, in Congress, it's not happening."
He did, however, take a hard line on "sanctuary cities" that don't deport undocumented immigrants.
"Sanctuary cities are a violation of the rule of law, and they are not to be tolerated," he said. "That means if you want federal assistance, you're not going to get it. You've got to enforce the law," Ryan said, referring to cities that adopt such policies.
Ryan took a tough line on Russia, saying the United States must "step up our game" and adopt a "stronger Russia engagement policy, for sure, across the board."
"The fact that a foreign government tried to meddle in another government's election is wrong," Ryan said, calling for stronger sanctions against the country.
He called Russia a "global menace led by a man who is menacing."
"Vladimir Putin does not share our interests," Ryan said. "He frustrates our interests. He violates his neighbors. ... He's not democratic. I really think a lot of the things that he is doing is to try to delegitimize the other democracies so that his illegitimate democracy doesn't look as illegitimate by comparison."
That's a contrast to Trump, who has praised Putin, the Russian president. The President-elect acknowledged at the Wednesday news conference that he thought Russia was responsible for the hack but blamed poor cybersecurity at the Democratic National Committee and said Putin wouldn't take such actions under a Trump administration.
Ryan said he believes intelligence -- including a two-page summary of unverified claims that Russian operatives claim to have compromising personal and financial information about Trump -- that CNN exclusively reported
was presented to Trump and Obama last week -- "has been politicized."
Still, he defended the intelligence community, saying of Trump: "I think he's going to learn that there are a lot of good men and women in the intelligence community who risk their lives to keep us safe."
But, in a nod to Trump's complaints that some news organizations published the uncorroborated details, Ryan said: "I completely understand why he's frustrated that eight, nine days before his inauguration, this junk gets thrown out there."
CNN has not published or aired any of the uncorroborated details from the memo.
The speaker was pressed at the town hall on the GOP's push to block Planned Parenthood from receiving federal health care dollars for services provided to women because the organization provides abortions -- even though abortions are not covered by taxpayer dollars.
"We don't want to commit taxpayer funding for abortion, and Planned Parenthood is the largest abortion provider," he said.
Tapper pressed Ryan, noting that existing law blocks taxpayer dollars from funding abortions. But, Ryan argued, "money's fungible, and it effectively floats these organizations."
He said Republicans would rather shift those dollars -- and redirect Planned Parenthood's patients using those dollars -- to federal community health centers.
"You don't have these controversies by funding health centers," he said.
The vast majority of federal money that Planned Parenthood does receive funds preventive health care, birth control, pregnancy tests, and other women's health care services.
Trump on Twitter
Ryan said he doesn't expect Trump to get off Twitter when he moves into the White House -- and he doesn't know how the President-elect's social media use will affect foreign and domestic policy.
"I think he's going to keep doing this, and I think he's going to be probably a little more restrained in his tweets probably, but it's all relative," Ryan said. "But I do believe it's been extremely effective for getting elected president, I've got to tell you. He was able to touch and tap into people's hearts and minds."
Ryan joked about his own viral sensation -- when a congressman's son left the Wisconsin Republican confused
with his Cam Newton-style move in a photo with the speaker.
"I actually do know what a dab is," he said to laughter. But, he said, the young man was dabbing incorrectly. "I thought he was sneezing."