Last week, House Majority Leader Eric Cantor (R-VA) promised to schedule the first full Obamacare repeal vote for this legislative session. That vote, which will likely come on Thursday, will give freshman Republicans in the 113th Congress the opportunity to cast their own purely symbolic vote against health care reform. It will also mark the 37th time that the GOP-controlled House has voted to get rid of the health law.

And, as the New York Times points out, House Republicans’ obsession with repealing Obamacare becomes even more apparent when the amount of time they’ve devoted to that issue is calculated as a percentage of the total time they’ve spent on the floor:

The repeal vote, which is likely to occur Thursday, will be at least the 43rd day since Republicans took over the House that they have devoted time to voting on the issue.

To put that in perspective, they have held votes on only 281 days since taking power in January 2011. (The House and Senate have pretty light legislative loads these days, typically voting only three or four days a week.)

That means that since 2011, Republicans have spent no less than 15 percent of their time on the House floor on repeal in some way. [...]

Michael Steel, [Speaker John Boehner's spokesman], said that spending 15 percent of their time on the issue was hardly a waste for Republicans. “Given that the bill amounts to a takeover of roughly 15 percent of the American economy,” he said, “that sounds about right.”

By some earlier estimations, Republicans in the 112th Congress wasted about 90 hours and $50 million dollars on their multiple failed efforts to get rid of the health reform law. This new Congress is shaping up to be no different. Even though Republicans have admitted they have lost on Obamacare, and are even acknowledging that their future repeal efforts will fail, they have continued to block legislative efforts to amend the health reform law in favor of stubbornly opposing it altogether.

The House conservatives who are focused on pushing the leadership further to the right have been particularly intent on scheduling a full Obamacare repeal vote this session. “It’s something that we wanted to move up on the list of priorities,” Rep. Steve Scalise (R-LA) told the New York Times. “And I’m glad they listened to us.”

Successfully repealing Obamacare would put more than 30 million Americans’ health coverage at risk, as well as increase the national deficit by billions. It would also ignore the opinion of the majority of the American public, who think that implementing Obamacare should be a top priority in their state. At this point, now that the bulk of the health law has already gone into place, most Americans aren’t interested in defunding it or repealing it altogether — they would rather tweak it to make it better.

Republicans are finally starting to admit they’ve lost on Obamacare, but that doesn’t mean they’re ready to give up the fight — even though they also acknowledge their repeal efforts are largely symbolic at this point. Some freshman Republicans in Congress have started pushing for yet another Obamacare repeal vote simply so they can assure their constituents back home they tried to get rid of the health law.

Thanks to House Majority Leader Eric Cantor (R-VA), those freshman lawmakers are about to get their wish. Cantor has promised to set an upcoming vote on a full repeal of the health reform law, tweeting that “it just keeps getting worse”:

It just keeps getting worse. I am scheduling a vote for next week on the full repeal of #Obamacare.

— Eric Cantor (@GOPLeader) May 8, 2013

Next week’s vote will mark the first vote on full Obamacare repeal so far this year. But it’s hardly the first ill-fated effort to repeal the law. The 112th Congress voted over 30 times to get rid of Obamacare, ultimately wasting about 88 hours and $50 million in taxpayer money in their efforts to deny health care to 30 million Americans.

It’s not exactly clear which aspect of the health reform law inspired Cantor’s assertion that it’s “getting worse.” There have been some recent claims that Obamacare’s implementation has been a “train wreck,” but those criticisms are largely overblown. In fact, the bulk of the health reform law’s provision have already taken effect, and have successfully improved coverage for millions of Americans. The rest of the Obama administration’s implementation efforts will focus on the 10 to 15 percent of Americans who remain uninsured, who will soon be able to gain health coverage through state-level insurance markets in 2014.

Partly thanks to the ongoing political battles over Obamacare, many Americans remain confused about whether it’s still law or whether Republicans have successfully been able to repeal it. Twelve percent of the population incorrectly believes Congress has already managed to dismantle the health reform law.

As some Republicans in Congress have recently considered a bill to expand an Obamacare program — an initiative that ended up being scrapped on Wednesday afternoon because the party could not secure enough votes from conservative members — some of the newest members of the GOP caucus want to take exactly the opposite approach. Freshman House Republicans are pushing for yet another vote on repealing the health care law, even though they acknowledge the effort is “just symbolic,” so they can tell their constituents they tried to get rid of the law.

The fact that the GOP bill to modify Obamacare was dropped on Wednesday points to the fact that a rift is forming in the Republican Party. Top leaders have accepted the fact that Obamacare is now the “law of the land,” and are therefore focusing their efforts on tweaking some of the health law’s provisions rather than pushing for full repeal. But that’s not enough for many of their right-wing colleagues, who are eager to accumulate their own anti-Obamacare records even if that involves voting on measures that are doomed for failure:

“The guys who have been up here the last two years, we can go home and say, ‘Listen, we voted 36 different times to repeal or replace ObamaCare.’ Tell me what the new guys are supposed to say?” second-term Rep. Mick Mulvaney (R-S.C.) said Wednesday at a forum sponsored by the Heritage Foundation. [...]

With repeal of the law seemingly impossible for the next four years, top Republicans are instead eyeing more modest measures that could change the law or its implementation.

But that’s not sufficient for many hard-liners in the conference who want the party to continue to push for full repeal.

“I want a chance as a freshman to do that, even if it’s just symbolic,” Rep. Trey Radel (R-Fla.) said.

