WASHINGTON — The Senate on Wednesday rejected the Republican effort to repeal the 2010 health care law, a vote likely to reverberate politically, as both sides used the debate to make partisan points they see boosting them for 2012 elections.
The final vote was 51-47 against repeal, which needed 60 votes to pass. The outcome was no surprise, since Democrats control 53 of the Senate's 100 seats, and none supported repeal. But the two days of partisan bickering over the measure underscored how this issue continues to dominate political discussion and is likely to for some time.
The Senate did agree to one change Wednesday, voting 81 to 17 to repeal a paperwork requirement that business interests found chafing.
The change, which is expected to win approval from the House of Representatives, would erase a requirement that businesses must report to the government purchases of goods or services of more than $600 from single vendors during a single year. President Barack Obama singled the provision out for extermination in his State of the Union Address last week.
Other alterations won't come so easily.
In the Senate debate this week, most Democrats aggressively defended the health care act that Obama signed into law 10 months ago.
Under it, nearly everyone will have to get health insurance coverage by 2014 or face a penalty. To help people afford policies, the government will provide subsidies, and consumers will be able to shop in exchanges, or marketplaces, where they can compare rates and coverage.
Republicans had political success in 2010 painting the law as an expensive, unprecedented government intrusion into people's lives. Officials in 27 states agreed and urged the courts to overturn the law.
U.S. District Judge Henry Hudson of Virginia ruled in December that the insurance mandate is unconstitutional, and on Monday, U.S. District Judge Roger Vinson in Florida overturned the entire law. Two other federal judges have upheld the law. The cases are probably headed to the U.S. Supreme Court.
At the Capitol, the Republican-dominated House approved repeal last month. Senate GOP leaders saw this week's debate as a momentum builder.
"The case against this bill is more compelling every day," insisted Senate Republican leader Mitch McConnell of Kentucky.
Democrats countered that Republicans are obsessed with fighting last year's battle instead of acting to create jobs. This week, Senate Democrats wanted to debate legislation to help modernize the air travel infrastructure.
"That they would ... turn their back on the (aviation) bill that's going to create and save so many thousands of jobs across American kind of tells the story," said Senate Majority Whip Richard Durbin of Illinois. "They're not seriously addressing the number one issue in America: jobs."
Polling suggests political openings for both sides. While backing for repeal is weak, people are not eager to embrace the so-called "individual mandate" — the requirement that everyone must get health insurance coverage.
A Jan. 6-10 Marist-McClatchy poll showed that Americans are still divided closely over the new health care law, with 49 percent in favor of keeping it the same or expanding it, and 43 percent for repealing it or changing it so it does less. Margin of error was plus or minus 3.5 percentage points.
But a Kaiser Family Foundation/Harvard University survey, conducted Jan. 4-14 and polling 1,502 people, found 76 percent disliked the individual mandate and 51 percent had a negative view of requiring employers to offer coverage or face penalties.
However, other provisions, such as the subsidies or help for seniors with their Medicare drug coverage, were overwhelmingly popular.
Even the House Republican "Pledge to America" declares that "health care should be accessible to all, regardless of pre-existing conditions or past illnesses" — a key guarantee in last year's law.
Without the insurance mandate, Democrats argue, keeping that pre-existing condition provision won't work, because healthy people may not buy coverage, driving up premiums.
"How do you say to an insurance company, you must insure someone that you know is going to cost you a lot more money ... if you do not have more people in the (risk) pool?" asked Sen. Claire McCaskill, D-Mo. "None of them (Republicans) can answer that question."
Sen. John Barrasso, R-Wyo., tried, saying, "We're going to continue to work for the replacement part of the health care law," without giving specifics. Republicans plan to keep pushing for ways to change or replace the law.
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