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House Speaker Mike Johnson, R-La., had Green removed from the chamber during the early moments of Trump's speech Tuesday night. Green stood and shouted at Trump after the Republican president said the Nov. 5 election had delivered a governing mandate not seen for many decades.

"You have no mandate," the Houston lawmaker said, shaking a cane and refusing an order from Johnson to "take your seat, sir!"

Republicans acted quickly to rebuke Green with a censure resolution that officially registers the House's deep disapproval of a member's conduct. Once such a resolution is approved by majority vote, the member is asked to stand in the well of the House while the speaker or presiding officer reads the resolution.

The resolution against Green was approved in a mostly party-line vote of 224-198.

Rep. Dan Newhouse, the resolution's sponsor, said it was a "necessary, but difficult step."

"This resolution is offered in all seriousness, something that I believe we must do in order to get us to the next level of conduct in this hallowed chamber," said Newhouse, R-Wash.

It's the latest fallout of the boisterous behavior that has occurred during more recent presidential addresses to Congress. Outbursts from lawmakers have happened on bothsides of the political aisle.

Rep. Jim McGovern, D-Mass., noted that Republicans were silent when members of their conference interrupted Democratic President Joe Biden's speech last year.

Some yelled "say her name" in reference to nursing student Laken Riley, as Biden spoke about immigration legislation that some lawmakers were working on. Riley was killed while running on the University of Georgia campus by a Venezuelan citizen who illegally entered the United States in 2022 and had been allowed to stay to pursue his immigration case.

"Nobody apologized for interrupting Joe Biden time and again," McGovern said. "You talk about lack of decorum. Go back and look at the tapes, and there was silence from the other side."

The censure resolution says Green's actions were a "breach of proper conduct" during a joint address and that his removal "after numerous disruptions." Democrats tried to table it Wednesday, but that effort failed on a party-line vote.

Johnson tweeted before Thursday's vote that Green "disgraced the institution of Congress and the constituents he serves."

"He deliberately violated House rules, and an expeditious vote of censure is an appropriate remedy," Johnson said. "Any Democrat who is concerned about regaining the trust and respect of the American people should join House Republicans in this effort."

Green, now serving his 11th term, offered no regrets Wednesday when he explained his actions. Before speaking in his own defense from the House floor, he walked up to the Republican side of the chamber and shook Newhouse's hand. Green said he did not blame Johnson or those who had escorted him out after his outburst.

"Friends, I would do it again," Green said.

He explained his actions by saying Trump had indicated he had won a mandate from voters. But Green said Trump does not have a mandate to cut Medicaid, a program that many of his constituents rely on.

"This is a matter of principle. This is a matter of conscience," Green said. "There are people suffering in this country because they don't have health care."

He concluded his remarks by saying, "on some issues that are matters of conscience, it is better to stand alone than not stand at all."

Trump said last week about the state-federal health care program: "We're not going to touch it."

Some Democratic lawmakers skipped Trump's address. Others walked out during it. With tensions clearly on the rise, House Democratic leader Hakeem Jeffries of New York had told colleagues beforehand that "it is important to have a strong, determined and dignified Democratic presence in the chamber."

"I think Al Green was telling the truth," said Rep. Mark Takano, D-Calif. He was among the dozens of Democrats who held up signs that said "False" and displayed other protest slogans throughout Trump's speech.

Rep. Nancy Pelosi, D-Calif., who was speaker during Trump's first term, recalled her own memorable moment during a Trump address when she ripped his speech up after he handed it to her following his address.

"Everybody has to make their expression of how they see things. I think we should keep our focus on the president's speech," Pelosi said.

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Associated Press writers Matt Brown, Lisa Mascaro and Leah Askarinam contributed to this report.