WASHINGTON – Almost a year after Democrats hailed passage of historic health insurance legislation, Republicans now in control of the House closed in Wednesday on the first big step to repeal the law.
Republican leaders predicted the evening vote would send a message to President Barack Obama that the country has turned away from government fixes to the public's pressing problems.
Democrats still run the Senate and pledge to block the GOP effort, so it's not clear what the House action would mean beyond a symbolic statement.
Some Republicans want to withhold money for carrying out the law, but that approach seems to have limitations. Money for major parts, including tax credits for buying purchase, creating state-based insurance markets and expanding Medicaid, was built into the law.
Republicans say don't underestimate their determination to repeal what they dismiss as "Obamacare," and replace it with their own vision.
"Repeal doesn't mean we aren't for health care reform, quite the contrary," said freshman Rep. Phil Roe, R-Tenn., an obstetrician-gynecologist who was elected on a promise to repeal the bill.
"This bill does increase the number of people who are insured. But it does nothing to decrease the costs." That, he predicted, will make Obama's expansion of coverage unsustainable.
The debate was free of the rancor seen during the marathon sessions that culminated in party-line passage of the legislation last year.
The law would provide coverage to more than 30 million uninsured people, with tax credits to make premiums more affordable for the middle class, along with an expanded Medicaid program for the poor. Starting in 2014, most people would have to have insurance, a first-of-its-kind mandate that Republicans are challenging as unconstitutional in federal court.
Democrats are confident that the law will stand. Millions are already getting its benefits, from lower prescription prices for Medicare recipients with high drug costs to extended coverage for young adults on their parents' insurance plan.
"We are not interested in taking down, repealing and destroying," said Rep. Xavier Becerra, D-Calif.
Opponents of the law would probably need 60 Senate votes to overturn it, which is a stretch given that Republicans have just 47 votes.
The House planned to vote Thursday to instruct several major committees to draft health care legislation that reflects Republican priorities. That includes limits on medical malpractice awards and stricter language barring taxpayer money for abortions. But an earlier GOP bill that offered a competing vision to the Democrats' only covered a fraction of the people reached by Obama's law.
No matter, Republicans say. A modest, step-by-step approach may turn out to be more sustainable in the long run than a new program whose costs and consequences are still unclear.
Polls find the public divided over the law and whether it should be repealed. A recent Associated Press-GfK survey found a 43 percent plurality wants the law changed so that it does more to re-engineer the health care system. About one in four said it should be repealed completely. Fewer than one in five in the AP poll said the law should be left as it is and 10 percent want to change it to do less.
Some surveys that only give respondents two options — keeping the law as it is or repealing it completely — find an edge for repeal.