The House succeeded in passing a repeal of the Affordable Care Act today, by a vote of 244-185. This is, according to House Republicans, the 33rd time they have repealed some or all of the law in the 112th Congress.

Five Democrats voted with the majority Republicans to repeal the bill. All of them had voted against the ACA in March 2010. The five are Dan Boren (D-OK), Larry Kissell (D-NC), Jim Matheson (D-UT), Mike McIntyre (D-NC) and Mike Ross (D-AR). Boren and Ross are retiring this year; Kissell and McIntyre were gerrymandered into very difficult, nigh impossible, districts in North Carolina; and Matheson always has trouble winning re-election in conservative Utah, and will have more trouble this year, as his district got redder.

The bill will now crawl into a black hole and die. The Senate might get a vote on repeal, through an amendment attached to a small business tax measure, that will probably need a 60-vote threshold, and almost certainly fail. But that’s about it.

But Republicans contended that they wanted to put all members on the record about the law, which was found mostly constitutional by the Supreme Court two weeks ago. This was theater on a grand scale, with the attendant talk of massive tax increases and government takeovers of health care, the kind of sober talk we’ve come to expect from this debate.

The loud voices on repeal mask the quieter actions being taken in the states, where Republican governors have threatened to simply not implement the law. This threatens the coverage of millions of low-income Americans who would otherwise become eligible for Medicaid. It also could spur additional court battles over whether federally-run exchanges (when a state refuses to enact the insurance exchanges, marketplaces for individuals who need to purchase insurance, that feds can create the exchange) can provide coverage subsidies to individuals under the law. This effort, and not what Congress will do in the next several months, will serve to undermine the law’s effectiveness, if the governors continue to resist.

As for Congress and their unending series of electorally-motivated machinations and message votes, Chris Van Hollen summed it up today. “It’s no wonder the American people think so little of this institution.”