WASHINGTON — House Republicans rallied behind their right wing Friday to launch a full-scale assault on President Obama’s health-care initiative, setting up a protracted confrontation with Democrats that risks shutting down the government in just 10 days.

On a vote of 230 to 189, the House approved and sent to the Senate a plan to fund federal agencies past Sept. 30, but also to strip funding from the Affordable Care Act, the president’s most significant legislative achievement.

“We had a victory today for the American people, and frankly, we also had a victory for common sense,” Speaker John Boehner, R-Ohio, said, surrounded by more than 200 cheering lawmakers at a news conference at the Capitol.

“Our message to the United States Senate is real simple: The American people don’t want the government shut down and they don’t want Obamacare.”

Friday’s vote was Step One in the Republican crusade to undermine the health law. Step Two comes next week, when House leaders hope to advance a separate measure that will demand a one-year delay in the law’s implementation in exchange for an agreement to avoid a first-ever default on the nation’s debts sometime next month.

Obama responded with an uncharacteristically angry speech in which he accused Republicans of “trying to mess with me” and “holding the economy hostage.”

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“They’re focused on politics. They’re focused on trying to mess with me. They’re not focused on you,” he told a friendly crowd of about 1,000 autoworkers and their families at a truck manufacturing plant on the outskirts of Kansas City, Mo.

Three times, Obama used the phrase “deadbeat nation” to condemn Republican brinkmanship on the debt limit.

“We are not a deadbeat nation. We don’t run out on our tab,” Obama said. “We’re the world’s bedrock investment. The entire world looks to us to make sure the world economy is stable.”

Sounding exasperated, he urged Congress: “Just do your job.”

Upon his arrival back in Washington, Obama called Boehner and reiterated his refusal to negotiate over the debt limit, a White House official said, speaking on condition of anonymity to discuss the private conversation.

Obama added that “the American people have worked too long and too hard to dig the nation out of the worst economic downturn since the Great Depression and the last thing that they and the nation’s economy needs is another politically motivated, self-inflicted wound,” the official said. Obama also called House Minority Leader Nancy Pelosi, D-Calif.

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Boehner has repeatedly said he wants to avoid a default, as well as a government shutdown. Last month, in a conference call with rank-and-file lawmakers, Boehner counseled against using the government funding bill to provoke a showdown over the health law.

But this week, Boehner bowed to pressure from about 40 House conservatives who signed onto an effort to block the law’s implementation on Oct. 1. That effort has been led by Sens. Ted Cruz, R-Texas, and Mike Lee, R-Utah, as well as vocal outside groups such as Heritage Action for America and the Club for Growth.

On Friday, instead of offering a simple bill to keep the government open through Dec. 15 and maintain the spending cuts known as the sequester, Boehner threw the full weight of House leadership behind the cause against the Affordable Care Act.

“This place is a mess,” Pelosi said before the vote. “If the idea is to limit government, let’s work together to do that. But what is brought to the floor today is without a doubt a measure designed to shut down government.”

Two Democrats — Reps. Jim Matheson of Utah and Mike McIntyre of North Carolina — joined 228 Republicans in approving the bill. One Republican voted against it: Rep. Scott Rigell of Virginia, whose Norfolk district has a heavy military presence.

The funding bill now moves to the Senate, where Republicans are relying on Cruz and Lee to continue the fight next week. Cruz infuriated many House Republicans when — after goading them for weeks to risk a shutdown over the health-care law — he acknowledged this week that he lacks the procedural tools to prevent Senate Democrats from stripping those provisions out of the bill and sending it back to the House.

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Cruz tried to make amends, vowing “to do everything necessary and anything possible to defund Obamacare,” including staging a filibuster. But Senate Majority Leader Harry Reid, D-Nev., can arrange the debate so that Cruz would be forced to filibuster the entire House bill, including the provisions to defund the health-care law. Those would come out later, just before final passage, when a filibuster was no longer possible and Reid could move to win approval of the funding solely with Democratic votes.

“Republicans are simply postponing for a few days the inevitable choice they must face: pass a clean bill to fund the government or force a shutdown,” Reid said in a statement. “The Affordable Care Act has been the law of the land for three years. Democrats stand ready to work with reasonable people who want to improve it, but Republican attempts to take an entire law hostage simply to appease the tea party anarchists are outrageous, irresponsible and futile.”

Depending on how long Cruz and his allies hold up the bill, Senate Democrats say they may be unable to send it back to the House until Sept. 29, leaving Boehner barely 24 hours to avoid a shutdown. Some House Republicans said that at that point, they would be ready to give in.

If the Senate bill is “clean” and doesn’t try to increase spending, “then I would lean yes,” said Rep. Steve Womack, R-Ark.

Others refused to acknowledge the possibility that Cruz and his allies might fail.

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