WASHINGTON (AP) – There they go again: The House is moving toward a vote on yet another Republican bill to repeal President Barack Obama's health care law.
Only months away from the rollout of coverage for uninsured Americans, Republicans on Thursday were making their 37th attempt in a little more than two years to eliminate, defund or partly scale back the Affordable Care Act.
All sides already know what the result will be. The Democratic-led Senate and the president will simply ignore the action by the Republican-led House.
But in a Congress where spin often trumps legislation, Republicans see a political advantage to keeping the pressure up as the administration tries to get all the moving parts of the law finally working.
Starting this fall, uninsured people who can't get coverage through their jobs will be able to sign up for government-subsidized insurance that takes effect Jan. 1. The rollout promises to be bumpy because about half the states are still resisting the law, and Republicans in Congress won't provide the administration with funds it says are needed for a smooth implementation.
Democrats said the House vote was a pointless exercise. They noted that the ACA – as the law is known – has been upheld by the Supreme Court, and millions are already receiving some benefits, from young adults able to stay on a parent's insurance until age 26, to seniors on Medicare whose high prescription drug bills have been reduced.
Democratic leader Nancy Pelosi of California said repeal vote is "clear waste of time and of taxpayer dollars."
"Unfortunately, House Republicans seem to think that their main responsibility is to do nothing," Pelosi said.
But Republicans see a soft target in a costly program that continues to divide the country.
They're hoping that implementation problems next year will help the GOP take control of the Senate in the midterm congressional elections and build on its House majority. Part of the political strategy behind Thursday's vote was to give freshmen Republicans a chance to vote on full repeal of what they dismiss as "Obamacare."
"Republicans will continue to work to scrap the law in its entirety so we can focus on patient-centered reforms that lower costs and protect jobs," said House Speaker John Boehner, R-Ohio.
What that alternative would look like, no one really knows, because Republicans have not presented a plan of their own since Obama's law was debated in Congress more than three years ago.
Boehner said a GOP approach would include medical malpractice reforms, risk pools for people with pre-existing medical problems, and allowing individuals to buy coverage from out-of-state insurers to spur competition. But nothing has been finalized.
Boehner also pointed out that not even Obama believes the health care law is perfect. On seven previous occasions GOP efforts to scale back parts of the law were eventually accepted by the president and signed into law. They included a Medicaid formula allowing thousands of middle-class people to qualify for nearly free coverage, a long-term care insurance plan likely to go belly-up, and paperwork requirements protested by small businesses. The administration sees those as relatively minor changes.
The House debate got creative. Rep. Michele Bachmann, R-Minn., compared the health care law both to a looming iceberg and an impending train wreck. "The more we learn about Obamacare, the more unpopular it becomes," she said.
Three years after its passage, Americans remain divided over Obama's signature domestic policy achievement. Even the uninsured are confused about whether they will be helped. Many people who have coverage worry it will raise their costs and make it harder for them to see their doctors. Some of the law's underlying goals, such as a ban on insurers turning away people with pre-existing conditions, remain popular. However, the requirement that virtually all Americans carry coverage or face fines is still widely disliked.
Although health insurance premiums have not gone down, as Obama once promised, there's no evidence that the law is breaking the bank. Health care costs have been growing at historically low rates, providing a respite for government programs like Medicare and employer plans as well. Experts say most people with job-based health insurance are unlikely to see major impacts from the law next year.
Less certain is the outlook for people who buy their own coverage and for small businesses. The insurance industry says premiums in the individual market are likely go up by double digits in most states. The administration says part of the reason costs could go up is because the coverage will be more comprehensive. But many people will receive tax credits under the law to offset those costs. Still, the anxiety is building as the law's full implementation draws closer.
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