Concerns over repealing Obamacare growing among GOP lawmakers

Paul: Trump backs health repeal, replacement at same time

WASHINGTON — A Republican senator who challenged Donald Trump for the White House nomination says the president-elect "fully supports" repealing President Barack Obama's health law only when there's a viable alternative to replace it.

Republican leaders in the GOP-controlled Congress are moving toward a vote on repeal legislation in coming weeks, but they anticipate a transition period of months or years to a replacement. Some Republican lawmakers are expressing reservations about scrapping the law, which now covers 20 million people, without a near-term replacement.

Kentucky Sen. Rand Paul, who clashed with Trump during the GOP primary, said in a tweet late Friday that the two had a conversation and that Trump agreed with Paul's approach.

"I just spoke to @realDonaldTrump and he fully supports my plan to replace Obamacare the same day we repeal it," Paul tweeted. "The time to act is now."

Trump aides did not immediately respond questions about the conversation and how it had come about.

Nothing about revamping the nation's $3 trillion-a-year health care system will come easy, but GOP leaders want congressional committees to have legislation dismantling much of Obama's overhaul ready by late January. They're hoping Congress can quickly send a measure to the incoming president that would phase out the law, perhaps a couple of months later.

Crafting a GOP replacement probably will take more time, thanks to Republican divisions and solid Democratic opposition. It would be a political nightmare for Republicans to repeal the Affordable Care Act and then fail to pass a new version of the law.

Sen. Bob Corker, R-Tenn., told reporters Friday that Republicans might find themselves in a "box canyon" if they erase the law without a substitute in hand.

One part of Obama's law Republicans are eager to repeal is its tax increases on higher-earning people and segments of the health care industry that help finance expanded coverage. Corker said that if those taxes are voided but Republicans temporarily continue subsidies to help people buy coverage, "that means Republicans would have to vote for a tax increase" to pay for them — usually a non-starter for the GOP.

Sen. Ron Johnson, R-Wis., said Friday that if he had his way, "I would start bringing up those elements that start repairing the damage and I would start taking votes on those right now."

Johnson also expressed concern that Democratic opposition could scuttle the effort. Senate Minority Leader Chuck Schumer, D-N.Y., has said if Republicans void Obama's bill, Democrats won't help them pass alternative legislation.

Republicans probably will need just a simple Senate majority to approve their repeal bill, but for procedural reasons, later replacement legislation likely will need 60 votes. Republicans now hold a 52-48 edge in the Senate. That means a need for at least eight Democratic votes, though there will be pressure on 10 Democrats facing re-election next year from states Trump won in November.

"I take Minority Leader Schumer at his word that if we do this we're not going to get any Democratic support. In order to actually pass a replacement, we need Democratic support," Johnson told reporters.

After repeatedly trying to repeal Obama's law since its 2010 enactment, Republicans are under tremendous pressure from their voters to annul it swiftly.

But GOP leaders have talked about their repeal not taking effect for perhaps two or three years. They're discussing providing some type of revenue during that period to maintain coverage for people and perhaps for insurers so they won't immediately abandon markets.

Sen. Tom Cotton, R-Ark., also called this week for a simultaneous effort to erase the health care law and rewrite it.

"I don't think we can just repeal Obamacare and say we're going to get an answer two years from now," Cotton said Thursday on MSNBC.

He added, "We haven't coalesced around a solution for six years, in part because it is so complicated. Kicking the can down the road for a year or two years isn't going to make it any easier to solve."

© The Associated Press FILE - In this Nov. 8, 2016, file photo, Sen. Rand Paul, R-Ky. addresses the crowd gathered at his election victory celebration in Louisville Ky.

GOP resistance grows to Obamacare repeal without replacement

A growing number of Senate Republicans are resisting the idea of repealing Obamacare without a concrete replacement proposal, complicating GOP plans to move swiftly to undo the health care law.

Sen. Rand Paul (R-Ky.) started the open, intra-party dissension this week when the libertarian-leaning senator urged Republicans to vote on a replacement plan at the same time they pass a repeal bill. He was followed a day later by hard-line conservative Sen. Tom Cotton (R-Ark.), then by the more centrist Sen. Bob Corker (Tenn.).

