Just three days after running a widely praised meeting among GOP senators devoted to repealing Obamacare, President Donald Trump threw Senate Majority Leader Mitch McConnell’s already ailing bill into further chaos Friday.
Trump, who has previously said that he would prefer Obamacare be repealed and replaced at the same time, reversed course Friday morning, and began echoing conservative senators who want to take up a 2015 bill that would have gutted Obamacare without providing an immediate replacement.
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“If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!” Trump wrote on Twitter Friday morning.
The GOP-led Congress passed the 2015 bill, but it was vetoed by President Barack Obama. Every Republican senator at the time supported it except Sen. Susan Collins of Maine, though some Republicans likely backed it in part because they knew it would be vetoed.
The irony of Trump’s latest stance is that it isn’t new at all for the party, which has struggled to fulfill its 7-year vow to dismantle the health law.
GOP leaders initially planned to repeal Obamacare in January by following the contours of their 2015 effort. But lawmakers themselves balked at the idea of slashing benefits to their constituents with no clear plan to replace them. Sen. Rand Paul of Kentucky lobbied strongly for simultaneous repeal and replace efforts, and Trump told him he "completely" agreed with him. Then the party went off on a six-month quest to try to do a complete overhaul of the law.
But on Friday, Paul made clear on Twitter that he now wants to again separate the two: "I have spoken to @realDonaldTrump & Senate leadership about this and agree. Let’s keep our word to repeal then work on replacing right away."
Another challenge for Republicans hoping to pursue a two-step strategy: If Republicans use reconciliation to only repeal Obamacare, they would almost certainly need Democratic support to replace it at a 60-vote threshold. GOP leaders are hoping to use reconciliation twice this year, but are earmarking the second one for tax reform.
McConnell spent Thursday desperately trying to strike consensus among skeptical senators on how to revamp the health care system, meeting with a bloc of conservative critics like Sen. Ron Johnson of Wisconsin and Ted Cuz of Texas on how many regulations to slash.
Trump’s comments on Friday and earlier this week suggested he has doubts that McConnell will ever get 50 of the 52 votes needed to repeal the law under a party-line budget reconciliation process. Trump also said it would be "OK" if the bill failed at the top of a meeting with the Senate GOP on Tuesday, a gathering that otherwise seemed to motivate Republicans to try again to find agreement.
McConnell’s office did not comment on Trump’s Friday tweet.
Shortly after Trump’s message, conservatives who have criticized McConnell’s effort as maintaining too much of Obamacare found heart in Trump’s position.
"Almost every House and Senate Republican voted to repeal most of Obamacare in 2015," said FreedomWorks President Adam Brandon. “We urge Republican leadership in both chambers to heed President Trump’s call and fulfill their promise to repeal Obamacare when they come back from recess."
Conservative groups in recent days have expressed their frustration over the Senate plan for falling far short of the “root and branch” repeal that McConnell promised to deliver — a feeling exacerbated by his willingness to further alter the bill to meet the demands of the party’s moderate wing.
“It’s good to see the president joining us in terms of a full repeal effort,” former Virginia Attorney General Ken Cuccinelli said Friday morning on a conference call with conservative groups. “All we’re asking for is people to keep their word: Restore the rule of law by undoing this abomination.”
Trump’s early-morning endorsement of a straight repeal gave them additional ammo to position the health care debate as a referendum on Republican leadership, and on politically vulnerable senators like Dean Heller of Nevada and Jeff Flake of Arizona.
“The entire problem with the House bill and the Senate bill is that full repeal was never considered,” said Andrew Roth, vice president of government affairs at the Club for Growth. “And the reason why is because moderate Republicans have fundamentally lied to the voters about their true position.”
Trump’s new stance is a "direct result" of Sen. Tom Cotton (R-Ark.) chastising his colleagues at the White House on Tuesday as being "too weak" to pass Obamacare repeal now that they have a Republican president who would sign it into law, argued one person briefed on conversations with White House officials.
His Friday tweet also came just minutes after Sen. Ben Sasse (R-Neb.) went on Fox News and said he would send a letter to the president, urging him to call on the Senate to separate repeal-and-replace into two pieces of legislation if a compromise is not reached by July 10, when Congress returns from recess.
“We need repeal. We need replace. Trying to do them together hasn’t seemed to work. Maybe it will over the next week or week-and-a-half,” Sasse said. “I would be willing to compromise on some stuff that wouldn’t necessarily be my ideal.”
With a thin, 52-seat majority in the Senate, Republicans can afford to lose the support of just two GOP senators and still pass the bill. Already, a procedural vote on the measure this week was postponed because the measure had not gained sufficient traction among both moderate and conservative Republicans.
There was some movement late this week on the bill, with agreement emerging to provide more opioid money to states, allowing people to pay health insurance premiums with pre-tax money and keep some of the savings from the Obamacare taxes to help fund health care subsidies.
But Republicans left town on Thursday seemingly still mired in an intractable disagreement over how much to cut Medicaid and which regulations to cut.
"We’re kind of at a stalemate right now I would say," said Sen. Shelley Moore Capito (R-W.Va.).