Now, as then, it is all ceremonial.  Republicans blocked Obama's nominees and his legislation.  They pretended to repeal the ACA, knowingly that the repeal would be voted.  
Remember that Obamacare is based on a plan Romney implemented in Massachusetts.  It's a republican idea.  It was opposed by republicans not because they disagreed with it, but because they didn't want Obama to have a victory.
There are a few Tea Partiers who think government should not have ANY social programs, but the bulk of republicans agree with it on all but a few minor points.