WASHINGTON — The Republican-led U.S. House voted to repeal President Barack Obama’s health-care law, an action party leaders said was intended to demonstrate their resolve to undo the president’s main domestic-policy achievement.

The bill, HR6079, was passed Wednesday on a vote of 244-185, with five Democrats, including Arkansas’ Mike Ross, joining Republicans in voting for repeal. The vote represents the 33rd time that House Republicans have voted to revoke all or parts of the 2010 health-care law, known as the Patient Protection and Affordable Care Act. The measure won’t advance in the U.S. Senate, where Democrats hold the majority.

Unless Republicans win the presidency and gain the Senate majority next session, their attempts to repeal the law will go no further than the House.

The health-care law “is making our economy worse,” House Speaker John Boehner, an Ohio Republican, said Wednesday before the vote. “Americans want a step-by-step approach that protects the access to care that they need, from the doctor they choose at a lower cost.”

Democrats said the House was wasting time that would have been better spent trying to create jobs.

But Rep. Marsha Black-burn, R-Tenn., said: “We’re going to keep at it until we get this legislation off the books. It was a bad bill, it has become a bad law.”

Democrats, who lost control of the House in 2010, provided all the votes to pass the health-care overhaul. The other House Democrats voting to scrap the law were Dan Boren of Oklahoma; Larry Kissell of North Carolina; Mike McIntyre of North Carolina; Jim Matheson of Utah; and Ross.

All five voted against the law’s passage in 2010. Boren, Ross and McIntyre voted to repeal the law in January 2011, while the other two lawmakers voted to keep it in place.

“From the beginning, I have said we need healthcare reform. However, the Affordable Care Act is too big, too costly and not right for Arkansas. The legislative process in crafting the healthcare reform law became more about politics rather than good public policy,” Ross said in a statement.

In an interview after Wednesday’s vote, Matheson said he opposed repeal the first time because he wanted the Supreme Court to rule on the law’s constitutionality. He said he supports some elements of the law, but on the whole “this does not create a path for us to have a sustainable health-care system for this country, and that’s why I think it’s time to hit the reset button and start over.”

Boehner said Republicans wanted to give Democrats who had previously voted to sustain the law a chance to reconsider, contending that“most Americans not only oppose this health-care law - they support fully repealing it.”

In a statement issued moments after the vote, Senate Republican leader Mitch Mc-Connell of Kentucky said he would press for a vote in the Senate, as well.

The U.S. Supreme Court on June 28 upheld the core of the health-care law. The justices, voting 5-4, said Congress can require Americans to carry insurance or pay a penalty, which the court said was within lawmakers’ constitutional power to tax.

Democrats said the ruling vindicated their policies, including a requirement for most Americans to havehealth insurance, starting in 2014.

Minority Leader Nancy Pelosi, a California Democrat, called the repeal provision “useless” and a “bill to nowhere.”

Pelosi said repeal would take away provisions that g uarantee coverage for children with pre-existing medical conditions, reduce prescription-drug costs for some senior citizens, provide for protective checks for patients of all ages and ensure rebates totaling more than $1 billion this summer for policyholders.

The law makes health care “a right, not a privilege for a few,” Pelosi said.

Michigan Republican Dave Camp criticized the overhaul law, saying “health-care premiums are not going down as a result of this law, they are going in the other direction.”

Camp, chairman of the House Ways and Means Committee, said the law contains a “pervasive incentive” for “employers to drop coverage because it’s cheaper to pay the tax” rather than insurance premiums.

In a column in Wednesday’s Washington Post, Health and Human Services Secretary Kathleen Sebelius disputed Camp’s contention about rising premiums. She also said the share of small businesses offering employee health-care coverage has held steady at 59 percent since the law passed.

“This is another of their message weeks dedicated solely to the politics of their base,” House Minority Whip Steny Hoyer, D-Md., said of the Republican efforts.

House Republicans had pledged to “repeal and replace” the health-care overhaul. Now, Republican leaders have dropped the word “replace” from their promise.

The omission is the result of an election-year calculation, analysts say: Republicans figure they stand to gain from public distaste for the 2010 measure’s central provision, the requirement that most Americans buy health insurance, and will lose if they start providing details about what they would do instead.

“They don’t care to replace it,” Ross Baker, a professor of American politics at Rutgers University in New Brunswick, N.J., said in a telephone interview. “They want to revert to the status quo. Whatever plan they have is going to end up alienating somebody, especially during a presidential campaign.”

The House won’t pursue other major health-care legislation before the November election because “the big thing is going to be the election,” Rep. Wally Herger, a California Republican who leads the health subcommittee of the Ways and Means Committee, said in an interview.

“Everybody is looking to the election, everything is second fiddle to November.”

MEDICAID WARNING

Meanwhile, Republican governors seeking to use last month’s Supreme Court decision to scale back Medicaid are being told by the Obama administration that the ruling on the 2010 health-care law leaves states little room to maneuver.

The ruling doesn’t allow states to cut people from their Medicaid rolls, Sebelius said in a letter to governors Tuesday. One passage of the law, called “maintenance of effort,” prevents states from reducing eligibility or benefits in Medicaid before new online insurance exchanges are to be available in 2014.

“I’m glad to see Secretary Sebelius reminding the governors that the Supreme Court only struck down a narrow part of the law about Medicaid expansion after 2014,” U.S. Rep. Chellie Pingree, D-Maine, said in a statement Wednesday.

Obama’s health-care overhaul sought to expand medical coverage to more than 30 million Americans by either subsidizing a person’s purchase of insurance from a company or by making them eligible for Medicaid. Sebelius moved to address a potential gap, saying she would exempt some people in states that opt out of the Medicaid expansion from the law’s mandate that they carry insurance or pay an annual penalty.

The Republican governors of Texas and Florida, two of the four most-populated U.S. states, along with South Carolina, Louisiana and Mississippi, have said they won’t participate in the law’s provision that raises income eligibility for Medicaid, which primarily provides health care to the poor. States opting out of the expansion would leave millions without insurance because they won’t be poor enough to qualify for Medicaid or wealthy enough to buy private insurance in the new exchanges.

“A very small number of affected individuals” who will still be subject to the law’s requirement that they carry insurance will receive a “hardship exemption” from the mandate, Sebelius said in her letter. She didn’t say how many people the exemptionmay cover. The law itself exempts from the mandate people who don’t make enough money to file a tax return.

Medicaid is run by states, with the federal government covering about 59 percent of the costs. Eligibility varies, with states such as Texas and Florida excluding most working-age adults who don’t have children. The federal healthcare law would expand state programs to cover everyone in families earning as much as 133 percent of the national poverty level, or about $30,657 for a family of four this year.

About 17 million people would be added to Medicaid if all states participate, according to the Congressional Budget Office. The federal government would eventually cover about 90 percent of the cost.

Information for this article was contributed from Washington by Roxana Tiron, James Rowley, Kayla Bruun and Alex Wayne of Bloomberg News; by Robert Pear of The New York Times; and by David Espo, Jennifer Agiesta, Alan Fram and Donna Cassata of The Associated Press.

Front Section, Pages 1 on 07/12/2012