The Democratic-controlled Senate was certain to let the measure die, and Obama stands ready with a veto should it somehow pass through Congress. But the vote in the House, newly under Republican control, signals the beginning of the Republican effort to chisel away at the law through attempts to deny funding for parts of the legislation as they go into effect in the coming years.
Republicans are hoping in part to build momentum through opposition to health care reform as the nation readies for the 2012 presidential election
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The bill that Obama signed into law in March extended health care coverage over a period of four years to 32 million Americans who now lack it, and put controls on insurance companies that were denying coverage to those with pre-existing ailments or removing protections from those who became ill. The law also gives tax breaks to lower- to middle-income Americans to help with insurance premiums and allows young people to maintain coverage until age 26 under their parents' policy.
The measure - much of which still does not go into effect until 2014 - was signed into law after a year of intense political battles. Obama had won a victory that eluded presidents stretching back almost half a century.
He said on Tuesday he was willing to work with Democrats and Republicans to improve the health care law but warned that lawmakers shouldn't "go backward" and repeal the measure.
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In a statement, Obama said Americans deserve the freedom and security of knowing insurance companies can't deny, cap or drop their health care coverage when they need it most.
Republicans and Democrats adopted a more civil tone without angry shouts as they debated the repeal legislation on the House floor Tuesday just 10 days after the shooting rampage in Arizona that left a Democratic congresswoman wounded and lawmakers of both parties stunned.
Rep. Steny Hoyer, the second-ranking Democrat, said he expected that "members will heed their own advice and will address the issues in a way that will deal with them on the merits." In the past, he added, too much of the public debate was "about incitement rather than informing, about making people angry, disrespecting the ... point of view of the other side."
Freshman Republican Rep. Phil Roe, an obstetrician-gynocologist who was elected on a promise to repeal the bill said Wednesday that "repeal doesn't mean we aren't for health care reform, quite the contrary.
"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.
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The House vote had been slated for last week as the Republicans' first order of business - a campaign promise that helped them regain the majority in the lower chamber. But action was put off after the attack on Arizona Rep. Gabrielle Giffords, who was shot through the head. She is hospitalized in serious condition but six others who attended her meeting with constituents in Tucson, Arizona, were killed, including a federal judge and a 9-year-old girl.
Now, the House vote is back on after more than a week of national soul-searching and questions about whether the brutal tone of the political dialogue helped fuel the deadly attack in Arizona.
While most politicians agree that the heated rhetoric had gotten out of hand, little has changed in narrowing the deep partisan divide on such key issues as the health care reform legislation.
An Associated Press-GfK poll taken earlier this month found Americans almost evenly divided on the law. The poll found that 40 percent of those surveyed said they support the law, while 41 percent oppose it. Strong opposition to the law stands at 30 percent, close to the lowest levels registered in AP-GfK surveys dating to September 2009.
As for repeal, only about one in four said they want to do away with the law completely. Among Republicans, support for repeal has dropped sharply, from 61 percent after the elections to 49 percent now.
Dissatisfaction with the law stems in part from a powerful campaign by Republicans and the conservative tea party movement to portray it as further intrusion into citizens' private lives by the federal government. Some insisted the new legislation amounted to socialized medicine, even though parts of the law were lifted from a Republican plan drawn up in the 1990s.