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AUDIE CORNISH, HOST:

The House has voted to repeal the Affordable Care Act. While the House has voted more than 50 times in the past four years to repeal the law, or parts of it, this was the first vote for a total repeal since 2013. NPR's Juana Summers joins us from the Capitol with the latest. Hey there, Juana.

JUANA SUMMERS, BYLINE: Hey there.

CORNISH: So what made this vote different from the dozens - I think upwards of 56, right - enough times that Congress has held votes attacking the heath care law?

SUMMERS: Right, quite a few. We've seen this play out before, but here's what's different. First of all, this was largely a party-line vote, but three Republicans actually joined with House Democrats to vote against repealing the health care law. Something else that's different is that actually real people's health insurance is actually on the line this time. According to a recent estimate by the Congressional Budget Office, the Affordable Care Act reduced the number of uninsured by 12 million people last year, and it'll cut the number of uninsured Americans by 19 million people this year. So this is no longer really a theoretical, political, philosophy vote. And lawmakers could potentially face political backlash if they've now voted in favor of tearing apart a program that has benefited their constituents. This bill also includes instructions to committees to begin working on a replacement for this health care law. Republicans, since the 2010 campaign, have been promising a vote on a so-called Obamacare alternative, but they've struggled to coalesce around a comprehensive way to go about that.

CORNISH: Do you get the sense that this vote was geared towards the new members, the freshmen, right? They're right off the campaign trail.

SUMMERS: I do. They are right off the campaign trail and a number of them were elected in part by their constituents for coming out and forcefully speaking against this law. House Speaker John Boehner said something to that effect in a Fox News interview last week. He said that this new class wanted an opportunity to vote against the law and to get on record as saying that they were against it. Now, I spent the day speaking with a number of Republican lawmakers, including some of these freshmen, and most of them acknowledged that despite the vote today, this law is unlikely to be repealed with President Obama in the White House. But what they are saying is that it's important to send a message to the American people who voted for them as well as to begin putting a plan, or at least the outlines of a plan, in place for what a viable alternative to this health care law is.

CORNISH: Meantime, what are you hearing from the White House?

SUMMERS: Now, earlier today, President Obama met with nearly a dozen people who have benefited from the Affordable Care Act and he specifically mentioned today's vote.

(SOUNDBITE OF ARCHIVED RECORDING)

PRESIDENT BARACK OBAMA: My understanding is the House of Representatives has scheduled yet another vote today to take health care away from the folks sitting around this table. I don't know whether it's the 55th or the 60th time that they are taking this vote, but I've asked this question before. Why is it that this would be at the top of their agenda?

SUMMERS: That event was earlier today with people who wrote President Obama letters saying how they've benefited from the Affordable Care Act.

CORNISH: Where does the bill go from here?

SUMMERS: Now, it's passed in the House and that means this bill heads to the Senate where it's actually rather unlikely to pass. In order for that to happen, Republicans would need the support of six Democrats in order to even bring the bill up in that chamber. President Obama, as we noted, has also threatened to veto the bill if it does reach his desk as he's said with any bill that would take - dismantle his signature achievement in office.

CORNISH: That's NPR's Juana Summers at the Capitol. Juana, thank you.

SUMMERS: Thank you, Audie. Transcript provided by NPR, Copyright NPR.

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