With the Senate already having launched the process of repealing Obamacare when, as reported yesterday, Senate Budget Committee Chairman Mike Enzi released a 2017 budget resolution setting up the process to partially repeal Obamacare early in Donald Trump’s administration, on Wednesday vice president-elect Mike Pence met with Republican congressional leaders to plot the strategy of how to repeal Obama's signature healthcare law.
Speaking to House republicans, Pence said Trump plans to take executive actions to start unwinding ObamaCare on day one: "Our first order of business will be to repeal and replace ObamaCare," Pence told reporters, adding the process would begin "day one."
"The speaker of the house used the word ‘stable,’ and we will do that," Pence said at a news conference after a private meeting Wednesday with House Republicans. There’s a "broad range of idea on how to do this," he said, without giving details of what a replacement might look like.
The VP-elect added that “it will be an orderly transition to something better...using executive authority to ensure it’s an orderly transition. We’re working now on a series of executive orders that will enable that orderly transition to take place even as Congress appropriately debates alternatives to and replacements for ObamaCare.”
Rep. Chris Collins added that, "The president in his first day in office is going to do some level of executive orders related to ObamaCare," however he added that there were "no details whatsoever" on the orders discussed in the meeting. Rep. Mark Amodei of Nevada said Pence had told Republican lawmakers that "we are mindful of disrupting the markets."
Incoming White House press secretary Sean Spicer told reporters Tuesday that Trump considers Inauguration Day as "Day One" of his presidency: "He is prepared and ready to go. As he's said before, he wants to enact real change on day one. That will mean within hours of being sworn in," Spicer said. "He put his team on notice that he expects nothing less than everyone getting right to work for the American people."
Pence's call for an "orderly" transition comes as healthcare experts warn that the Republican strategy of repealing ObamaCare on a delay without an immediate replacement would cause chaos, leading to insurers dropping out of the market and people having few or no options for coverage.
At the same time, in a series of posts on Twitter, Trump urged fellow Republicans to assign blame to Obama's Democrats: "Republicans must be careful in that the Dems own the failed ObamaCare disaster, with its poor coverage and massive premium increases," Trump tweeted. "Don't let the Schumer clowns out of this web."
“Massive increases of ObamaCare will take place this year and Dems are to blame for the mess,” he added. ”It will fall of its own weight -- be careful!”
Despite Trump's eagerness to unwind Obamacare, Republicans will have obstacles to overcome. For one, they have not decided how long to delay the repeal of ObamaCare. Options floated range from two years to four years. Some Senate Republicans, meanwhile, are uneasy with the idea of repealing ObamaCare without a replacement immediately available. Roughly twenty million people stand to lose coverage if ObamaCare is repealed and no replacement materializes.
As The Hill notes, Senator Rand Paul this week became the latest Republican to call for simultaneous repeal and replace.
And while Republicans from Pence on down are clearly eager to get rid of ObamaCare, there is much more cautious enthusiasm among the GOP about crafting a healthcare policy to replace it. Lawmakers close to the pending overhaul described it as a lengthy and deliberative process, aimed to minimizing disruptions for Americans as the nation’s healthcare system changes.
“We have to make sure there’s a very effective transition going forward,” said Rep. Kevin Brady (R-Texas), who chairs the House Ways and Means Committee. “I’m hopeful that we can continue to lay out those pieces on a step-by-step basis through this year.”
“The devil is always in the details. What does repeal include, and what is the pace of replacement so that we can do it responsibly,” said Rep. Patrick Meehan (R-Pa.). “It’s not going to be any kind of one-and-done process. It’ll be work that will go on for a period of time.”
GOP lawmakers emerging from the meeting with Trump’s inner circle said no details for a replacement were discussed. Rep. Walter Jones equated the powwow to a “pep rally” aimed at boosting enthusiasm among Republicans for the job ahead.
Still, GOP conservatives in the caucus are clearly eager to get moving on repeal, even as a replacement continues to remain unclear. “Healthcare will be better and less expensive when ObamaCare is repealed,” said Rep. Jim Jordan (R-Ohio), head of the conservative Freedom Caucus. “I believe that.”
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Meanwhile, in a bid to salvage a major piece of his political legacy, Obama is meeting on Wednesday with congressional Democrats, including U.S. Senate Democratic Leader Chuck Schumer, to discuss ways to counter Republican-led efforts to repeal the Affordable Care Act.
Obama met with House and Senate Democrats at the Capitol in the morning to talk about ways that Democrats can keep in place at least some parts of the divisive health-care law, the signature legislative accomplishment of Democrats during Mr. Obama’s eight years in office. Obama told Democrats that he takes responsibility for not having fully communicated the potential benefits of the health-care law, according to a Democratic aide.
“Despite the negativity you have a big chunk of the country that wants this thing to succeed,” the president said, according to the aide. “There are real lives at stake in this thing.”
Representative Louise Slaughter, a New York Democrat, told reporters Obama’s speech was "nostalgic" and that he spoke of the 20 million people who rely on Obamacare. He spoke of letters received from people who said they would have died without it, she said. She scoffed at the GOP’s repeal strategy, saying, "You wouldn’t think of tearing down a house before you have a new one." Asked whether she intends to work with Republicans on a replacement, she said no.
"We don’t even think of repealing the law. Our job is to save the one we’ve got," Slaughter said.
Democratic Representative Tim Ryan of Ohio said the ball is in Republicans’ court on a replacement. "They’ve got to come up with a lot of answers if they repeal it," he said.
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Obama might have some success in preserving at least parts of Obamacare: Trump has vowed to protect some popular parts of the Obamacare law, such as barring insurance companies from denying coverage to people with pre-existing medical conditions. But he wants to replace it with a system that is "much better and much less expensive," as he told Reuters on Oct. 25 after premium increases emerged in some healthcare markets.
A House Republican leadership aide said there are lots of Republican “ideas” but it was too early to know what will end up in replacement legislation.
Cited by Reuters, the American Medical Association doctors' group urged caution in making changes to Obamacare, which the organization supported. "In considering opportunities to make coverage more affordable and accessible to all Americans, it is essential that gains in the number of Americans with health insurance coverage be maintained," the AMA said in a letter to congressional leaders.
The AMA said before any action is taken on Obamacare policymakers should lay out for the American people "in reasonable detail what will replace current policies."
That, however, does not appear realistic if, indeed, Trump plans to issue an executive order in just 16 days beginning the process of undoing Obamacare.