House Republicans repeal Obamacare again. Why do they keep doing it?

House Republicans booked yet another chapter of their drive to repeal President Obama’s signature health-care law on Thursday night, ramming their fourth complete repeal and 37th elimination of some portion of the law through the chamber on a 229-to-195 vote.

Two Democrats joined Republicans in voting for a measure that represents a cornerstone of the Republican attack on Mr. Obama and congressional Democrats in the election cycle to come. 

While the scandals currently roiling Washington – from the IRS’s overreach to the Department of Justice’s seizing of Associated Press phone records to a lack of clarity over the Obama administration’s response to the terror attacks in Benghazi, Libya – don’t seem to have a common theme, Republicans see a unifying thread: government overreach.

Republicans argue, in effect, this is what happens when you put your faith in big government. And at the bedrock of that critique, the purest form of this governmental overreach in the minds of many conservatives, is Obama’s signature health-care law.

Sen. Marco Rubio (R) of Florida put it just so on the Senate floor on Wednesday.

“This same IRS [who targeted conservative groups for more scrutiny] will now have unfettered power to come after every American and ensure that either you’re buying insurance or you’re paying them a tax. Every American business. The front lines of enforcing Obamacare falls to the IRS. That is what happens when you expand the scope and power of government,” Senator Rubio said.

“It’s always sold as a noble concept. It’s always offered up by government as, ‘We’re going to give the government more power so they can do good things for us.’ But the history of mankind proves that every time a government gets too much power, it almost always ends up using it in destructive ways against the personal liberties of individuals,” he continued.

The health-care law is such a fundamental piece of the Republican political playbook because it has enormous implications for the lives of ordinary Americans – and thus weighty political implications.

Republicans have argued for a long, long time that excluding a handful of popular provisions in the health-care law, the implementation of the bulk of the law regarding insurance exchanges in late 2013 and 2014 will be a disaster. That’s because, they argue, the law is too complex and dysfunctional to be well-implemented, Republicans argue, and will drive up insurance costs with little accompanying benefit.

“Ultimately, that’s the meaning of the vote being taken by the House of Representatives on Thursday,” said Joe Trauger, a vice president at the National Association of Manufacturers, in an e-mailed statement. “It is a vote of no-confidence.”

Americans tend to agree that the law will drive up premiums, according to a recent survey by TIPP/The Christian Science Monitor. Some 61 percent say that premiums will increase significantly versus 7 percent who think they will stay the same and 25 percent who think premiums will drop significantly.

Republicans have had some policy impact on the law already. On seven occasions, bills specifically targeting the health-care law or changes to the law folded into other bills have passed the House and been signed by the president.

Republicans think it’s such a bad deal, in fact, that they’re willing to overlook something that usually stops bill dead in its tracks – the fact that repealing the law adds to the deficit. When the Congressional Budget Office looked at the impact of repealing the law in July 2012, it concluded that such legislation would add just over $100 billion to the deficit over the next decade.

They also see a political benefit. Senate Republicans’ campaign committee targeted Democratic Reps. Bruce Braley of Iowa and Gary Peters of Michigan, two 2014 Senate contenders, with statements challenging them to vote to repeal the health-care law, for example.

Conservatives remember the 2010 midterms, when rage about the health-care law helped them give congressional Democrats a “shellacking,” in the president’s words, and put Republicans into the majority in the House. It’s that 2010 election – and to a lesser extent the 2012 polls – that force the GOP to hold votes on the issue.

The Monitor/TIPP poll shows the public is split on the law, with 46 percent saying the law should be repealed in full but roughly the same share of Americans saying the bill should either be expanded or left as-is (21 and 24 percent, respectively).

However, momentum may be in the GOP's favor. Forty percent of Americans view the health-care law more negatively than they did one year ago, according to the poll, compared with 10 percent who view the law more favorably. A slim majority, 51 percent, oppose the law either somewhat or strongly, while 39 percent support the law in some fashion.

But the law is a lightning rod with the conservative base, and conservative lawmakers are concerned about appearing to go soft on the issue.

Several members on the GOP conference’s most rightward flank objected to voting for a GOP proposal that aimed to shift funds from one part of the law to another last month, arguing that because the conference had not yet voted to repeal the entire law yet. Republicans didn't want to appear to be validating the law by tweaking it before voting to rip it out by the roots once again.

Those conservative concerns didn’t appear to be misplaced on Thursday: The base is certainly paying close attention.

Obamacare was not far from the lips of tea party activists protesting the IRS’s targeting of conservative groups on Capitol Hill.

“When you think about Obamacare being implemented and 16,000 more people added to the IRS, are they going to be next determining who can get health care based on your political views?” asked Dianne Belsom, a leader of a South Carolina tea party group.

As such, the 37th vote almost certainly won’t be the last.

“Many people have said this issue was dead. Many people have said that Obamacare is here to stay. We are here as the people's representatives, as real people from across the United States, to say this issue is now revived,” said Rep. Michelle Bachmann (R) of Minnesota, the sponsor of the health-care repeal law. “It is back on the table.”