Republican leaders, still stung by the supreme court ruling upholding Barack Obama's healthcare reforms, launched another furious but largely symbolic bid to overturn the law on Tuesday.
The House of Representatives held a long debate on what Republicans have derided as Obamacare, ahead of a vote on Wednesday on a bill to strike down the reforms.
While the Republicans are almost certain to win the vote – the 31st attempt to kill the legislation by cutting off funding, killing key provisions or outright abolition – it will prove little more than symbolic as it is expected to meet the same fate as similar legislation in February that died in the Democrat-controlled Senate.
Still, Republican leaders waded back in to the fight in the hope of damaging Obama's re-election campaign by playing on the widespread unpopularity of parts of the reforms, particularly the requirement for compulsory health insurance. But the Democrats hit back by portraying the Republicans as more interested in replaying old battles instead of focussing on more pressing issues such as job creation.
Pete Sessions, a Republican congressman from Texas, opened the arguments by lamenting the supreme court ruling. "Just 12 days ago the United States supreme court upheld the individual mandate provisions in Obamacare thereby forcing every American to purchase health insurance. While I may disagree with how they ruled, I respect their decision and there's nothing we can do to change that," he said.
"Obamacare is now the official law of the land. However there is something this body can do to reverse the course and prevent the job destroying aspects of this bill from taking effect – a complete repeal of the bill... We need to repeal Obamacare today."
Republicans reprised many of the debates and claims of the past three years, painting the healthcare law as an intrusion on individual liberty that will lead to a diminution in the quality of care while the cost of insurance rises. The Republicans also seized on the supreme court's view that the health reforms are legal under Congress's powers to tax, portraying that as further evidence the president is raising the tax burden.
"Last month the supreme court made its regrettable ruling to uphold the president's job killing tax programme known as Obamacare. Well the high court may have deemed it constitutional as a tax. Americans deem it burdensome and unaffordable," said Sam Johnson, a Texas congressman.
"Before we know it a trip to the doctor will feel more like a trip to the DMV, the department of motor vehicles. Our tax and spender in chief needs to stop throwing more hard earned tax dollars at a broken healthcare system and start working with Congress to implement common sense reforms."
Democrats responded by deriding the Republicans for having yet another vote on reforms that have already been passed into law. Louise Slaughter, a New York congresswoman at the forefront of healthcare reform, said the Republicans do not expect the bill overturning Obamacare to become law. She accused them of being more interested in using the debate as a campaign weapon in the run up to November's presidential election.
"Over this last two years over 30 votes have been taken on this healthcare bill alone," said Slaughter. "They want to defund or dismantle or do whatever to it. Never in the history of this Congress has anybody voted this many times on a single issue."
Slaughter said the debate was a waste of time because the Senate has already rejected a similar measure passed in February. "We're not trying to make law here, we're making political points and that is a shame because it's not that the country doesn't need our attention. It isn't as though the unemployment rate isn't so high and people's futures are not so grim that they're crying out for us to get something done."
Democrats also honed in on the Republicans' weakness in failing to propose alternatives to parts of the healthcare reforms that are popular, particularly requirements for insurance companies to stop charging women higher premiums and forbidding them from cutting off coverage for people with pre-existing conditions or who suddenly require expensive care.
"We'll spend at least six hours debating this but not one minute considering a Republican replacement. That's because there isn't one," said John Yarmuth, a Democratic party congressman from Kentucky. "I invite any Republican in this body to come to the floor and explain to my constituents and theirs why they made the choice to repeal all of these patient protections while offering the American people nothing in return."
Slaughter pressed the point home. "What's going to happen to the millions of women who will once again be charged more money than men for the same health insurance coverage? Did you know women pay 40% more?" she said. "What's going to happen to the thousands of children who will once again be denied health insurance coverage because they were born with a pre-existing condition? And what will happen to the young people on their parent's healthcare unable to find work because Congress is not involved with that?"
Mitt Romney, the Republican presidential candidate, has already implicitly acknowledged his party's vulnerability on that issue by pledging to take measures to preserve protections for people with pre-existing conditions and to ensure that those who have already obtained insurance under the reforms do not lose it.
Recent opinion polls show that Americans are equally divided over the reforms although the drift has been toward greater support for Obamacare and a majority is now opposed to complete repeal. But while the issue holds some dangers for Republicans, some members of Congress say they continue to press for reform because it is a red meat issue for many of the party's core supporters.
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