And Paul said on Twitter late Friday that the most important Republican, President-elect Donald Trump, is fully on board, too.

"I just spoke to @realDonaldTrump and he fully supports my plan to replace Obamacare the same day we repeal it," Paul wrote. "The time to act is now."

At least a half-dozen GOP senators have now expressed public or private concerns about the party's current trajectory. Their worry: Republicans will be blamed for wreaking havoc on the health care system and causing people to lose their coverage without any assurance they have a superior — or any — plan of their own.

“I think the president-elect’s position is the right position,” Corker told reporters on Friday morning. “During the campaign he said that repeal and replace should take place simultaneously. That to me is the prudent course of action.”

The GOP can only lose two votes in the narrowly-divided Senate once Mike Pence becomes vice president and can break a tie. The package is expected to include a related provision to defund Planned Parenthood, which makes it more difficult for a pair of moderate Republicans, Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, to support it.

People close to Senate Republican leadership believe that they’ll ultimately have the votes to get the repeal plan through. Republican lawmakers, they say, will be hard-pressed to vote against killing a law so widely despised by conservatives.

But the complaints among lawmakers from various wings of the party are clouding the outlook.

“We’re going to have to work out the differences and try to build consensus to get it done. To me it’s unfathomable that we would not come up with the 51 votes. So we have to figure out where that sweet spot is,” said Senate Majority Whip John Cornyn (R-Texas). “I just don’t think failure is an option.”

Pence discussed the party's repeal-and-delay plans with House and Senate Republicans this week. But he gave no specific direction on whether he or Trump believes lawmakers should have an immediate replacement ready or how long the transition should be. Several Republican sources said Pence was “intentionally vague” about the administration's preferences so as not to make waves in the divided conference.

GOP senators said that the party is discussing issuing a framework for a replacement law that would be unveiled alongside the GOP’s repeal measure. They want to quell concerns among voters and insurance companies that Republicans actually have a plan to replace Obamacare. House Speaker Paul Ryan (R-Wis.) has issued principles for replacing the law, but the GOP’s efforts in the Senate have been disparate and uneven.

Paul said he intends to release a replacement bill next week.

“There’s political pressure to move quickly and to be decisive. It’s prudent to be thinking through not only what happens next month but in two, three, four years,” said a Republican senator familiar with internal deliberations. “It may be wise to put forward some replacement provisions so you take away the argument that it’s all about repeal.”

"The most important thing for the American people is to know that there aren’t going to be 20 million people without healthcare," added Sen. Dean Heller (R-Nev.), who is up for reelection in a swing state in 2018. "It's a messaging issue."

The criticism from Republican senators of the "repeal and delay" tactic may be aimed more at pressuring leaders to produce a replacement than to tank the repeal.

Cotton said Thursday that “when we repeal ObamaCare, we need to have the solution in place moving forward,” a warning against pushing a replacement far into the future. But his spokeswoman was clear on Friday: Cotton, she said, “will be voting in favor of repeal.”

Republicans said privately they're most worried about Paul. The Kentucky Republican and 2016 presidential candidate voted against a procedural budget measure this week to protest that Republicans aren't doing enough to cut the federal deficit. That was seen as a shot across the bow, since the budget is the tool Republicans will use to repeal Obamacare with a simple majority.

Paul then huddled with House conservatives to get them to join his push to simultaneously repeal and replace Obamacare. But when pressed, Paul said he’s likely to go along with his party.

“I will vote no on the budget, (but) in all likelihood, I will vote for the repeal. I am working very hard in my committee and in my caucus to say that we should simultaneously vote on replacement,” Paul said. “I think if you do repeal alone, the disaster continues to unfold.”

Sen. Bill Cassidy (R-La.) is also in Paul’s camp, though he said he’d “rather not answer the hypothetical” of how he would vote on a repeal bill that did not come with a replacement plan. Cassidy, however, said it’s pretty clear what Trump wants and that he hopes the Senate will give it to him.

