In his press conference on Tuesday, President Elect Donald Trump didn’t offer any indications of what a new health care plan might look like, but he did seem to confirm what other Republicans are saying, the Republicans won’t eliminate the Affordable Care Act before they have a replacement worked out.
“It will be essentially simultaneously,” Trump explained to reporters gathered at the Trump Tower in New York. “It will be various segments, you understand, but will most likely be on the same day or the same week, but probably the same day, could be the same hour. … And we’re going to get a health bill passed. We’re going to get health care taken care of in this country.”
That’s enough to put the 6.4 million Americans who’ve already signed up for Obamacare coverage in 2017, but Trump also seems to feel he’ll have a replacement in place in a few months, if not weeks.
During his first major news conference since last summer, Trump said that within days of the Senate confirming Rep. Tom Price (R-GA) as Trump’s secretary of health and human services, the new administration will propose specific language for both repealing key provisions of Obamacare and replacing it with a new Republican-style health insurance program.
His latest declaration on the subject clearly undercut those in his party who say it could take many months or even years before a full-blown replacement program can be agreed upon and phased in. Even the most optimistic of Republicans, including House Majority Leader Paul Ryan, have indicated it could take until the end of the year to strike an agreement on a major health insurance bill to replace Obamacare.
Republican congressional aides say that dismantling the Affordable Care Act would be the easier task and will involve passing a budget resolution which is protected from a filibuster in the Senate under special budget reconciliation rules. However, replacing Obamacare with a new health insurance program would be much tougher because Senate Republicans are eight votes short of the 60-vote super majority needed to pass major legislation. That means the Republicans will ultimately need help from the Democrats to push through a replacement.
Senate Majority Leader Mitch McConnell (R-KY) has pledged to bring up the replacement legislation as “quickly” as possible, and Ryan insists that “our goal is to bring it all together concurrently. But that sounds more like wishful thinking than an iron-clad strategy to accommodate an impatient incoming Republican president.
Virtually anyone who knows anything about the way Congress operates understands that replacement legislation of that magnitude takes many months, if not years, to assemble and enact. Even if McConnell and Ryan (manage to ram through a budget resolution repealing Obamacare on an expedited basis, drafting replacement legislation that meets the approval of Republican and Democratic rank and file members, insurers and other special interests and the more than 20 million Americans currently covered by Obamacare will be a herculean effort.
It took President Obama and his Democratic allies nearly two years to negotiate the terms of the Affordable Care Act.
“Even the repeal part isn’t very easy because you have to think yourself through what provisions you really want to keep and what you can afford to change,” said Joseph Antos, a health care expert with the conservative-leaning American Enterprise Institute. “But replace is so much more complicated. There are layers and layers of policy decisions that have to be made, and they interact with each other.”