In the heat of the legislative fight over the Affordable Care Act, Obama administration officials argued that including a steep tax on high-cost health insurance plans would hold down soaring costs by prompting employers to rein in such plans and force employees to spend more of their own money on their care.
On Wednesday, that feature, once considered central to Obamacare, was dealt a blow by an unlikely foe: Democrats.
The House voted almost unanimously to repeal the tax, not only a key cost-containment provision in Barack Obama’s signature health law but also one of the main ways it was supposed to pay for itself.
The tax is supposed to take effect in 2022, after being delayed twice. But the overwhelming vote in the House — 419 to 6, with only three Democrats opposed — increased the likelihood that it never does. Indeed, the debate on the House floor was striking, with one Democrat after another denouncing the provision as if Democrats had nothing to do with its creation.
But for Democrats, a key constituency is demanding repeal — organized labor. For decades, unions found it easier to bargain for richer benefits than higher wages, producing labor-sponsored health plans that now could face the tax.
On Monday, the A.F.L.-C.I.O., which represents more than 12 million workers, sent a letter to House members saying the tax was “driving employers to hollow out the health care benefits they provide, making medical care less affordable and creating serious access barriers for millions of workers.”