Overnight Healthcare: Three Republicans buck party in ObamaCare repeal vote

The House on Tuesday voted for the fourth time to completely repeal ObamaCare, but this time with instructions for its most powerful committees to craft its own version of a new healthcare law. All Democrats in the chamber -– joined by three Republicans, Reps. Robert Dold (Ill.), John Katko (N.Y.) and Bruce Poliquin (Maine) -- voted against repealing the law, by a final vote of 239-186. This is the first time the House has coupled an ObamaCare repeal with instructions to write a replacement, but they included a significant caveat. The legislation doesn't impose any deadlines on committees to finish their work. The House bill's sponsor, Rep. Bradley Byrne (R-Ala.), said he hopes the Senate will consider the bill by the end of the month. He added that lawmakers will face extra pressure because of the looming Supreme Court case on ObamaCare subsidies. "It's been a topic of conversation at that retreat and dozens of other conversations. It's obvious that we've got a likelihood of a court decision going against the administration and we've got to be prepared," he said. A spokesman for Senate Majority Leader Mitch McConnell (R-Ky.) said no decision had been made yet on when the House-passed repeal measure would hit the Senate floor. Cornering Paul and Christie on vaccines: The field of GOP presidential hopefuls is seizing on controversial comments from Sen. Rand Paul (R-Ky.) and New Jersey Gov. Chris Christie that have sparked a national debate on vaccinations this week. Sens. Marco Rubio (R-Fla.) and Ted Cruz (R-Texas), and Govs. Scott Walker (R-Wis.) and Bobby Jindal (R-La.) aimed to put their potential rivals in a corner as they all said Tuesday that parents should vaccinate their children, a stance widely backed by science. "There is a lot of fear mongering out there on this. I think it is irresponsible for leaders to undermine the public's confidence in vaccinations that have been tested and proven to protect public health," Jindal, a self-described health policy wonk, wrote in a sharply worded statement Tuesday afternoon. Paul enters damage-control mode: After 24 hours of intense media coverage for his vaccination comments, Paul received a Hepatitis A booster from the Capitol physician's office – and invited a New York Times reporter to watch. "It just annoys me that I'm being characterized as someone who's against vaccines," Paul, a medical doctor, told the Times as he received the shot, which was a follow-up from vaccines he'd received before traveling to Guatemala last year. Read more here. Government scientists chime in: Republicans on a House Energy and Commerce subcommittee on Tuesday used a hearing on the flu season to debunk claims that vaccines are not safe for children as fear continues to grow over the country's measles outbreak. Rep. Tim Murphy (R-Pa.) asked four of the country's top infectious disease experts if they believed that parents should have their children vaccinated. "Definitely," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "To me it's really a slam dunk what the decision should be." The three other officials — representing the Food and Drug Administration, the Centers for Disease Control and Prevention and the Office of the Assistant Secretary for Preparedness and Response — all emphatically agreed. All said they had vaccinated their own children. Read more here. GOP senator says hand-washing regs unnecessary: A freshman GOP senator argued this week that the government should not require food workers to wash their hands after using the toilet, saying "the market will take care of that." Sen. Thom Tillis (R-N.C.) called routine hygiene rules an example of government overreach at an event hosted by the Bipartisan Policy Center on Monday. "I don't have any problem with Starbucks if they choose to opt out of this policy as long as they post a sign that says, 'We don't require our employees to wash their hands after leaving the restroom,' " Tillis said to audience laughter in a clip captured by C-SPAN. "That's probably one where every business that did that would go out of business," he conceded, "but I think it's good to illustrate the point, that that's the kind of mentality we need to have to reduce the regulatory burden on this country." Read more here. Wednesday's schedule The Senate Finance Committee will hold a hearing on the White House budget request for the Department of Health and Human Services and the implementation of the Affordable Care Act. The House Energy and Commerce Health Subcommittee will consider a series of public health bills. State by state Conservative group targeting GOP legislators who won't sign anti-Medicaid-expansion pledge Tenn. shows how Republicans learned to embrace Obama's Medicaid Ill. Medicaid expansion could carry hefty price Fla. lawmakers say telemedicine deal likely this year What we're reading House Oversight chairman will give  Gruber a chance to hand over ObamaCare documents FDA approves Pfizer's high profile breast cancer drug Medicare offers relief to 400K caught in drug plan mix-ups Infection likely cause of post-surgery readmission What you might have missed from The Hill GOP: 'Risk corridor' payments unlawful Ted Cruz proposes to repeal ObamaCare Local officials blast proposed cuts to vaccination program HELP to examine drug, device development CBO: ObamaCare vets bill would raise deficit $900M Please send tips and comments to Sarah Ferris, sferris@thehill.com, and Elise Viebeck, eviebeck@thehill.com. Follow on Twitter: @thehill, @sarahnferris, @eliseviebeck