The Republican-led House on Wednesday voted to repeal a financially troubled part of the 2010 health care law that was designed to provide affordable long-term care insurance.
The House vote comes months after the Obama administration suspended the Community Living Assistance Services and Support program, known as the CLASS Act.
Health and Human Services Secretary Kathleen Sebelius in October said she was unable to find a way to make the program financially solvent.
Still, the White House has said it does not support repealing the program, under which workers would pay a monthly premium during their careers and collect a daily cash benefit if they become disabled later in life.
Republicans have targeted the program as part of their overall goal of dismantling the health care overhaul law. Action on the bill in the Democratic-controlled Senate is uncertain.
"Republicans are committed to repealing and defunding it, piece by piece if necessary," House Speaker John Boehner, R-Ohio, said of the health care bill after the CLASS Act vote.
The House vote was 267-159, with 28 Democrats joining all 239 voting Republicans in support.
The Senate has ignored House votes in the past year to repeal the entire health care law or to block funding for parts of it. One of the few changes Congress has been able to bring about concerned a requirement for small businesses to file more health care paperwork.
The CLASS Act was supposed to address the crisis in long-term care coverage. Currently some 10 million Americans need long-term care, and that number is expected to hit 15 million by 2020. But only about 8 percent of people buy private long-term care insurance.
Under the voluntary program, a priority of the late Sen. Edward Kennedy, monthly premiums would be used to finance benefits of at least $50 a day for those needing long-term care. The money would go for services at home or to help with nursing home bills.
But government actuaries determined that unless a large number of healthy people signed up, premiums would have to soar to unaffordable levels to meet the growing needs of the disabled.
Experts have concluded, said Rep. Phil Gingrey, R-Ga., that "the CLASS program can't be operated without mandatory participation so as to ensure its solvency." Unless it is terminated, he said, "it poses a clear danger to the fiscal health of our budget and to the American taxpayer."
The administration finally has come to the conclusion "that we knew even before the bill passed, that this was unsustainable, it was unworkable, it was fatally flawed," said the bill's sponsor, Rep. Charles Boustany, R-La.
But Rep. Henry Waxman, D-Calif., said the Republican goal was to "tear down and dismantle programs that provide health care in the United States." He said "the solution is to amend the program to make it work, not just repeal it and leave nothing in its place."