In forcing the vote, House Speaker Nancy Pelosi (D-Calif.), who was crucial in ensuring passage of the 2010 law, now has Republicans on record on the lawsuit, and those votes could be used in campaign ads next year.

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The measure passed 235 to 192, with all Democrats supporting it and all but three Republicans opposing it.

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“A campaign is part of forming a government, and no issue resonated with the American people in the last election like the issue of preexisting conditions,” said House Ways and Means Committee Chairman Richard E. Neal (D-Mass.). “There’s no arguing with the following statistic, that today, between 17 million and 20 million Americans have health insurance that didn’t have it before the Affordable Care Act.”

In the midterm campaign, Democrats argued that Republican efforts to repeal the ACA would deny the insurance protection afforded to millions of Americans with preexisting medical conditions, a core element of the Obama-era law.

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Democrats have said that their singular focus on health care throughout the campaign was a winning political message as they flipped 40 House seats and claimed the majority.

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Republicans, led by President Trump, repeatedly said they would ensure coverage for those Americans with conditions such as cancer, diabetes or even a pregnancy, while at the same time backing a lawsuit to invalidate the ACA.

About 20 states with Republican attorneys general sued to invalidate the law, arguing that its coverage guarantee was unconstitutional because the 2017 GOP tax law eliminated the individual mandate. The Trump administration supported the lawsuit, arguing in court that a key part of the ACA was unconstitutional.

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In Texas, U.S. District Judge Reed O’Connor ruled last month that the ACA is invalid because of the change in tax law. His ruling is under appeal, and the law remains in effect pending a resolution.

GOP lawmakers argued Wednesday that the measure was a pointless messaging exercise and that Democrats are papering over problems with the ACA.

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