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House To Vote On Bill Repealing Affordable Care Act

AUDIE CORNISH, HOST:

With a vote this afternoon, Congress is sending a bill to repeal Obamacare and defund Planned Parenthood to the president's desk. The House has just passed the measure. The Senate has already passed a version. In doing so, many Republican lawmakers are making good on their campaign promises. And yet, no one expects the bill to become law. Joining us to talk about this is NPR's Congressional correspondent Ailsa Chang. Hey there, Ailsa.

AILSA CHANG, BYLINE: Hey there.

CORNISH: So as we mentioned here, President Obama has vowed to veto this bill. And yet, Republicans spent a great deal of time and energy getting it through Congress. What's the point?

CHANG: The point of all of this is symbolism, pure and simple. Republicans want a direct confrontation with the president, and putting a bill repealing the health care law on his desk, forcing him to veto it and therefore making him defend the Affordable Care Act and Planned Parenthood, for that matter - that is the end game. What Republicans are trying to do is highlight the contrast between their party and Democrats and to make it clear to voters this year how life might be different under a Republican president with a Republican-led Congress. This is totally about messaging.

CORNISH: Right. But this is not an entirely new message, right? I mean, Republicans have voted dozens of times to repeal the health care law.

CHANG: Yes, but they've never been able to show their constituents that they can get the bill to the president's desk until now. You're right. In the House, Republicans have voted more than 50 times the last five years to repeal all or parts of the Affordable Care Act, but it's never been so easy in the Senate because in the Senate, you need 60 votes to pass most legislation. And Republicans have never had that, neither before nor after they took control of the chamber.

But in 2015, what Senate Republicans did have at their disposal was a special legislative process called reconciliation. It's a procedural tool that allows certain kinds of legislation to get through the Senate with only 51 votes instead of the usual 60. This is actually one of the tools Democrats used to pass the health care law in the first place. Ad now Senate Republicans are using it to repeal the law.

CORNISH: Meanwhile, you know, if President Obama plans to veto this bill, voters aren't actually going to get to see, like, an alternative health care regime - right? - like, something that Republicans have come up with and put into action.

CHANG: That's right. Neither the House nor the Senate has ever debated any bill to replace the Affordable Care Act. So what would that replacement look like? You know, Senate majority leader Mitch McConnell famously said that he wants to repeal Obamacare root and branch. But he's from a state - Kentucky - that's shown significant improvement to health care access because of Medicaid expansion under this law. In fact, a number of Republican lawmakers are from states that have chosen to expand Medicaid, so the question is, could voters actually stomach it if Republicans really wiped away Obamacare?

CORNISH: All right, Ailsa, so what kind of Republican health care proposals are we likely to see out of Congress this election year?

CHANG: Well, that's the question that still needs to be answered. House speaker Paul Ryan gave a speech last month at the Library of Congress. And in that speech, he promised to unveil a plan that would replace every word of Obamacare. It would be a plan that's more driven by free market principles, but so far, no plan has been set forth. Ryan says Republicans can't just be the party of opposition. They can't just let the presidential candidates dictate the Republican agenda. But so far, he's been skimpy on details about what that new agenda would look like. And maybe next week we'll have some better idea. Republican lawmakers will be meeting in Baltimore for their annual retreat, and perhaps some concrete ideas will be hashed out then.

CORNISH: That's NPR's congressional correspondent Ailsa Chang. Ailsa, thanks so much.

CHANG: You're welcome. Transcript provided by NPR, Copyright NPR.

Ailsa Chang is an award-winning journalist who hosts All Things Considered along with Ari Shapiro, Audie Cornish, and Mary Louise Kelly. She landed in public radio after practicing law for a few years.