WASHINGTON The Republican-led House of Representatives, on a near party-line vote of 244-185, on Wednesday once again passed a bill to repeal President Barack Obama's overhaul of the healthcare system.
Just like previous House efforts to end the two-year-old healthcare law, the bill is certain to be stopped by Obama's fellow Democrats who control the Senate.
Regardless, the fight over the landmark law, which has divided Americans and rallied the Democratic and Republican political bases, will likely rage on into the November 6 elections.
Five Democrats joined all Republicans in voting to repeal the law, which requires nearly all Americans to obtain insurance or pay a penalty tax.
House Speaker John Boehner and fellow Republicans scheduled Wednesday's vote after a divided U.S. Supreme Court last month upheld the law.
"We were promised this health care law would lower costs and help create jobs," Boehner scoffed. "One congressional leader even suggested it would create 400,000 new jobs. Guess what? It didn't happen. It is making our economy worse, driving up costs and making it harder for small businesses to hire new workers."
House Republican Leader Eric Cantor said, "This is a law that the American people did not want when it was passed and it remains a law that the American people do not want now."
House Democratic Leader Nancy Pelosi fired back by calling the Republican repeal measure "a useless bill to nowhere" that would hurt the "health and economic well-being of America's families."
Pelosi and other Democrats also ripped into Republicans for having long pushed to end Obama's healthcare law while failing to keep a promise to offer an alternative.
Democrats took advantage of the debate to highlight some of the law's popular benefits, including allowing young adults to stay on their parent's health plans until age 26.
The law also provides additional benefits for the elderly, including free wellness checkups, and bars insurance companies from setting lifetime limits on care costs.
By the Republicans latest count, this was the 33rd time that they have passed House bills to repeal all or parts of the 2,700-page healthcare law.
While a few provisions have been eliminated or changed, Senate Democrats have not permitted an outright termination of the law.
Democratic Representative Jim McDermott mocked Republicans repeated efforts to repeal the Affordable Healthcare Act, as the law is formally called.
"As a psychiatrist, I'm qualified to say this: One definition of insanity is doing the same than over and over again and expecting a different result," McDermott said.
At the White House, press secretary Jay Carney denounced Republican efforts as counterproductive.
"Casting these votes again and again and again ... does nothing to improve the bottom line for middle class families, does nothing to send a single 18 yr old American to college," Carney told reporters.
Democrats failed in their bid to attach to the Republican bill a provision that would require lawmakers to surrender their own taxpayer-subsidized federal healthcare benefits.
Voter dissatisfaction with the healthcare law helped Republicans win the House in the 2010 elections, and they hope it can give them a boost again this year. But Democrats are fighting back, and both sides are using the issue to raise campaign funds.
The House Democratic campaign committee has begun offering bumper stickers that read: "Dear John Boehner. It's constitutional. Get over it."
Public support for the healthcare law, despite some fluctuation, is divided just as it was in 2010. Neither side has made significant lasting headway.
Some recent polling has suggested that the law is of low importance to voters compared to other issues, such as the struggling U.S. economy.
A Washington Post-ABC News poll published Tuesday showed more voters than in the past saying the healthcare law will not be a factor when they cast their vote in November.
Another poll - a Kaiser Family Foundation survey taken after the Supreme Court upheld the law's constitutionality last month - found that 51 percent of independents and 82 percent of Democrats said opponents should move on to other issues.
But 69 percent of Republican respondents said they want to see efforts continued to roll back the law.
(Reporting By Thomas Ferraro; Editing by Fred Barbash, Eric Walsh and Jackie Frank)