Trump’s U-turn on health care
President pushes Republican senators towork through summer recess, get bill back on track.
WASHINGTON— President Donald Trump resurrected his party’s effort to replace the Affordable Care Act on Wednesday, a day after the Senate legislation collapsed, by abruptly reversing course to push Republican senators to work through their August recess until they pass something.
Trump’s attempt to inject fresh momentum into an effort that has split his party came as a surprise at a White House lunch for the senators, given his defiant statements on Tuesday that he would simply “let Obamacare fail” — a stance that seemed to end the longrunning GOP bid to undo his predecessor’s health care legacy.
Trump’s reversal came as the nonpartisan Congressional Budget Office said in an updated analysis that Senate Republicans’ proposal to repeal much of the ACA without a replacement would leave 32 millionmore Americans without health insurance over the next decade.
At the same time, it would double health care insurance premiums by 2026, budget analysts concluded.
The report offers a grim picture of what would happen if Congress moves forward with a plan to repeal much of the current health care law while waiting to develop a replacement.
The latest CBO score is similar to ones the office previously released to study the impact of repealing Obamacare without a replacement.
Trump’s sudden resolve to get an Obamacare repeal-and-replace passed came after he’s been on all sides of the issue in a whiplashinducing series of remarks over recent days and weeks, supporting repeal-and-replace, straight repeal and doing nothing.
The president’s shift seemed a tacit acknowledgment of the political danger of walking away from a campaign promise he’d made to repeal the law, just as Republicans had vowed for years before him.
Yet he also seemed to grasp that simply letting the health insurance program unravel without a replacement was not politically sustainable, now that millions of Americans depend on it for health care coverage.
“For seven years you promised that you would repeal Obamacare,” Trump chided senators as they sat down for lunch.
“Inaction is not an option. And frankly, I don’t think we should leave town unless we have a health insurance plan, unless we can give our people great health care.”
Despite new interest from the president, who for months has done little to sell the legislation to members of Congress or the public generally, the chances of success remain dim. Although Trump repeatedly portrayed the Senate as “close” to reaching agreement, the 52 Republicans remain deeply divided over health care policy and can afford to lose just two votes given the united opposition of Senate Democrats.
Senate Majority Leader Mitch McConnell, R-Ky., insisted he would push forward with a vote next week to start the legislative debate, but it is not clear he will have the 50 votes needed to proceed.
The inability to clear that hurdle stopped the bill this week. Several Republican senators had said they would vote against even proceeding to debate because they so objected to the legislation that McConnell had brokered behind closed doors. Most were unwilling to simply repeal Obamacare but could not agree with colleagues on alternatives for replacing it.
McConnell, backed by the White House, argued that Republicans had no chance to keep their campaign promise if they didn’t at least start the debate process. He promised that senators would have ample opportunity to offer amendments. “It’s pretty obvious that we’ve had difficulty getting 50 votes to proceed,” McConnell said. “But we cannot have a debate until we get on the bill.”
Senators emerged from the White House luncheon seemingly upbeat but also skeptical that their differences could be resolved.
Conservatives want to fully end the Affordable Care Act while more centrist lawmakers want to preserve aspects of the law, including its Medicaid expansion in their states.
Republican governors are among the more powerful critics of the overhaul effort in Congress, and key senators, including Sen. Dean Heller of Nevada and Sen. Rob Portman of Ohio, are not likely to part ways with governors from their own party who have been among the most vocal.
Trump used a familiar approach with senators — mixing friendly banter with pointed jibes. At one point, Trump singled out Heller, who was seated on his immediate right and is considered the most endangered Republican senator facing re-election in 2018. The president awkwardly implied Heller could lose his job unless he backed the Obamacare repeal.
“He wants to remain a senator doesn’t he?” Trump said, prompting a game smile from Heller.
But for Heller, and others, keeping aspects of the Affordable Care Act in place may be the more politically viable route to re-election in states like his with many beneficiaries.
The White House encouraged senators to let the administration know what changes would be needed to win their support. By retaining some of the Obamacare taxes on high-income earners, the Republican billwould preserve revenues that could be used to shore up coverage.
“We’re going to spend some more money to make sure everybody is protected,” Trump said.