No doctors in white lab coats will be paraded before the television cameras pleading for repeal. The rhetoric is likely to be less about socialized medicine and government takeovers of health care and more about the health care law’s impact on the real issue driving the election — jobs and the economy.

Moreover, divisions are emerging over the wisdom of pulling the law out, root and branch. Some Republicans, facing re-election in swing districts, are openly suggesting that some measures should remain.

Others worry that the Republican leadership has yet to detail what the party would replace the health care law with. Representative Nan Hayworth, an ophthalmologist and a freshman Republican from New York, said she and others have a clear framework: bolstered health savings accounts, the option to purchase insurance across state lines, medical malpractice limits and a government-subsidized insurance pool for sick people who cannot buy insurance on their own. But those alternatives have not been broadly aired.

“We need to start expressing our principles promptly,” she said.

Such concerns are a sharp contrast to the first repeal vote, when a new, vigorous Republican majority was confident that they owed their triumph to voter anger over the health care law. Democrats were on the defensive, with all eyes on which survivors of the 2010 midterm tsunami would switch their votes for the law and embrace repeal. The House voted 245-to-189 to undo President Obama’s signature domestic achievement, with three Democrats joining in.

Representative Pete Sessions of Texas, chairman of the National Republican Congressional Committee, said the health care law was passed “with deception at its core” — a penalty for those who fail to purchase insurance has been unmasked by the Supreme Court as a tax on the middle class. He said he was still convinced that the issue would be “probably the biggest driver” ensuring Republican victory in November, outside of the tax increases that could come next year with the expiration of the Bush-era tax cuts.