H.R. 2: The Evening Show

H.R. 2 now heads to the Senate, where Senate Majority Leader Harry Reid, D-Nev., has shown no interest in bringing the bill to the Senate floor.

If implemented as written, the bill woud repeal the Affordable Care Act, the legislative package that includes the Patient Protection and Affordable Care Act.

In the House, the Budget, Education and Labor, Energy and Commerce, Judiciary, Small Business and Ways and Means committees are supposed to develop proposals for replacing the Affordable Care Act.

Republicans in Congress are also trying to block implementation of the act by withholding funding, and, away from Congress, at least 27 states are challenging the constitutionality of the act.

America's Health Insurance Plans, Washington, has not been visible in lobbying for H.R. 2, and some executives of large health insurers have expressed support for the Affordable Care Act, or skepticism about the wisdom of fighting to repeal it or block overall implementation efforts.

But some Democrats framed the fight over the bill as a clash between the interests of health insurers and the interests of ordinary Americans.

"This vote establishes who you're for," said Rep. Steve Israel, D-N.Y. "Are you for insurance company profits, or are you for the middle class?"

"This bill lays bare what the new Republican majority

is all about," said Rep. David Price, D-N.C.

Repealing the Affordable Care Act would take away the new small business health insurance tax credit, prescription help for seniors, and the provision forbidding insurers from rejecting children with pre-existing conditions, Price said.

"Once again you can be denied coverage altogether," Price said.

Democrats contended that the Republicans had been in the majority in Congress for a decade without passing significant health reform legislation of their own.

Republican speakers argued that continuing with Affordable Care Act implementation would add trillions of dollars to the federal deficit and discourage employers from hiring workers.

House Speaker John Boehner, R-Ohio, noted that even President Obama has agreed that the act needs improvements.

"Why would we keep this law on the books?" Boehner asked.

Republicans on the House Ways and Means Committee have suggested that repeal of the Affordable Care Act need not lead to abandonment of all ideas in the act.

Republicans, for example, proposed a bill in 2010 that would have made it illegal for an insurance company to deny coverage to someone with prior continuous coverage on the basis of a pre-existing condition, and to make it illegal for an insurance company to cancel a policy except in cases of fraud, committee officials say.

The Republican proposal also would have ended lifetime and annual benefit caps, provided full funding for high-risk pools and reinsurance programs, and added less to the budget deficit than the Affordable Care Act, committee officials say.

"Repeal of the Democrats' health care law is the first step, but not the last," the committee officials say. "Republicans will continue to work to develop solutions that ensure every American has access to coverage that meets their health care needs."