- The Washington Times - Friday, June 30, 2017

President Trump on Friday floated a potential Plan B to Senate Republicans who are struggling to break an intraparty logjam and pass a health care bill.

“If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!” he tweeted.

The idea mirrors one floated by Sen. Ben Sasse, Nebraska Republican, in a Friday letter to Mr. Trump.

It says if Senate Republicans cannot agree on an Obamacare replacement by July 10, when Congress returns from the Independence Day recess, they should revive a 2015 bill that used fast-track budget rules to gut the 2010 law without fear of a Democratic filibuster.

He said senators should then cancel the August recess and work — six days a week — on a reform package that can be passed by Labor Day.

“You campaigned and won on the repeal of ObamaCare. So did every Republican senator. We should keep our word,” Mr. Sasse told Mr. Trump.

Sen. Rand Paul, Kentucky Republican, offered his support for the idea on Twitter, saying “Let’s keep our word to repeal then work on replacing right away.”

Breaking the Republican repeal-and-replace effort into discrete parts would be a departure from the current strategy.

The House already passed a bill that attempts to gut the 2010 Affordable Care Act and replace as much of it as possible under the budget process.

Yet Senate Majority Leader Mitch McConnell is still trying to mollify competing factions within his conference.

Moderates are leery of gutting Obamacare’s consumer protections for the sick and curtailing federal spending on Medicaid coverage for the poor, while conservatives have been pushing to kill off as much of President Obama’s signature program as they can.

“On the current path, it looks like Republicans will either fail to pass any meaningful bill at all, or will instead pass a bill that attempts to prop up much of the crumbling ObamaCare structures,” Mr. Sasse said in his letter. “We can and must do better than either of these — both because the American people deserve better, and because we promised better.”

Mr. Sasse had been in touch with the Trump administration, including Vice President Mike Pence’s team, for months on repeal-and-replace strategy.

The senator discussed his “repeal, then replace” strategy in an interview on the “Fox & Friends” television program early Friday, and Mr. Trump tweeted his support for the idea shortly thereafter.

It’s unclear how much traction the repeal-then-replace idea will get.

Republican leaders initially planned to pursue a form of that strategy, delivering a quick strike at the law and then using a multi-year transition to usher in a replacement, yet key senators and Mr. Trump pushed for a simultaneous replacement.

Moderate Republicans who’ve already balked at a bill that preserves parts of Obamacare would likely be skittish about voting to gut Obamacare without knowing if their party can agree on a replacement.

A coalition of conservative groups blasted centrists for appearing to get cold feet on full repeal of Obamacare, saying they want to “trim the hedges” instead of ripping out the law root and branch.

And they applauded Mr. Trump and Mr. Sasse for prioritizing repeal ahead of the replacement effort, saying it would fulfill a Republican pledge that dates back to the tea party wave of 2010.

“This would get repeal done and allow the Democrats and the Republicans to work together on improving our health care system,” said Jim DeMint, a former U.S. senator and president of the Heritage Foundation who is now adviser at the Convention of States.

The 2015 repeal effort would have scrapped Obamacare’s mandate penalties on individuals and employers and then phased out its taxpayer-funded subsidies and expansion of Medicaid a couple years out, so no one would lose their coverage right away.

Conservatives want to replicate that effort, though the free-market Club for Growth said congressional Republicans should try to scrap all of Obamacare’s regulations on insurers, too, so lawmakers don’t lock them in during the replacement phase.

“All of it needs to go,” said Andy Roth, a vice president of government affairs for the group.

The Senate parliamentarian could strike the deregulation push as outside the scope of the budget process, though Mr. Roth said Republicans need to test the waters instead of hiding behind an assumption of defeat to preserve aspects of Obamacare.

Jenny Beth Martin, president of the Tea Party Patriots, said at a minimum, Senate GOP leaders should adopt an idea being pushed by Sen. Ted Cruz of Texas that would allow insurers who sell Obamacare-compliant plans to also offer noncompliant plans that would be cheaper for consumers.

Providing those options could win over the likes of Sen. Mike Lee, Utah Republican, and other conservatives.

Centrist holdouts, meanwhile, are focused on applying savings from the plan to soften the bill and satisfy their priorities, including $45

Senators were weighing a proposal that would keep Obamacare’s 3.8 percent investment tax on wealthier individuals, which could free up $172 billion elsewhere to head off rising premiums or help people in danger of losing coverage.

But idea has run into opposition from conservatives, who want to repeal as many of Obamacare’s taxes and regulations as possible.

The Congressional Budget Office also released an updated analysis of Republicans’ bill on Thursday that said Medicaid spending would drop by 35 percent over 20 years compared to its baseline budget.

Democrats said the figures prove the GOP plan would force states to shoulder more health care costs or slash benefits beyond the 10-year budget window that’s typically used to vet legislation.

• David Sherfinski contributed to this report.


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