Freshman members of Congress may be envious of the 36 different failed attempts to toss Obamacare that they missed out on, but those votes came at a cost. Between 2011 and 2013, Republicans wasted about 88 hours and $50 million in taxpayer money on their failed votes to repeal Obamacare. Meanwhile, the 112th Congress failed to pass a single piece of legislation to create jobs. Those misplaced priorities earned that body of lawmakers the unfortunate distinction of being the least productive Congress in history.

Nonetheless, the majority of the GOP still isn’t ready to change course. At the beginning of this session, Tea Party members introduced legislation to totally repeal the law even though they admitted their efforts were likely in vain. And last month, Senate Minority Leader Mitch McConnell (R-KY) asserted that “when it came to Obamacare, we gave it everything we have, everything we have, and we just lost” — only to go on to say that his party is “not backing down from this fight” anyway.

Continuing the Republican propensity to use every single policy and political issue imaginable as an excuse to launch attacks against Obamacare, Rep. Charles Boustany (R-LA) — a member of the powerful House Ways and Means Committee — asserted on Tuesday that Congressional efforts to comprehensively overhaul America’s tax code would include measures to repeal several important Obamacare funding provisions.

Boustany explained that the Obamacare tax measures “will be considered, most likely, in the context of fundamental tax reform,” since wrapping them into a bipartisan tax reform bill makes them more difficult to vote against. Among the provisions on the chopping block would be Obamacare’s 2.3 percent tax on medical devices, as well as a tax on so-called “Cadillac” health plans that wealthier Americans may choose to purchase.

The GOP-led House already voted to repeal the medical device tax, and as many as 17 Democratic senators have voiced their support for getting rid of the tax. But revenue sources such as the medical device tax and the fee on high-end health plans are crucial to funding Obamacare’s subsidies for buying private insurance, its expansion of the public Medicaid program, and its consumer protections for Americans pursuing health coverage.

While there has been some debate over the wisdom of the medical device tax — particularly since some lawmakers worry it could place too much burden on hospitals and device manufacturers — it will help provide tens of billions of dollars in Obamacare funding, along with the law’s other tax measures. Replacing that funding won’t come out of thin air. The lawmakers pushing for repeal will need to make sure that alternative revenue is available to carry out important provisions of the health reform law that seek to extend coverage to millions of Americans.

Boustany’s comments make one thing crystal clear: Obamacare opponents will continue using every possible piece of legislation as a vehicle for obstructing health reform. And, given national lawmakers’ mercurial approach to budgeting, there’s always the distinct possibility that Congress will be tempted to take away more and more funding once they begin chipping away at some of Obamacare’s revenue sources.

In the months since the tragic shooting at Sandy Hook Elementary School in Connecticut, what used to be a relatively hush-hush topic in American health care policy has become an open secret: the U.S. mental health care system is littered with serious coverage gaps. The stigma associated with receiving such care, a lack of readily-available access, and high out-of-pocket costs all contribute to the fact that millions of Americans aren’t getting the mental health treatment they need.

Newtown forced mental health care into the national spotlight, and both states and the federal government have proposed reform proposals — some of which are worse than others — to increase funding for mental health programs and strengthen community resources for treating mental illnesses at an early stage. For instance, Obamacare requires private insurance plans on its statewide marketplaces to cover mental services as part of its “essential health benefits,” and early results indicate that a 2008 law mandating that large insurers treat mental health benefits in the same manner as more traditional care may be working.

But as Politico reports, the biggest challenge facing Americans seeking mental health care therapy is the exorbitant out-of-pocket costs associated with such care, since many psychiatric practices still refuse to accept private insurance coverage:

Andrew Sperling, a lobbyist for the National Alliance on Mental Illness, said, “There are a lot of private practice psychiatrists who refuse to accept the lower rates offered by a plan, particularly for outpatient services, so that can create an access problem.”

A 2008 survey by the American Psychological Association found that 85 percent of licensed psychologists reported receiving some third-party payments. But a majority of those claims were paid by federal, state and local government programs.

That means that many Americans struggling with mental illnesses must pay out of their own pocket for talk therapy — which can run a couple of hundred dollars for a session — and other treatments. [...]

Those findings are even more worrisome considering the disproportionate effect that a lack of mental health care has on children enrolled in private health plans, where “there’s a tremendous dearth of practitioners… and of the few who are there, many, many of them don’t take insurance plans,” according to Debbie Plotnick, senior director of state policy for the advocacy group Mental Health America.

Surprisingly, government programs such as Medicaid offer fairly strong benefits for mental health patients, as Politico’s report shows. But the limited number of providers who accept private insurance for therapeutic care — and the high per-visit out-of-pocket costs such providers charge — lend some context to the 2011 Substance Abuse and Mental Health Services Administration (SAMHSA) finding that over half of Americans simply cannot afford the cost of mental health care. Unlike more traditional medical problems, mental health care treatment often requires ongoing therapy and outpatient treatments for which Americans are charged for every visit, making them less likely to purse essential care — and for children, the problem is even worse, seeing as 70 percent of children in need of mental care do not receive it.

Congress has recently introduced two separate bills to bring more integration between physical and mental care, as well as to provide schools and communities resources for early identification and treatment of mental health issues in America’s youth. But until steps are taken to encourage outpatient mental health providers to accept private insurance, Americans — and particularly American children — may still be unable to afford the coverage they need.