The House voted Wednesday to repeal most of Obamacare, sending legislation to President Barack Obama for the first time that would dismantle his biggest domestic policy achievement.
The 240-181 House vote, following Senate passage of the bill Dec. 3, won’t succeed in undoing the 2010 Affordable Care Act. Obama has said he’ll veto the repeal measure, and Democrats in each chamber have enough votes to block an override by the Republican majority.
“We are confronting the president with the hard, honest truth: Obamacare doesn’t work,” House Speaker Paul Ryan told reporters in Washington. He set up the repeal legislation as the first vote on Republicans’ election-year agenda.
The measure passed Wednesday, H.R. 3762, provides the beginning of a template for how Republicans would address health care in 2017 if they win the presidency and keep control of the House and Senate.
While retaining parts of the Affordable Care Act, the measure would eliminate penalties for not complying with its requirement that individuals and large employers buy insurance for themselves and their workers. The Obama administration contends that would encourage healthy policyholders to drop coverage, causing a “death spiral” of rate increases for less healthy people who retain their policies.
The bill also would cancel, in 2018, the law’s expansion of the federal-state Medicaid health program for the poor, as well as subsidies for people who buy insurance coverage through federal or state exchanges.
The vote was well short of the two-thirds majority needed to override a presidential veto. One Democrat, Collin Peterson of Minnesota, voted for the repeal, while three Republicans opposed it: Robert Dold of Illinois, and Richard Hanna and John Katko, both of New York.
‘Repeal and Replace’
Republicans have repeatedly said they want to “repeal and replace” the Affordable Care Act, though they haven’t coalesced around a replacement plan.
“Just wait,” Ryan, a Wisconsin Republican, told reporters Wednesday when asked what Republicans would offer as an alternative. The speaker, who took over the job in October, is asking House committees to work on an alternative. Budget Committee Chairman Tom Price of Georgia said Tuesday the goal is “to have a piece of legislation we can be proud of.”
The legislation passed Wednesday also would deny federal money for Planned Parenthood, the reproductive health-care organization that Republicans have sought to defund since undercover videos purported to show its officials discussing reimbursement for providing tissue from aborted fetuses to medical researchers. Planned Parenthood said it received only the cost of providing the tissue, and it later stopped taking such payments.
Planned Parenthood receives about $450 million in federal funds annually, most of it through Medicaid coverage for health- care services for the poor. A ban on federally funded abortions has been in place for decades. Bloomberg Philanthropies provides financial support for Planned Parenthood.
All Democratic Votes
Republicans have sought to kill the Affordable Care Act since Congress enacted it during Obama’s first term with all Democratic votes. The House has voted more than 50 times to repeal, defund or delay the law. This latest attempt marks the first time such a measure got through the Senate because lawmakers used a procedure allowing the Republican majority to pass it without having to overcome a Democratic filibuster.
“Let’s make the president decide,” Representative Bradley Byrne, an Alabama Republican, said during floor debate. “Let’s hold him accountable.”
The repeal bill is “going nowhere,” Representative Jim McGovern, a Massachusetts Democrat, told Republicans at a House Rules Committee meeting Tuesday. “We go through these motions so you can go back and tell your right-wing base that you are doing something when you are basically running in place.”
The White House has said Obama would veto the repeal bill because it would “take away critical benefits and health-care coverage from hard-working middle-class families.” Ryan said on Fox News Channel’s “Hannity” program Tuesday that the House will attempt to override the veto later in January.
About 17.6 million previously uninsured people have gained coverage under Affordable Care Act provisions including expanded Medicaid, marketplace insurance plans, and young people allowed to stay on their parents’ plans through age 26, the Department of Health and Human Services estimated in September.
The measure wouldn’t entirely dismantle the Affordable Care Act. For example, it would retain the requirement that insurers offer coverage and set premiums without regard to someone’s pre- existing conditions.
Also untouched would be revisions in Medicare that reward the value of procedures, rather than the volume of procedures and reduce excessive provider payments.
That has prompted Democrats to complain that Republicans, while denouncing Obamacare and repealing some key provisions, are holding on to other aspects that help boost their bill’s 10- year deficit-reduction projections.
The repeal legislation would decrease the U.S. deficit by about $516 billion over 10 years, according to the Congressional Budget Office, Congress’s nonpartisan scorekeeper. It would increase the number of people without health insurance coverage by about 22 million people in most years after 2017, the CBO said in a Dec. 11 letter.
In December, Congress voted in separate tax and spending legislation to suspend three taxes intended to fund the health- care law. A so-called Cadillac tax on high-cost health insurance plans would be delayed from 2018 to 2020; a 2.3 percent tax on medical devices would be paused in 2016 and 2017; and a fee on health insurers would be paused for 2016.
The U.S. Supreme Court has twice upheld key provisions of the Affordable Care Act. The court in June preserved subsidies that help millions of Americans pay their health insurance premiums. Obama said at the time that the law has helped tens of millions of Americans and is here to stay.
–With assistance from Zachary Tracer.