WASHINGTON (Bloomberg)—With a symbolic vote to repeal the health care reform law, the Republican majority in the U.S. House of Representatives is starting a two-year campaign to undermine the law through piecemeal dismantling tactics and efforts to weaken public support.

The House is almost certain to pass legislation Wednesday that would roll back the law, fulfilling Republican campaign promises. Democrats, who control the Senate, say that they will block a repeal effort in that chamber—and that, in any case, President Barack Obama would veto it.

Once the vote is complete, Republicans will attack the law by trying to remove funding from key provisions and force Democrats to defend the law ahead of the 2012 presidential election. They also will move to craft an alternative health care plan.

“We'll do everything we can to delay and defund the provisions of the bill so that we can get some discussion going on how we can replace it,” House Majority Leader Eric Cantor, R-Va., told reporters Tuesday.

The health care law, enacted in March 2010 after being passed by the House and the Senate with no Republican support, was the top domestic priority for President Obama and congressional Democrats. It extends coverage to tens of millions of uninsured Americans, imposes new taxes on the highest wage-earners and health care companies and provides hundreds of billions of dollars in Medicare savings.

‘Can't go backward'

In a statement Tuesday, President Obama said he was “willing and eager” to work with Congress on improving the existing law. “But we can't go backward,” he said.

Repealing the act would be a “major setback” for tens of millions of people and hurt the economy, Treasury Secretary Timothy F. Geithner said in a blog posting on the Treasury Department and White House websites Wednesday.

“Repeal would mean children with pre-existing conditions could once again be denied coverage, young adults would be thrown off their parents' policies, and the chronically ill who have already enrolled in pre-existing condition insurance plans would have their coverage canceled,” Mr. Geithner wrote.

Thursday, House Republicans plan to pass a resolution directing four committees to draft and advance legislation that would replace the law. The 1½-page measure doesn't give specifics on what such legislation would contain, and Republicans haven't provided a timeline for moving forward with a proposal.

32 million uninsured

Drafting an alternative health care plan would force Republicans to make some of the same choices that President Obama made last year as he sought to expand coverage for the 32 million uninsured Americans, according to the Congressional Budget Office, while controlling costs for industry and government.

Republicans “haven't figured out what the alternative is yet” to President Obama's health care law, said Thomas Miller, a health care policy expert at the American Enterprise Institute, a Washington-based public policy center that favors limited government and free markets.

Still, he said, the vote on repeal is the beginning of a larger Republican campaign against the law.

“Does it succeed? That's beside the point,” said Mr. Miller. “Everything has to start with the first step to change the center of gravity and the way in which this issue is seen.”

Republicans plan to use the House Appropriations Committee to strangle the law's implementation.

Defunding the law

The panel's chairman, Rep. Hal Rogers, R-Ky., said in a Jan. 6 interview on “The Hugh Hewitt Show,” a syndicated radio talk show, that he would spend “the good part of the year, if not all the year” finding areas where his committee can defund the law.

Rep. Rogers' committee controls the congressional purse, and agencies administering the health care law need to be funded in coming years. The CBO estimates that the government needs at least $20 billion over a decade to meet the law's requirements.

Rep. Rogers said he would start by canceling “as early as possible” $12 billion in funding for Internal Revenue Service agents to enforce the law.

Republican lawmakers also plan a vigorous oversight operation led by House Oversight and Government Reform Committee Chairman Darrell Issa, R-Calif. Rep. Issa has said he will hold hundreds of hearings across a range of topics, and he has created a subcommittee that will examine the health care law.

Midterm elections

Democrats view the debate as a chance to build support for the law, a task some say the party failed to do last year before the Nov. 2 midterm elections.

“Apparently none of us did a good enough job, because public opinion is divided and they're unsure whether this legislation is going to be positive for them and their families,” House Minority Whip Steny Hoyer, D-Md., told reporters Tuesday.

The Republican proposal gives Democrats “an opportunity to remind people what's at stake,” Health and Human Services Secretary Kathleen Sebelius said on a conference call with reporters.

Democrats say that if the Republicans managed to undo the law, they would roll back a number of benefits that have already been implemented.

Young adults are now allowed to stay on their parents' group insurance plans up to age 26. About 1.2 million are expected to take advantage of that provision this year, according to an Obama administration estimate.

Benefits for workers

Companies also have gotten help paying for health care benefits for workers who retire before age 65, according to a government fact sheet.

So far, 4,748 companies—including financial services company Deutsche Bank Americas Holding Corp., food and beverage maker PepsiCo Inc., drugmaker Pfizer Inc., communications provider AT&T Inc. and carmaker General Motors Co.—have qualified for the assistance, which pays up to 80% of health insurance claims costs up to $90,000 per year.

A report issued Tuesday by the Department of Health and Human Services estimates that between 50 million and 129 million Americans have some sort of pre-existing medical condition. Starting in 2014, the health care law will bar insurers from excluding coverage for those people.

Republican efforts to take away those benefits will keep the health care law in the spotlight through the 2012 elections, Rep. Hoyer said.

“Is this going to be a two-year process? I think it will be,” he said. “It’s going to be an important issue in the election.”

Copyright 2011 Bloomberg