The US House of Representatives voted Wednesday evening to repeal the Obama health care legislation passed by Congress just ten months ago, the first major action by the new Republican majority. The 245-189 margin was a nearly party-line vote, with every Republican supporting repeal, and all but four Democrats voting against.
The bill would not take effect unless ratified by the Democratic-controlled Senate and signed into law by Obama, an unlikely prospect. The purpose of the Republican leadership in pushing through passage of the bill, as the first major legislative action of the new Congress, was to reassure ultra-right Tea Party elements who supported Republican candidates in last November’s election.
The ritualistic character of the action found expression in stereotyped arguments on both sides. Republican speakers denounced the Obama health care bill largely on right-wing ideological grounds, calling it an unwarranted expansion of government that would increase health care costs.
Incoming House Speaker John Boehner and other top Republican leaders had suggested that references to “death panels” and other overwrought language would be toned down in the wake of the shooting of Democratic Congresswoman Gabrielle Giffords in Arizona, and the debate was thus largely low-key, with its outcome foreordained.
Some of the Republican rank-and-file nonetheless continued to demonize the Obama health plan—a conservative, cost-cutting measure largely modeled on Republican proposals of the 1990s—portraying it as a radical, even revolutionary measure. Thus Michele Bachman of Minnesota, one of the more deranged in the Tea Party faction, declared, “Obamacare is the crown jewel of socialism—socialized medicine.”
Democratic speakers defended the bill, citing the extension of coverage for patients with pre-existing conditions, young people and others without insurance. Most confined their remarks to reciting the names and circumstances of individuals who had already obtained coverage, mainly for their children, since most other benefits are not scheduled to take effect until 2014.
Like the Republicans, they upheld cutting health care costs as a major goal, but pointed out that the Obama legislation would cut health care costs by $143 billion over the next decade, according to the Congressional Budget Office.
With less rhetorical hysteria, the fundamental agreement of the two parties was more in evidence. Both subscribe to the principle that the health care system must be based on private profit, not human needs. Both claim to deplore the exclusion of tens of millions from adequate health care because they cannot afford insurance or because no insurance company will sell them a policy because of pre-existing medical conditions. Neither proposes any serious change in this setup, let alone the guarantee of access to health care to all as a basic human right.
President Obama underscored this consensus by declaring on the eve of the House vote, that he was willing to consider Republican proposals to “improve” the health care law. Aside from the fact that the Republicans want to scrap the law, not improve it, their proposals amount to making a pro-insurance company, pro-drug company bill even more favorable to the medicine-for-profit lobby.
One Republican congressman, John Carter of Texas, took note during the House debate of Obama’s op-ed column Tuesday in the Wall Street Journal, in which he declared his general opposition to government regulation of business. Obama should join the Republicans in repealing this biggest of all government regulations, the regulations laid down in the health care legislation, he said.
Congressman Jeb Hensarling, chairman of the House Republican Conference, declared during the debate that repeal of the health care law was vital to economic growth. “You cannot help the job-seeker by punishing the job creator,” he said. No Democrat could or would violate the pro-business consensus by pointing out that American private employers have not created a single net new job in ten years. Far from being the “job creator,” American capitalism has been destroying jobs, cutting wages and driving down living standards.
While the House vote has no immediate effect on health care policy, House Republican leaders have vowed to block implementation of the new law by cutting off funding for the federal agencies tasked with drafting regulations and actually administering the structures established by the bill, such as insurance exchanges.
On Thursday, the House is to vote to instruct several major committees to prepare health care bills that would replace the legislation adopted last year. These would include major attacks on the rights of patients, including limits on the right to sue for medical malpractice and even stricter bans on the use of federal money to pay for abortions.
According to a report in the Los Angeles Times, the Republican legislation would reduce regulations on insurance companies so they can exclude even larger numbers of people from coverage. “GOP leaders also showed that it was possible to slow the rise in insurance premiums by allowing insurers to avoid mandates in some states to cover services such as maternity care, cancer screenings and mastectomies,” the newspaper reported.
On the eve of the House vote, the Department of Health and Human Services issued a study that found that 129 million Americans, half of those under age 65, have medical problems that insurance companies would use to deny them coverage. These include such common conditions as cancer, heart disease, asthma and high blood pressure.
The report noted that as many as 46 percent of uninsured Americans have such pre-existing conditions, and an even higher proportion among adults aged 55 to 64—those aging but still too young to be eligible for Medicare.
While outright repeal of the entire Obama health care law is unlikely to pass the Senate, several influential Senate Democrats have voiced support for significant changes. Two Democrats who voted for the Obama law, Ben Nelson of Nebraska and Claire McCaskill of Missouri, said they were looking for an alternative to the individual mandate that provides penalties for those who do not purchase private insurance.
Meanwhile the conflict in the courts over the constitutionality of the 2010 law continues. On Tuesday, the Obama administration filed notice with US District Judge Henry Hudson that it would appeal his ruling that the individual mandate is unconstitutional. This is the first step in taking the case to the Fourth Circuit Court of Appeals in Richmond, Virginia.
In Florida, the state’s attorney general, Republican Pam Biondi, filed a motion to add six more states to a lawsuit brought by 20 states against the health care law. The suits were brought by Republican governors or state attorneys general, and the six additional states were captured by the Republicans in the November election.