WASHINGTON — Republican anxiety is mounting over voting to unravel the healthcare law without having an alternative in hand, fanned by words of encouragement from Donald Trump to a GOP senator who wants to simultaneously repeal and replace the statute.
GOP leaders have made dismantling President Barack Obama’s treasured healthcare overhaul their premier 2017 priority. But even as the Republican-run Senate moves toward passing a budget that would make it harder for Democrats to protect Obama’s law later, at least six GOP senators have expressed qualms about repeal without having a substitute — something Republicans have failed for years to produce.
“We should start immediately to repeal, reform and replace Obamacare, and it shouldn’t be finally repealed until we have a replacement ready,” Sen. Lamar Alexander, R-Tenn., who is chairman of the Senate Health Committee that will be at the center of this year’s battle, said in a brief interview.
The Affordable Care Act, signed into law in 2010, has required people to obtain coverage. It also created subsidies to help lower-earning people buy policies and expanded Medicaid, but the overhaul has been troubled by rising costs for many consumers and markets that some insurers abandoned.
Sen. Rand Paul, R-Ky., who wants repeal and replace together, said the president-elect telephoned him January 6 to voice support for that timing. Trump voiced that opinion shortly after his November election, but he called Paul as GOP congressional leaders have moved in a different direction: A quick repeal vote, followed by work on an alternative that could take months or years to craft.
“He’s aware of my arguments for doing replacement at the same time, and he agreed,” Paul said.
House Speaker Paul Ryan said Republicans would try to repeal and replace the healthcare law “concurrently.”
Ryan told reporters, “It is our goal to bring it all together concurrently.”
Doing so is a challenge because of complicated rules in the Senate that allow Republicans to push through a repeal of the Affordable Care Act without Democratic votes – but may require Democrats to go along with replacing the health law.
Ryan indicated Republicans would try to use fast-track budget rules in the Senate for elements of the replacement plan, too, adding, “We’re going to use every tool at our disposal.”
Even if Congress passed repeal rapidly, Republicans say they would phase it in, perhaps over two or three years. Republicans don’t want to abruptly end coverage for 20 million Americans who’ve received coverage under the 2010 law, and don’t want to be vulnerable to Democrats already accusing them of preparing to tear down the statute without knowing how or if they’ll replace it.
“Turn back before it’s too late,” Senate Minority Leader Chuck Schumer, D-N.Y., said on the Senate floor just short of midnight as Democrats, before leaving for the night, lambasted Republicans with five-and-a-half hours of speeches. “It will damage your party,” Schumer said, “and it will hurt millions of Americans, far more importantly.”
Highlighting GOP indecision, Steve Bannon, who will be White House senior adviser after Trump is sworn in January 20, said, “We’re still thinking that through” when asked by reporters after a meeting in the Capitol if repeal and replace should happen together.
The burgeoning Republican divisions come as the GOP-led Senate pushed toward a final vote this week on a budget that would prevent Democrats from using a filibuster to block repeal. That’s crucial because filibusters take 60 votes to halt in a chamber that Republicans control by only a 52-48 margin.
Other senators voicing Paul’s sentiment include Republicans Susan Collins of Maine, Ron Johnson of Wisconsin, Tom Cotton of Arkansas and Bob Corker of Tennessee.
The budget gives congressional committees until January 27 to produce legislation annulling much of the healthcare law, although consequences for missing that deadline are minor.
Even so, Corker, Collins and three other GOP senators introduced a budget amendment delaying that target date until March 3. Corker said that would provide “additional time to get the policy right.”
On CBS’ “Face the Nation” on Sunday, Senate Majority Leader Mitch McConnell, R-Ky., said replacement legislation would follow repeal “rapidly” but did not define the timetable.
Democrats’ Senate talk-a-thon condemning the GOP healthcare push ended just after midnight after roughly two dozen lawmakers spoke to C-SPAN cameras on the nearly vacant Senate floor. Democrats said Republicans want to “make America sick again” and were using a “repeal and run” strategy.