Congress is stymied at approving a sweeping health care reform bill. But that’s not preventing the House has from taking a “piecemeal” approach and passing more narrow, specific health care reform bills.

On Wednesday, the House okayed legislation that would strip health insurance firms from an antitrust exemption Congress granted them 65 years ago.

The vote was 406 to 19. All nay votes came from Republicans. House Minority Leader John Boehner (R-OH) who voted the package while House Minority Whip Eric Cantor (R-VA) voted yes in a rare split for the GOP leadership team. Other lawmakers voting no were Reps. Steve Buyer (R-IN), Todd Tiahrt (R-KS), Jim Sensenbrenner (R-WI), Paul Ryan (R-WI), Tom Price (R-GA), Ron Paul (R-TX), Jerry Moran (R-KS), John Linder (R-GA), Doug Lamborn (R-CO), Steve King (R-IA), Lynn Jenkins (R-KS), Jim Jordan (R-OH), Scott Garrett (R-NJ), Trent Franks (R-AZ), Paul Broun (R-GA), Kevin Brady (R-TX) and Todd Akin (R-MO).

“This is a victory for common sense,” said Rep. Tom Perriello (D-VA), one of the key sponsors of the measure.

Those for the repeal say that diminished competition helps drive up health care costs. But opponents of the bill say that concerns over health insurance monopolies are unwarranted.

The comprehensive version of the health bill approved last year by the House would have eliminated the exemption. The Senate bill did not.

The Senate hasn’t scheduled action on the measure yet. White House Press Secretary Robert Gibbs says he favors repealing the antitrust exemptions for the health insurance industry.