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On Thursday, House Republicans have scheduled a vote on a bill to repeal the Affordable Care Act.

Haven't they already done that, you ask? Yes, they have, in one form or another, 36 times since it has been enacted. This week's vote would make 37.

It's gotten to the point that today the director of the Congressional Budget Office, which is tasked with the job of informing Congress of the budgetary impact of the bills it is considering, said in a letter it didn't have time to go through the exercise for the 37th time.

One reason, the letter noted, is that "there are hundreds of provisions in the ACA and those provisions are already in various stages of implementation."

These provisions in effect now include the elimination of lifetime medical benefit limits, requirements that insurance companies cover children under 19 regardless of preexisting conditions, the ability of people up to age 26 to remain on their parents' health plan, coverage for preventative care, the shrinkage of the notorious Medicare "doughnut hole," and constraints on how high insurance premiums can increase relative to what they actually pay out in health care claims. In the works are the creation of health-care exchanges, which as early as October will allow people to compare and buy insurance plans online.

The latest CBO letter notes that the last time it did an analysis of the cost of repealing the Affordable Care Act last July, the costs to the federal government outweighed the savings by $100 billion. The raw numbers may have changed somewhat since then, but the bottom line hasn't. A House Republican caucus obsessed with lowering the deficit keeps voting for a bill that would increase the deficit.

There is one thing that the House could do this week instead that so far the Republican leadership is refusing to touch: vote on a budget. The Senate passed its version of a fiscal 2013 federal budget on March 23, two days after the House passed its version. House and Senate leaders were next supposed to designate conferees to iron out the considerable differences between the two budgets. But it has been 53 days, and House Republicans have yet to move forward to appoint conferees so that budget discussions could begin.

The failure of Democrats to pass a budget on time was a favorite GOP talking point. Now that the Democrats have put forward its vision of the country's priorities and how they should be paid for, House Republicans have shown no real interest in doing what it was elected to do: come to an agreement with Democrats on how the country can move forward. Their recent gambit is to insist on a "framework" for a budget deal before the actual dealing – but that's not how the process should work. That negotiate-the-negotiation tactic is surely their way of refusing to engage with the Senate on the loophole-closings for high-income earners and corporations that are in the Senate bill. Much better to cast a meaningless vote to repeal Obamacare than to struggle to find agreement on the federal budget.

Two numbers to remember: 37 votes to repeal Obamacare, 53 days and counting without a House agreement to negotiate on the 2014 federal budget. That should tell you a lot about today's House Republicans and the source of dysfunction in Washington.

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