The mounting U.S. debt and rising deficits that will continue under a proposed Republican budget blueprint may trigger critical votes in Congress to hold off on repealing the Affordable Care Act.

Such a scenario emerged this week when U.S. Sen. Rand Paul, a Kentucky Republican, said he wouldn’t vote for a budget that increased the federal debt even if it included a repeal of the ACA. Paul is a critical vote among the GOP’s 52-member caucus in the Senate, which needs 51 votes to pass a budget that would conceivably include a repeal of the ACA. Democrats are unified in their opposition to a repeal.

A budget resolution the Senate approved this week without Paul’s support is a blueprint that would lead to another nearly $9 trillion to the federal debt, which already stands at about $20 trillion.

“I won’t vote for a terrible budget just to repeal Obamacare,” GOP Sen. Paul told MSNBC’s Morning Joe program on Wednesday. “If I have to weigh the two problems, I actually think the debt is a more important problem than Obamacare.”

“Everybody’s hot and heavy to vote on this budget because they want to repeal Obamacare, but the budget Republicans are going to introduce will add $8.8 trillion to the debt over the next 10 years,” Paul added.

Getting rid of Obamacare will add more to the debt and deficits. A new report from the bipartisan Committee for a Responsible Federal Budget says that “repealing the ACA in its entirety would cost roughly $350 billion through 2027.”

While many of Obamacare’s problems are focused on rising premiums from private individual coverage offered on exchanges, the law also includes myriad reforms that have slowed the growth of spending, particularly in the Medicare health insurance program for seniors.

The ACA’s Medicare reforms have shifted away from fee-for-service medicine that pays doctors and hospitals no matter how patient care turns out to value-based models that reimburse providers based on outcomes and quality measures. Insurers in the Medicare program like Aetna AET -0.20%, UnitedHealth Group UNH +0.14%, Humana HUM +0.50% and others are rated via a star system created by the ACA that many believe has spurred more competition.

Though Republican Senators this week voted to proceed with the budget blueprint, some of them have said they don’t want to proceed with an Obamacare repeal without having a replacement that would continue to cover more than 20 million Americans who have gained benefits since the law was enacted in 2010.