The Republicans' time-crunched effort to pass a health-care bill stalled in the Senate. The Post's Paige Cunningham explains five key reasons the party is struggling to move their plan forward. (Jenny Starrs/The Washington Post)

 

As health-care legislation continues to stall, President Trump pitched a new idea in a tweet Friday morning, suggesting that the Senate could repeal the Affordable Care Act now and deal with replacing it later.

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

Doing so could leave in the lurch more than 20 million Americans who now have private health plans or Medicaid coverage under the ACA and would lose that insurance with no guarantee of any alternative. And the tweet seems to contradict Trump's earlier promises that he would provide “insurance for everybody” and that he would repeal and replace Obamacare as soon as he took office.

At a meeting at the White House earlier this week, Senate Majority Leader Mitch McConnell (R-Ky.) had threatened a different sort of Plan B: working with Democrats. A spokeswoman for McConnell declined to respond to a request for comment on the president's tweet.

Sen. Rand Paul (R-Ky.) has been calling for a repeal followed by an immediate replace for some time, and he responded to Trump's tweet by saying: “I have spoken to @realDonaldTrump & Senate leadership about this and agree. Let's keep our word to repeal then work on replacing right away.”

Earlier Friday morning, Sen. Ben Sasse (R-Neb.) — a frequent critic of the president — sent Trump a letter that proposed this “Plan B” for the health-care legislation: If senators have not agreed on the legislation by July 10, then Congress should “immediately repeal as much of Obamacare as is possible under congressional budget reconciliation rules,” and then cancel the August recess so that lawmakers can work six days a week writing a health-care reform package that can pass by Labor Day.

“You campaigned and won on the repeal of Obamacare,” Sasse wrote in the letter to the president, which was released by his office early Friday. “So did every Republican senator. We should keep our word.”

Trump’s tweet went further than the senator’s suggestion, because the president did not limit his suggestion to those parts of the current health-care law that could be dismantled under the Senate’s reconciliation process — special budget rules that allow the chamber to pass a bill with 50 votes and no risk of a filibuster. That process requires the bill to contain only items that affect federal spending, so could not be used to repeal many other parts of the sprawling 2010 health care law.

Sasse appeared on “Fox & Friends” Friday morning to pitch the idea to viewers — a group that often includes the president. Sasse said that he's still hopeful that the Senate can repeal and replace the Affordable Care Act at the same time, but he noted that the approach has yet to be successful. Sasse said there would be a one-year delay before the repeal kicks in, so lawmakers would have enough time to get a replacement plan in place.

“We need repeal. We need replace. Trying to do them together hasn't seemed to work,” Sasse said on the morning show. " … But we need to do as much repeal as we can. Every Republican voted for that.”

Trump's tweet came soon after Sasse's appearance, and the senator responded with a tweet of his own, saying: “Glad you agree, Mr Pres. If no agreement next wk, 2 steps: 1. Repeal 1st; then 2. Spend August full-time on replace.” He included a link to his Fox News appearance, just in case the president had not seen it.

Sean Sullivan and Amy Goldstein contributed to this report.