About 15 freshmen Republicans in the U.S. House of Representatives made news when they declined the health insurance coverage plan available to members of Congress. These fiscal conservatives, many backed by the tea party movement, came to Congress to reduce government and see it as inconsistent to take the government-subsidized plan, particularly when they are attempting to repeal the Affordable Care Act health care law.

"I feel I was sent to Washington to be something different," said Rep. Joe Walsh of Illinois in a recent interview. The decision comes at considerable expense because Rep. Walsh's wife has an undisclosed pre-existing medical condition that makes buying an individual insurance plan costly, if she can get one.

This region's Democratic congressman, Rep. Joe Courtney of the 2nd District, has watched the stance taken by the freshman Republicans with considerable interest. Fulfilling a campaign pledge he made before his election to the House in 2006, Rep. Courtney also forgoes congressional health coverage offered through the Federal Employees' Health Benefits Plan.

"I give them credit for being consistent," said Courtney of his new Republican colleagues.

Courtney declined to enroll in the health plan for a different ideological reason. Long an advocate for reforming health care so that coverage is available to all Americans, Courtney said in good conscience he could not accept the insurance until Americans had a chance to receive coverage as good as Congress's.

While not the only Democrat to take that position in Washington, he might be the last. Another noted holdout, Sen. Sherrod Brown, D-Ohio, elected in 1992, enrolled after the Affordable Care Act became law last year.

Courtney, however, said he will sign up only when the health exchanges called for by the new law begin in 2014; that is if Republicans are not successful in killing the act. In many respects the plan available to Congress since 1960 - that provides federal workers a variety of plans to choose from - is quite similar in structure to the planned state exchanges, intended mainly for those who don't have employer insurance.

The AARP compared the federal program and new health care reform law and concluded: "Many Americans will get the same deal as members of Congress."

Courtney concedes his stance is largely symbolic, though he considers it important nonetheless. Though it's a bit more expensive and not quite as comprehensive as the federal plan, Courtney does have insurance through his wife's plan. She's a nurse practitioner.

The congressman questions how any Republicans in Congress find it morally OK to continue receiving benefits that they want to prevent other Americans from gaining access to.

The health care law will use private insurance to provide near universal coverage, yet many Americans remain under the misimpression that it creates a new government-run insurance plan. A recent non-partisan Kaiser public opinion poll found 59 percent of people questioned think the law creates a new government plan. It doesn't.

Another 65 percent thought all businesses will be required to provide health insurance for their workers. They won't. In fact, businesses with fewer than 50 employees are exempt from that requirement. It does provide tax credits as an incentive for small businesses to provide coverage.

The law will give subsidies to help low- and moderate-income Americans to pay for insurance in the private sector and will expand an existing program, Medicaid, to cover very low income, uninsured adults, regardless of whether they have children. But it creates no new program.

Republicans are successfully campaigning against the myth, rather than the reality of the new law.

Most controversial is the provision requiring those who remain uninsured to pay a penalty tax. The tax is intended to dissuade freeloaders who go without insurance and then turn up in emergency rooms for costly care, the expense passed on to the rest of us through higher premiums when those folks can't pay.

Insurance companies say they cannot offer the popular elements of the law - providing insurance to individuals with pre-existing conditions, allowing young Americans to stay on parent plans through age 26, and ending yearly and lifetime coverage limits - unless all Americans are in the pool and risk is spared equitably. The industry cannot afford to cover people who only get insurance when sick.

Most federal judges reviewing challenges to the tax penalty have upheld its constitutionality, but two have not and an eventual ruling by the U.S. Supreme Court awaits.

Courtney is optimistic that Justice Anthony M. Kennedy, often the swing vote on the ideologically divided court, will find the law constitutional. He also expects that growing support for the law, as Americans learn more about it, will undermine Republican efforts to block it.

Perhaps, but this long fight is hardly over. It remains to be seen whether Courtney, if he sticks by his pledge, will ever get the opportunity to sign up for that congressional health plan.

Paul Choiniere is the editorial page editor.