WASHINGTON — For the 33rd time, House Republicans took legislative aim at the nation's healthcare law — this time in a largely symbolic vote to repeal it.
The two-day floor debate was orchestrated by GOP leaders in an effort to tap into the deep disagreements that remain two years after President Obama's signature domestic achievement became law.
Americans continue to give the Affordable Care Act mixed reviews, with conservative and some independent voters among the most opposed. After the Supreme Court upheld the law in a landmark decision this summer, Republican leaders promised another repeal vote. It's a strategy that poses some risk as polls show many Americans want to move on to other issues.
The House voted 244 to 185 Wednesday, with all Republicans present voting for repeal. Five Democrats joined the GOP — two more than supported repeal a year ago, reflecting the continued political strain the law has put on some in the president's party.
The bill will languish in the Senate, where Democrats, who have the majority in that chamber, have complained that the vote is a waste of time given the sluggish economy and disappointing jobs outlook.
Obama sought this week to push the next issue — the threat of a tax increase if Congress fails to extend lower rates set to expire at year's end. The president called on Congress to keep theGeorge W. Bush-era tax cuts for incomes up to $250,000, which would essentially amount to a tax increase on wealthier households, something Republicans oppose.
Sen. Mitch McConnell of Kentucky, the GOP leader, sought to engineer a Senate vote on the tax measures Wednesday. Democrats rejected the maneuver, promising tax votes in the weeks ahead.
As hours of debate over the healthcare law came to an end, House SpeakerJohn A. Boehnerof Ohio began closing arguments.
"I think there's a better way and that's why we're here today," he said. "We're giving our colleagues in the Senate another chance to heed the will of the American people.... It's an opportunity to do the right thing for our country."
Republicans and their allies in the business community have attacked the healthcare law as an overreach by government that will raise healthcare costs and impose new taxes.
At its core, the healthcare law requires most Americans to have insurance or pay a fine, which the Supreme Court recently concluded was a tax.
Those who do not receive coverage through their employers could buy it through new state-based exchanges. Many will receive federal assistance to pay their premiums.
Businesses with more than 50 employees would be required to provide insurance to their workers or pay a penalty; smaller businesses would receive tax credits if they provided coverage. Most of the provisions in the law, including the requirement to have insurance, do not kick in until 2014.
Rep. Nancy Pelosi (D-San Francisco), the minority leader who as House speaker was an architect of the 2010 legislation, focused on parts of the law already in effect, including provisions that bar insurance companies from refusing coverage for children with preexisting medical conditions, allow young adults to remain on their parents' policies until age 26, and help seniors afford prescription drugs.
"Republicans must stop this effort to take away patient protections from Americans," Pelosi said.
The floor debate was animated in some ways.
Holding a copy of the bulky healthcare law, Democratic Rep. Al Green of Texas said his constituents had asked him to read the bill back in 2010.
On Wednesday, he said he wanted to use his floor time to read aloud the GOP plan — drawing silence in the chamber.
Republicans had promised a "repeal and replace" approach in opposing healthcare, but the "replace" effort has been postponed, as Republican leaders say they cannot offer alternatives until the new law is repealed.