The House is expected to vote tomorrow on legislation that would repeal the health care law. While the measure is likely to pass the House, Senate Democrats are expected to block the legislation.

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JACKIE JUDD: Good day, this is Health On The Hill, I’m Jackie Judd.  The House of Representatives is debating today a repeal of the health care overhaul law.  A vote is expected on Wednesday.  Here to discuss the next 48 hours is Mary Agnes Carey, Senior Correspondent for Kaiser Health News.  Welcome, Mary Agnes.  The vote was delayed a week out of respect for the victims in the Arizona shooting.  Now that it’s here, will the tone change?  Will the substance change?

MARY AGNES CAREY: I think the tone may change.   I think that members may want to be a little more civil to each other, a little more respectful.  But the substance of the arguments will not change and the votes will not change.  Republicans are adamant about repeal of this law.  Democrats are trying to defend it.  And I think you’ll hear the same arguments, perhaps in a nicer tone, but the votes certainly aren’t going to change. 

JACKIE JUDD: And one of the main concerns is that this bill, this law, is a job killer.  In what ways?

MARY AGNES CAREY: They are very concerned that employers won’t add jobs, they’ll eliminate jobs, because the bill is too costly.  They think that many regulations that have been put forth so far and will come to be will be difficult for businesses to master.  And that somehow they will simply not create jobs or eliminate jobs based on it.  And it’s really very bad for business, that’s their feeling. 

JACKIE JUDD: Democrats have called the Republicans the party of “no.”  So what do the Republicans have to do after this vote to prove that they have a strategy beyond this to help Americans who are struggling, either with accessing health care or paying for health care?

MARY AGNES CAREY: The game plan in the House is to go to the committees of jurisdiction, ask them to take a look at the health care system and come up with ways to may health insurance more affordable, more available . They want to take some action, I’m sure, on medical malpractice reform; they want to help people with pre-existing conditions.  They say that they have similar goals that are attained with the new law, but they want to do it in a different way that’s smaller, less regulatory and scaled-back.

JACKIE JUDD: This debate is an opportunity for Democrats to try to resell those Americans who weren’t sold on this bill last year. Just today, and some would say it’s not an accident in timing, today the administration issued a report about the number of Americans with chronic conditions  who – they say – could be at risk for getting health insurance. Fill us in.

MARY AGNES CAREY: The report said that up to 129 million Americans who have chronic conditions – heart disease, asthma, this sort of thing – could be at risk, if they had to go to the individual market, to either not get coverage at all or face higher premiums.   The administration is trying to hone in on the feeling – their argument and that of many Democrats — that if this law is repealed, a lot of people will suffer. There are provisions of the law that are currently in place; things like lifting the lifetime limit, allowing an adult child up to age 26 to stay on your health insurance policy, help for seniors who fall into the doughnut hole on Medicare, 50 percent discount on the brand-name drugs.

Now the president and Democrats, with these tangible elements of the law in place, could say “If Republicans could repeal the law, you, America, would lose these protections.” Now, again, Republicans say: “We favor some of those. We want to do them in a different way.”  But I think president and Democrats will seize upon the fact that there’s not a viable Republican alternative right now, ready to go. They’ll say that will put Americans at risk to lose many of these elements of the law.

JACKIE JUDD: Just as a footnote, there are Republicans who have taken a first look at this report out today and have said that the number is greatly inflated.

MARY AGNES CAREY: Right. The health insurance industry said it overstates the problem. The Republicans have certainly said that not only does it overstate the problem but, in their view, it’s not all or nothing. They say they want to help with some of the problems in the health care system, but then again they want to do it in a different way.  But they don’t have something ready to go and I think that could hurt them.

JACKIE JUDD: Okay. Thank you so much, Mary Agnes Carey. We will check back with you later in the week.