It's 2,444 miles from Santa Rosa to Washington, D.C.

The distance between Sonoma County policymakers and House Republicans may be greater still — at least on the subject of health care reform.

This week, county health officials predicted a big demand for insurance under the Patient Protection and Affordable Care Act. In Washington, meanwhile, Republicans renewed their efforts to bury the landmark health care law before it takes full effect on Jan. 1.

Rita Scardaci, the county's health director, estimated that 25,500 people will be enrolled within the first year — about half of all local residents eligible for health insurance under Obamacare, as the program is commonly known.

A newly formed coalition of health care professionals, called Covered Sonoma County, will start signing people up when the region's insurance exchange opens on Oct. 1.

"We do believe we are ready," Scardaci told the Board of Supervisors on Tuesday. "This is the beginning, and it's always good to start on a strong foot."

The action in Sonoma County and other communities stands in sharp contrast to the inaction on Capitol Hill.

House leaders postponed a critical budget vote this week because so many conservative Republicans are holding out for a government shutdown on Oct. 1 unless funding for Obamacare is taken out of the federal budget or the effective date is postponed for a year.

Some Republicans are so desperate to stop the health care law from taking effect that they're reported to be discussing an offer to reverse some of the sequester cuts.

With just five legislative days left before the end of the federal fiscal year, House Republicans staged yet another futile vote to undermine President Barack Obama's signature accomplishment.

Unlike many past votes, Thursday's wasn't about repealing some or all of the health care program. It was, instead, intended to paint Obamacare as a mismanaged disaster, a woeful failure before it even gets started.

The bill in question targeted tax subsidies designed to make health insurance premiums affordable for the working poor. It would mandate a verification program to ensure no one receives a larger subsidy than they're entitled to, and it passed on a mostly party-line vote.

The bill goes next to the Senate where it has no better chance than the 40 previous House attempts to undermine Obamacare. Even if it got through the Senate, it would be vetoed.

If you think verification of eligibility is a good idea, even a basic accounting principle, don't worry. That's already required by federal regulations. The legislation was just a pretense for yet another meaningless debate in the House.

Much of Obamacare already is in effect. In 17 days, people can enroll for a plan offered by private insurers through the health exchanges. Coverage takes effect Jan. 1. So does a ban on insurers denying coverage due to pre-existing conditions.

Republicans in Congress don't have the votes to change any of that. It's time to stop the theatrics and focus on something that Congress can — and must — do: Settle on a spending plan for the new fiscal year.

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