By Amy Goldstein and N.C. Aizenman
Washington Post Staff Writers
Thursday, January 20, 2011; A01
In the first major act of the new Congress, the Republican-led House voted Wednesday to repeal the Democrats' health-care overhaul, fulfilling a pledge that GOP candidates made during the fall midterm campaigns. Three Democrats sided with a unified GOP in the 245 to 189 vote, a largely symbolic step that has little chance of being considered by the Democratic-controlled Senate.
Senate Majority Leader Harry M. Reid (D-Nev.) has said he will not allow a similar vote.
Republicans vowed to keep pushing to overturn the law. But with no immediate likelihood of that happening, they said they would try to change it by eliminating certain parts of the law, such as a requirement that nearly all Americans obtain health insurance - and working to replace others. They also hope to take advantage of Democratic support for a proposal to remove a tax on businesses, an idea that President Obama has indicated he is willing to consider.
The vote came after a long day of debate in which members of both parties sparred over the benefits and drawbacks of the law. Each side spoke of findinga bipartisan path forward but offered few specifics about what that might look like.
"If we agree that this law needs improving, why keep it on the books?" asked House Speaker John A. Boehner (R-Ohio). "Let's challenge ourselves to do better."
Democrats said they are receptive to revisiting parts of the far-reaching law. "All important bills - Social Security, Medicare, civil rights laws of the 1960s - they needed to be tweaked," said Rep. Eliot L. Engel (D-N.Y.). "Let us put our heads together and figure out what makes sense."
But Democrats voiced skepticism that the GOP would devise a better plan. "For 12 years they had control of the Congress. For six years they had a Republican president to work with," said Rep. Xavier Becerra (Calif.), vice chairman of the Democratic caucus.
Republicans variously described the law as "socialistic," "a monstrosity" and a "dark chapter" in American history. At the same time, they said they wanted to join with Democrats to find other approaches.
"I'm committed to working on reforms that we both agree on in a bipartisan manner," said Rep. Steve Stivers (Ohio).
Some Republicans said they support certain parts of the law. Among them is a provision that allows young adults to stay on their parents' insurance policies until they turn 26, and another that has created temporary subsidies for special insurance - called high-risk pools - for people with ailments that have led insurance companies to deny them coverage.
But Fred Upton (Mich.), chairman of the Energy and Commerce Committee, made it clear that the GOP still favors ideas that many Democrats oppose. They include placing federal limits on damages in medical malpractice lawsuits and giving Americans tax credits to help them pay for insurance.
In the days leading up to the vote, GOP leaders said several House committees would soon convene hearings aimed at finding ways to dissect specific provisions of the law.
As Republicans spoke of preserving parts of the legislation and Democrats talked about rethinking it, both parties tried to align their positions with public opinion. Americans are evenly split on the law overall, but fewer than one in five say all of it should be repealed, accordingto a new Washington Post-ABC News poll. More Americans say they prefer to eliminate only certain provisions.
Both sides claimed to be the champion of small business, older Americans and the middle class. GOP lawmakers contended that the law is leading business owners not to hire workers and insurance companies to raise their prices. Meanwhile, they said, older Americans are at risk of losing access to private health plans that take part in Medicare. Starting next year, the law is scheduled to curb increases in federal payments to such health plans for the older patients they enroll.
Democratic lawmakers countered with stories about children with leukemia who no longer can be refused insurance. And they spoke of older Americans who are beginning to receive better coverage for prescription drugs, as the law will gradually eliminate a gap in those benefits, commonly known as the "doughnut hole."
Repeatedly, Democrats used public disapproval of the insurance industry as a club in the debate, saying that repealing the law would, as House Minority Leader Steny H. Hoyer (Md.) put it, "put insurance companies back in charge of American health care."
The industry's main lobbying group, America's Health Insurance Plans, has taken no position on repealing the law, but the leaders of some major insurance companies have said they oppose the idea.
The two parties also spoke to the sympathies of specific constituencies. At one point, Reps. Louise McIntosh Slaughter (D-N.Y.) and Marsha Blackburn (R-Tenn.) sparred over how women would be affected by a repeal of the legislation.
"Thanks to the new law, women do not have to worry anymore about being treated as second-class citizens," Slaughter said, arguing that the law will forbid insurance companies to charge women higher premiums and will require them to provide coverage for victims of domestic violence. Blackburn countered that the health-care overhaul would make it "more difficult for women under the age of 50 and over the age of 75 to get mammograms."
Democrats quoted new estimates by congressional budget analysts that show repealing the law would deepen federal deficits. House Majority Leader Eric Cantor (R-Va.) disagreed, saying the Congressional Budget Office's predictions are flawed because the legislation "is riddled with double-counting and gimmicks."
At times during the seven-hour debate, members seemed to struggle to maintain a civil tone, recalling the often inflamed rhetoric about the measure as it worked its way through Congress last year.
"Why don't we just settle down and we can make some amendments to this bill?" Rep. Jim McDermott (D-Wash.) told his GOP colleagues. "I'm sure there are some things you'd like. But throwing it away is a political farce."
Republicans vowed to continue in their efforts to remake the law.
Said Rep. Michele Bachmann (Minn.): "To those . . . who think this may be a symbolic act, we have a message for them: This is not symbolic. This is why we were sent here, and we will not stop."
Staff writers David Fahrehthold and Felicia Sonmez contributed to this report.