Repeal of Health Care Law Approved, Again, by House

Waging old battles with new zeal, the House passed a bill on Wednesday to repeal President Obama’s health care overhaul law less than two weeks after the Supreme Court upheld it as constitutional.

The bill was approved by a vote of 244 to 185, with five Democrats supporting repeal.

It has no chance of approval in the Senate and would face a veto from Mr. Obama if it ever got to him. But the House debate exposed the depth of passion over efforts to remake the health care system and suggested that the fight would continue next year, regardless of who wins the November elections for president and Congress.

House Republican leaders had many reasons for voting on another repeal bill. They detest the 2010 law. They see it as a winning issue for them. And they wanted to placate freshman Republicans like Representative Ben Quayle of Arizona, who described repeal as a way to protect constituents from “the tyranny of government overreach.”

The House has voted more than 30 times to repeal part or all of the 2010 law or to choke off money needed for various provisions, including coverage of more than 30 million uninsured people.

Democrats said the House was wasting time that would have been better spent trying to create jobs.

But Representative Marsha Blackburn, Republican of Tennessee, said: “We’re going to keep at it until we get this legislation off the books. It was a bad bill; it has become a bad law.”

In two days of House debate this week, both parties recycled talking points with minor changes to take account of the Supreme Court decision.

Democrats said the ruling vindicated their policies, including a requirement for most Americans to have health insurance, starting in 2014. And they said Mr. Obama needed to do a better job of defending the law, on which public opinion is deeply divided.

The Supreme Court ruling fired up Republicans because, they said, it confirmed their argument that the law would impose a tax, not just a penalty, on people who go without health insurance.

“The court has spoken,” said Representative Sandy Adams, Republican of Florida. “Obamacare is a tax.”

Nancy Pelosi, the House Democratic leader, described the law as one of the Democrats’ greatest achievements, making health care “a right, not a privilege, for all Americans.”

Asked about the possible electoral impact of the Republican offensive, Ms. Pelosi said: “The politics be damned. We came to do a job. We are very proud of what we did.”

Republicans are still seething over how the law was adopted, without any Republican votes.

Representative John Fleming, Republican of Louisiana, said the law “never would have gotten passed” if the penalty for violating the individual mandate had been acknowledged as a tax.

Democrats said the attacks were overblown. And they gleefully quoted statements by Mitt Romney supporting an individual mandate as part of the health plan adopted in Massachusetts in 2006, when he was governor.

Representative Sander M. Levin of Michigan, the senior Democrat on the Ways and Means Committee, said “almost no one” would pay the federal penalty.

“The Congressional Budget Office estimates that only 1.4 percent of Americans will pay anything for refusing to purchase insurance,” Mr. Levin said. “That is just about identical to the percent of people in Massachusetts who have paid the penalty under Governor Romney’s health care law.”

Contrary to Republican claims, Mr. Levin said the federal law should be viewed as a tax cut for middle-income people because it would provide tax credits to help them pay premiums for private health insurance.

Mr. Romney, the Republicans’ likely presidential nominee, says he would take immediate action to roll back the federal law if he wins the White House.

Representative Charles B. Rangel, a New York Democrat and strong supporter of the 2010 law, said members of his party had made “a lot of mistakes” in selling its benefits to the public. Faced with unrelenting Republican opposition, he said, “the administration has not made the case that uninsured people get health care” under the law.

The Supreme Court rejected claims that the individual mandate was justified by Congress’s power to regulate interstate commerce, but upheld it as a permissible exercise of taxing power. Republicans said imposing a mandate by the tax power was scarier than using the commerce power. And they said it set a precedent for taxing “inactivity.”

“How is this different from the government requiring Americans to purchase broccoli or pay a tax for not doing so?” asked Representative Dave Camp, Republican of Michigan and chairman of the Ways and Means Committee.

Representative Daniel Lipinski, Democrat of Illinois, was a lonely voice pleading for a middle way. “We need a fix, not a repeal,” he said, asserting that Congress should keep “good parts of the law” and add stronger cost controls.