After a narrow victory for Republicans in the U.S. House, Sen. Ed Markey said he does not see a viable path for Congress to agree on a replacement for the Affordable Care Act, predicting doom for the effort to undo President Barack Obama's signature law.

"There is an ideological hardcore group of Freedom Caucus Republicans who harbor an ancient loathing toward Medicare, Medicaid and the Affordable Care Act, and they will only be satisfied if these programs are destroyed," the Malden Democrat said at an event at the Boston offices of Health Care for All and other advocacy groups. He said, "Nothing will satisfy them less than that full success that they enjoyed last week."

Last Thursday, the U.S. House voted 217-213 to pass the American Health Care Act, which House Speaker Paul Ryan said would offer "more options to choose from, lower costs, and greater control over your coverage."

President Donald Trump and congressional Republicans ran on the promise of repealing and replacing Obamacare, the federal program for linking people to health insurance and providing subsidies that Trump in March said was bound to "explode" and have a "very bad year."

Working out the particulars of replacing the 2010 law has proven sticky for Republicans, and senators have indicated they plan to start fresh rather than working off the draft the House sent them.

"The bill that passed the House of Representatives is dead on arrival in the United States Senate," Markey said. He said, "The Republicans are now looking for a unicorn, something that can make the radical rightwing members of the House of Representatives happy" and will simultaneously please senators whose states have welcomed the federal law, which allows states to expand Medicaid coverage.

Markey said, "It is an impossible thing to do, and my job, and the Massachusetts delegation's job, is to make their job even tougher."

U.S. Senate Majority Leader Mitch McConnell called the House vote an "important step" in the effort to "repeal and replace this failed law."

Dennis Heaphy, a 55-year-old advocate for Disability Advocates Advancing Our Healthcare Rights who has been quadriplegic for more than 30 years and requires help with pretty much every daily task, spoke alongside Markey, telling the crowd that people like him are scared.

"We're scared that our civil rights are being denied," Heaphy said. "We're scared that they're going to take away everything that enables us to participate in society and that we're going to be going back to the pre-Medicaid times when people with disabilities were either locked in institutions or kept in their homes or dying early deaths unnecessarily."

After Thursday's House vote, Trump said that the Affordable Care Act has been a "catastrophe" and insurance companies are "fleeing" from it.

"We're going to get this passed through the Senate. I feel so confident," Trump said at the Rose Garden, according to a transcript. The president said, "This is a great plan. And we had no support from the other party."

The all-Democrat Massachusetts delegation to the U.S. House voted against the bill, and Gov. Charlie Baker spoke out against the legislation, which he said would result in "a massive loss of critical funds."

While Obamacare included provisions that "compromised" the state's own 2006 universal health care access law, a Trumpcare law based on the bill that cleared the U.S. House would force Massachusetts to revisit its tax system, according to Senate President Stanley Rosenberg.

"First, we're going to count on the U.S. Senate to do the right thing and make sure that if a plan moves forward it's rational, reasonable and doesn't gut the budgets and the programs in the various states," Rosenberg told Jon Keller during an interview that aired Sunday morning on WBZ-TV. "But it's a huge hit to Massachusetts because as you remember we had a universal care plan before the federal government did theirs. They made a series of changes which compromised our plan. We had to adapt because it was federal law. So we're just barely holding on . . ."

Estimating health care costs as consuming 42 percent of the state budget, Rosenberg said passage of a federal law based on the U.S. House bill would pit the state's budget-balancing needs against the health care needs of individuals and the "robust" Massachusetts health care system that is an economic anchor.

Baker has estimated a previous version of the U.S. House health care bill could eventually lead to as much as $2 billion less in federal health care aid to Massachusetts. State lawmakers are weighing a surtax on incomes above $1 million to generate $1.6 billion to $2.2 billion a year in new revenues.

Critics have said that people with cancer diagnoses and other pre-existing conditions would be priced out of plans under the House bill. Markey on Monday said there are people in need of expensive medical care all around the country and he diagnosed Republicans who favor the legislation with hard-heartedness.

"For many of these Republicans, if you kicked them in the heart, you would break your toe. They don't care," Markey said. "The only thing they care about is dismantling these programs, taking the money and handing it over as tax breaks to the wealthiest in our country."