WASHINGTON — The House of Representatives voted Thursday to repeal a key part of the 2010 federal health care law, triggering a bitter, partisan debate that's likely to be repeated throughout this election year.
The Republican-led House voted 223-181 to do away with a new 15-member board designed to help control Medicare costs, a move that the Democratic-dominated Senate is likely to reject.
Yet the House effort had considerable bipartisan support at one time, before it became mired in election-year politics. Both parties see their positions on the health care overhaul as important to their re-election efforts.
Democrats generally portray the program, which will require nearly everyone to obtain health insurance by 2014, as perhaps President Barack Obama's boldest, most historic domestic achievement. Republicans have been blasting away at the law, maintaining that it's an offensive government intrusion that will make it hard for people to get the care they want or need.
The debate erupted again this week because the Supreme Court is scheduled to begin three days of oral arguments on Monday over challenges to the law. A court decision is expected by late June.
The House had its say Thursday. As many as 80 of the House's 190 Democrats were thought to be sympathetic to repealing the commission, which Republican critics have labeled a "death panel," charging inaccurately that it could determine who might live or die.
However, Democratic leaders feared that a big Democratic vote against the commission would embarrass Obama, as well as signal that a relentless GOP could pick off pieces of the law and gradually dismantle it.
Republican leaders had different concerns. They realized that by voting to end the panel, Democrats in more conservative districts would get to argue both ways: that they'd voted for the whole bill because they liked parts of it, but also voted to strip out parts they didn't like.
As a result, both parties' leaders worked hard to discourage Democrats from backing the bill to kill the Medicare commission. Republicans added a measure that would cap some medical malpractice awards, a provision Democrats have opposed for years, poisoning the initial bills appeal to them.
"When they included that, it took away any doubt (about the bill) I had," said Rep. Nick Rahall, D-W.Va.
At the same time, Democratic leaders insisted: Don't let Republicans win one.
"I think a lot of Democrats, however they are on (the Medicare panel), see this as simply a drip, drip, drip, you know, trying to cut out this paragraph, that paragraph, the other paragraph, and I think they don't want to be part of that," said House Minority Whip Steny Hoyer, D-Md.
The Independent Payment Advisory Board would have 15 experts, including physicians and patient advocates, who'd suggest policies to Congress that would help Medicare reduce costs. Its first report would be due on Jan. 15, 2014. The president would appoint the members, subject to Senate confirmation.
The law bars the panel from recommending any policies that ration health care, increase taxes, increase premiums or cost-sharing, restrict benefits or modify who's eligible for Medicare, according to the White House.
Congress could consider the panel's recommendations. But here's the controversy: If Congress rejects them and Medicare spending goes above specific levels, Congress must either pass legislation to reduce costs or let the government follow the panel's suggestions.
That provision concerns a lot of Democrats.
"It's not the job of an independent commission to make decisions on health care policy for Medicare beneficiaries," said Rep. Frank Pallone of New Jersey, the top Democrat on the Health Subcommittee. "For me, this is about congressional prerogatives being limited."
Supportive Democrats couldn't swallow the bill's malpractice measure, however.
"Attaching at the very last minute a medical malpractice bill that provides protection to every entity involved in medical malpractice except the victim is just wrong," said Del. Donna Christensen, D-Virgin Islands.
Backers argued that the bill would improve health care.
"We must provide patients and medical professionals with the security and the safety net," said Rep. Renee Ellmers, R-N.C.
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