The Republican-led House fulfilled a GOP campaign promise Wednesday by voting 245-189 to repeal the year-old health care law, a symbolic gesture unlikely to affect the current law or its benefits, but one that will set off a battle over the implementation of its many pieces. All Republicans voted yea as did three Democrats.
With the Democratic-led Senate refusing to take up the repeal legislation and President Obama vowing to veto, the House vote was largely a display of political theater. But since many Republicans in the House were elected last fall after campaigning to repeal the health care act, House leaders were compelled to bring the repeal bill to a vote.
In the wake of the shooting of Rep. Gabrielle Giffords, D-Ariz., and 18 others in Arizona Jan. 8, the debate rhetoric, while passionate on both sides, was largely devoid of the vitriolic language that has characterized past health care debates. The House reduced references to "job-killing," for example, even though the official name of the bill, H.R. 2, is the "Repealing the Job-Killing Health Care Law Act."
The arguments, however, were pointed and well honed. Republicans contended the law increased bureaucracy, added to the deficit, hurt the economy and deprived patients of choice. They proposed replacing it, but keeping some of its more popular elements. Democrats argued that the law helps the economy and streamlines Medicare even as it creates jobs and eases the deficit. They pointed out that the law assists seniors in particular by closing the Medicare prescription drug coverage gap, or "doughnut hole." They also said it reduces insurance company bureaucracy, allows people with preexisting conditions to get coverage and permitts young adults to stay on their parents' policies until they turn 26.
Obama delivered a strong statement of support for the law Tuesday, saying he was "willing and eager to work with both Democrats and Republicans" to improve it, while declaring, "But we can't go backward."
In defense of the health care reform measure, the Department of Health and Human Services issued a report earlier this week saying that nearly half of all Americans under age 65 — 129 million people — have a preexisting condition that would preclude them from getting health insurance if the law were repealed. And Democrats recounted hundreds of personal stories of their constituents who already are benefiting from the law.
In a letter to Congress before the repeal vote, AARP CEO A. Barry Rand said older Americans support key provisions of the law, including lowering drug costs under Medicare, reducing drug costs in the Medicare doughnut hole, adding free preventive services, eliminating the ability of insurance companies to cancel policies if a policyholder gets sick, and capping out-of-pocket insurance costs. Another key provision, he said, helps Americans better plan for their long-term care needs, particularly by giving them new options for home care. Repealing the health care reform law would "result in the loss of these important protections for older Americans," he said.
An ABC News/Washington Post poll found this week that 46 percent of those surveyed think the new law is likely to result in fewer jobs and 54 percent think it will hurt the economy, while 62 percent said it will increase the federal deficit. Still, only 37 percent of those polled favored repealing all or parts of the law. Only 18 percent called for the law to be rolled back entirely.
Many political experts doubt the Republicans will continue to pursue total repeal of the massive law after this vote. Instead, they say, the GOP is more focused on a number of strategies — in Congress, in the courts, in the states — to change, amend and rework the law.
Elaine S. Povich is a veteran congressional reporter and author of three books on Washington politics and politicians.