Despite White House veto threats, the House is ready to vote to repeal taxes on medical devices and kill a Medicare advisory board that foes say would ration health care as the chamber aims its latest whack at President Barack Obama's health care law.
Thursday's votes were slated a day after top House and Senate Republicans briefed rank-and-file GOP lawmakers about their plans should the Supreme Court annul federal health care subsidies for millions. Under the tentative House GOP proposal, states could design their own plans for funneling federal health dollars to residents and drop the health law's consumer protections, such as guaranteeing that family policies cover children until age 26.
A decision in the case, which Republicans have backed, is expected any day. A ruling voiding the subsidies would be a major blow to millions of people and to Obama's prized health care overhaul, which relies on the assistance to help make insurance affordable.
The medical device tax and the Medicare advisory board were "two of the most flawed and ill-conceived" parts of the law, said Rep. Michael Burgess, R-Texas.
Rep. Jared Polis, D-Colo., accused Republicans of restaging "the same tired debates." Since 2011, the Republican-run House has voted more than 50 times to repeal all or part of the law.
To help pay for the health overhaul, the law imposed a 2.3 percent tax on medical equipment, excluding personal items like bandages and eye glasses, starting in 2013.
Supporters of repeal — including Democrats from states where the devices are made — say the tax drives up companies' expenses, costs jobs and stifles innovation.
Opponents say taxes the law imposed on many branches of the health care industry were outweighed by added customers the law has created. They also object that opponents would pay the $24 billion, 10-year cost of repeal with bigger federal deficits.
The other GOP target is the Independent Payment Advisory Board that the law established. Its 15 members are supposed to propose ways to save Medicare money that would take effect unless Congress blocks them.
No board members have ever been appointed. It can only suggest savings if Medicare spending grows above specified amounts that haven't been reached recently and are not projected soon.
Board foes say it has too much power and would end up rationing health care to Medicare's elderly recipients. Its defenders say the GOP bill is just an attempt to weaken the health law.
In threatening vetoes, the White House said both measures would weaken federal health care efforts.
The potential impact of the looming Supreme Court decision — both to people and politically — could be far greater.
Conservatives bringing the case say the law's language limits subsidies to people in states that run their own insurance marketplaces — and not to residents of roughly three-dozen states relying on the federal HealthCare.gov website.
The Health and Human Services Department says canceling those subsidies would deprive 6.4 million people of assistance. Many experts say most would drop coverage, which would become unaffordable.
With Republicans running Congress, most want to find a way to avoid being blamed for causing such problems and antagonizing voters.
In the tentative responses discussed in separate closed-door meetings Wednesday, House GOP leaders said they would continue the subsidies for a year.
Then, states could receive federal block grants for the following two years that they could structure into any kind of health care aid they wish. All of the health law's regulations would end for those states, including popular ones like assuring coverage of children until age 26.
In 2017 — when Republicans hope to control the White House — the entire health law would be eliminated.
The Senate GOP plan, which could change, would continue federal aid for people who lost subsidies until after the 2016 elections, said a chief author, Sen. John Barrasso, R-Wyo.
Like the House plan, it would erase the mandates for individual and employer-provided coverage. Democrats say without those requirements, the health law would not function properly because too many people would be uncovered.
It remains unclear whether Republicans would have enough votes to push such plans through Congress. Solid Democratic opposition and a virtually certain Obama veto would await them.