House Republicans continued their multipronged attack on the health care law enacted last year with a vote Wednesday to eliminate a section in the law providing $15 billion over the next decade on such preventive health care issues as fighting obesity, reducing smoking and promoting better nutrition.
Republicans described the Prevention and Public Health Fund as a "slush fund" for the secretary of health and human services that is not subject to congressional approval or oversight.
The vote, almost entirely along party lines, was 236-183.
As with other GOP attempts to overturn or weaken the law, chances of making headway are slim as long as Democrats control the Senate and a Democrat resides in the White House.
The White House said Wednesday that President Barack Obama would be advised to veto the bill because passage "could worsen the nation's health and increase system costs by defunding prevention activities such as programs that promote physical activity, reduce the burden of chronic disease and prevent smoking and other tobacco use."
Republicans were not deterred: "We will repeal Obamacare piece by piece if that is what it takes," said Rep. Virginia Foxx, R-N.C.
Under the law, the HHS secretary has authority to allot some $7 billion through fiscal year 2015 and $2 billion a year thereafter on prevention, wellness and public health programs.
Secretary Kathleen Sebelius last year made grants of $500 million to states and communities, and in February this year she announced another $750 million to coordinate efforts to prevent chronic diseases such as diabetes and cancer, increase physical activity to prevent obesity and train public health workers in responding to infectious disease outbreaks.
The nonpartisan Congressional Budget Office estimates that the government would save $16 billion over the next decade by shutting down the program. But its supporters, led by Senate health committee chairman Sen. Tom Harkin, D-Iowa, said wellness and prevention programs can save billions of dollars in health care costs as well as save millions from early deaths.
Democrats: 'Saving a buck in the short term'
Republicans, Harkin said after the vote, "voted to save a buck in the short term rather than save lives in the long term."
Democrats cited a report from Trust for America's Health concluding that spending $10 a person every year for physical activity, nutrition and anti-smoking initiatives would result in more than $16 billion in health care savings annually within five years.
Christopher Hansen, president of the American Cancer Society Cancer Action Network, said eliminating the fund "would reverse an unprecedented nationwide effort to refocus the health care system on keeping people healthy instead of treating them when they get sick."
But the sponsor of the repeal legislation, Rep. Joe Pitts, R-Pa., said that while some of the spending might be laudable, "we have created a slush fund that the secretary can spend from without any congressional oversight or approval." The bill, he said, "is about reclaiming our oversight role of how federal tax dollars should be used."
The fund survived another challenge last fall when Sen. Mike Johanns, R-Neb., unsuccessfully sought to cut off money for the program for several years as a way to pay for a bill to remove an unpopular tax filing requirement from the health care law. Johanns said Congress already spends $1 billion a year on public health programs, and another slush fund was not needed.
Democrats rejected the slush fund characterization, saying the House and Senate appropriation committees also have the authority to allocate money under the fund and that Sebelius worked with Congress in crafting the $750 million plan for this year. They said allocations go through the normal budget process.
The House already this year has voted to overturn the health care act and on Thursday is expected to vote for a second time to withhold all funding for the act this year as part of the agreement to keep the government running for the rest of the budget year. Such legislation is almost certain to be defeated in the Senate.
Less certain is the outcome of court cases challenging the constitutionality of the law, which will likely to be decided by the Supreme Court.