“I think we need to know where we’re going to end up in a practical way so that when we begin this process we’re heading in that direction,” Cassidy said. He noted that Trump told CBS' "60 Minutes" after the election that "we should begin repeal when we replace.”

The GOP’s long-planned goal of cutting federal funding for Planned Parenthood is another wildcard. Murkowski has at times been a supporter of the family planning organization, though she did support the GOP’s 2015 effort to defund it along with repealing Obamacare.

Collins, however, did not side with her party's effort then. The Maine senator said she was “not happy” that Ryan wants to again try and defund Planned Parenthood as part of the Obamacare repeal effort. But she wouldn't commit to voting against such a package.

“I’m going to wait and see what happens,” Collins said. "So at this point, I feel it’s simply too early to predict exactly what’s going to come over to us.”


Senators wary of only repealing ObamaCare adds to GOP's dismantle travails

Congressional Republicans’ years-long mission to dismantle ObamaCare is becoming more of an uphill battle, amid a growing concern among some GOP senators about voting to repeal the health care law without a replacement.

The most recent is Kentucky Sen. Rand Paul, who late Friday tweeted that incoming President Donald Trump, a fellow Republican, agrees with his approach to simultaneously repeal and replace the 2010 law.

"I just spoke to @realDonaldTrump and he fully supports my plan to replace Obamacare the same day we repeal it," Paul tweeted. "The time to act is now."

Earlier in the day, GOP Sens. Bob Corker, Tennessee, and Ron Johnson, Wisconsin, expressed similar thoughts.

Corker said Republicans might find themselves in a "box canyon" if they just incrementally replace parts of the law.

He worries about congressional Republicans having to take an unpopular vote to increase taxes if, for example, they repeal the part of ObgamaCare that increased taxes on higher wage-earners but temporarily continue subsidies in the law that help lower-income Americans buy coverage.

Johnson said: “I would start bringing up those elements that start repairing the damage and I would start taking votes on those right now.”

President Obama’ signature law was created to provide universal health coverage to Americans, in an effort to reduce overall health care costs by curtailing emergency room visits for routine care and other uninsured medical expenses.

However, under-enrollment, particularly among young and healthy participants, along with doctors and insurance companies dropping out, has resulted in rising premium costs.

Trump and other Washington Republicans have campaigned almost endlessly on the promise to dismantle ObamaCare. But ending it without an alternative for the roughly 20 million now enrolled could result in a political train wreck. 

Senate Republicans on Tuesday, the first day of the 115th Congress, took the first legislative steps to repeal the law.

However, they made clear in the time between Trump’s November win and their return that a full replacement might take years, considering they had no alternative plan. The situation puts them under tremendous pressure to fulfill "Day One" promises to voters to end ObamaCare.

The Trump transition team did not respond Saturday to a request from FoxNews.com to verify Paul’s claim about Trump’s support.

Sen. Tom Cotton, R-Ark., also called this week for a simultaneous effort to erase the health care law and rewrite it.

"I don't think we can just repeal Obamacare and say we're going to get an answer two years from now," he said Thursday on MSNBC.

"We haven't coalesced around a solution for six years, in part because it is so complicated,” he also said. “Kicking the can down the road for a year or two years isn't going to make it any easier to solve."

With Trump as president and fellow Republicans controlling Congress, the GOP indeed finally has an opportunity to repeal the law.

But nothing about revamping the nation's $3 trillion-a-year health care system will come easy, with congressional Democrats vowing the stop Republicans at essentially every step. 

Senate Minority Leader Chuck Schumer, D-N.Y., has said if Republicans void Obama's bill, Democrats won't help them pass alternative legislation.

Republicans probably will need just a simple Senate majority to approve their repeal bill, but for procedural reasons, later replacement legislation likely will need 60 votes.

Republicans now hold a 52-48 edge in the Senate. That means a need for at least eight Democratic votes, though there will be pressure on 10 Democrats facing re-election next year from states Trump won in November.

"I take Minority Leader Schumer at his word that if we do this we're not going to get any Democratic support. In order to actually pass a replacement, we need Democratic support," Johnson said.

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