With conservatives clamoring for quick action on dismantling and replacing the Affordable Care Act, the White House on Tuesday sought to reassure supporters that President Trump and congressional Republicans were still on track to complete work on legislation before the end of the year.
But White House Press Secretary Sean Spicer was less than reassuring, saying that repeal might happen sooner than later, but that “implementation of the pieces may take a little bit longer.”
“What we’re focused on is the end solution,” Spicer told reporters this afternoon. “And I think we have been very clear over and over again that the President is going to repeal and replace it, and that what Americans will get at the end of it is a health care solution that . . . is going to give them a lower cost health solution with more options.”
Trump on Sunday touched off an alarm bell among his conservative allies by suggesting in an interview with Bill O’Reilly of Fox News that the task of repealing and replacing the national health insurance program was proving to be far more complicated and difficult than he originally assumed – and that congressional action could spill over into 2018.
The president campaigned on a pledge of eviscerating Obamacare, boasted at a post-election press conference that Congress would act to repeal and replace the insurance program almost simultaneously, and then told The Washington Post more than two weeks ago that he would unveil a comprehensive replacement plan that would cover “everybody” within days.
But over the weekend he was noncommittal when asked by O’Reilly whether Americans can expect Obamacare to be replaced within the calendar year. "I would like to say, by the end of the year, at least the rudiments, but we should have something within the year and the following year," Trump said.
The Republican president also noted that the process is “very complicated” – but then urged Americans to remember that “Obamacare is a disaster” and needs to be replaced. The national health insurance program, while troubled from the start, has provided coverage to more than 20 million Americans and provides protection for older people and those with preexisting medical problems from discrimination by insurers.
But the 10 million people or so using the Healthcare exchanges have seen double-digit premium increases and untenable deductibles. The popular silver plan caps out of pocket costs for a family at $12,270; $6,110 for an individual. Perhaps more important to the average taxpayer: Obamacare would cost taxpayers $1.34 trillion over the next ten years according to the Congressional Budget Office. Last year alone, the program cost $110 billion.
House Speaker Paul Ryan (R-WI), arguably one of the most ardent proponents of toppling Obamacare, told reporters Tuesday morning that he still intends to pass legislation to supplant Obamacare this year. While Ryan has become highly cautious about contradicting the bellicose president, he said that Trump’s weekend comments have done nothing to alter his ambitious timeline.
“We are going to be done legislating with respect to health care and Obamacare this year,” Ryan said. But he, too, offered the caveat that it could take time for the new Trump administration to implement the changes.
“The question about how long it takes to effectuate the change, how long it takes to put these things in place, that’s a question that the [Department of Health and Human Services’ can answer, he said.
Ryan insisted that he and other Republican leaders have already carefully designed numerous elements of a replacement plan. However, it’s the worst kept secret in Washington that the Republicans are still lightyears away from a consensus on how to stitch an overall plan together and push it through Congress. The Republicans already have missed a Jan. 28 deadline for acting on a budget resolution designed to repeal key components of Obamacare – an essential first step in ultimately replacing the program.
And a number of more moderate senior Republicans, including Sen. Lamar Alexander of Tennessee, Susan Collins of Maine and Bob Corker of Tennessee, have advised slowing down the process and considering ways to “repair” Obamacare instead of replacing it.
With some GOP lawmakers literally skipping town hall meetings in their districts for fear of being pummeled with questions from constituents fearful of losing their health insurance, the air appears to be going out of the balloon of the “repeal and replace” movement on Capitol Hill.
But many conservatives are voicing frustration with Ryan and Trump about the slow pace and are demanding stepped up action to fulfill their party’s campaign pledge to voters.
Dan Holler, a spokesman for Heritage Action for America, told the New York Times yesterday that the political uncertainty around Obamacare repeal is mounting. “If the House has not passed a repeal bill and sent it to the Senate by mid-March, that would be serious cause for concern,” he said.
Conservative Reps. Mark Meadows of North Carolina and Jim Jordan of Ohio, the current and former chairs of the House Freedom Caucus, issued a statement last Thursday demanding a vote on a repeal bill “as soon as possible.”
“Health care will be better and more affordable once Obamacare is repealed,” they wrote. “We committed to the American people to repeal every tax, every mandate, the regulations, and to defund Planned Parenthood. That’s what the American people expect us to do – and they expect us to do it quickly.”