Republicans have no intention of heeding President Trump’s urgent demands for a new health-care plan to replace the Affordable Care Act, fearing the potential political damage that such a proposal could cause in 2020 and hoping he will soon drop the idea, according to interviews with numerous GOP lawmakers, legislative staffers and administration aides.
Not only is there no such health-care overhaul in the works on Capitol Hill — there are no plans to make such a plan.
Senate Republicans, who were caught off guard by Trump’s rapid shift to focus on health care last week, said the White House would need to make the first move by putting forward its own proposal. But administration officials said nothing firm is in the works.
Senate Majority Leader Mitch McConnell (R-Ky.) — acutely aware of the perils that health care poses for Republicans — does not intend to wade extensively into the issue, senators and aides said, even as Trump has revived his fixation on a campaign promise to eliminate former president Barack Obama’s health-care law.
Nor does Senate Finance Committee Chairman Charles E. Grassley (R-Iowa), whose panel would be central to any such debate. When asked whether the two Senate committees overseeing health-care policy are planning to draft a replacement proposal for the Affordable Care Act, Grassley responded flatly: “No.”
“Obamacare is something that’s not going to be replaced unless the courts would declare it unconstitutional,” Grassley said in an interview. “You won’t know that for a long time.”
The renewed debate over health-care policy was set off by Trump’s abrupt decision last week directing the Justice Department to intervene in a federal-court case seeking to eliminate the ACA in its entirety on constitutional grounds.
Although the outcome of that case is far from certain, the Trump administration’s aggressive move in court sparked panic among many Republicans — and a measure of glee among Democrats — over the prospect of a protracted battle over health insurance for tens of millions of Americans during a presidential election cycle. Most Republicans are particularly wary given that Democrats took control of the House after last year’s midterm elections in part because of their focus on preserving and expanding health-care programs.
Trump’s move also has baffled Republicans who wish he would have remained focused on the end of special counsel Robert S. Mueller III’s investigation into Russian interference in the 2016 elections rather than plunging the party into another fight over Obamacare, which the party has tried and failed to eliminate for nearly a decade.
But any plans to ride on the high of Mueller’s findings — which, according to Attorney General William P. Barr, did not establish a criminal conspiracy between the Trump campaign and Russia — swiftly ended with a tweet around 1 p.m. last Tuesday as the president began making his way to the Capitol.
That tweet — in which Trump proclaimed “The Republican Party will become ‘The Party of Healthcare!’” — was how McConnell learned the president was interested in taking up the issue again, according to an adviser to the majority leader, who spoke on the condition of anonymity to describe internal GOP interactions.
McConnell had previously wondered why Trump had suddenly invited himself to the weekly Senate GOP policy meeting at the Capitol, the adviser said. But McConnell later learned that Sen. Lindsey O. Graham (R-S.C.), out golfing with Trump at his southern Florida resort last weekend, had revived the subject.
Another perplexed GOP senator speculated that the rest of the party will figure out the next steps the next time Graham goes golfing with Trump.
The private pessimism from Republican lawmakers is nonetheless leaving Trump undeterred.
In phone conversations with senators and discussions with White House officials, Trump has made it clear he sees health care as a priority. He announced before traveling to a political rally in Grand Rapids, Mich., on Thursday that he had tapped a trio of GOP senators with health-care expertise — Sens. John Barrasso (Wyo.), Bill Cassidy (La.) and Rick Scott (Fla.) — to piece together an ACA replacement.
Barrasso, the No. 3 in Senate leadership, has drafted legislation promoting short-term, limited-duration health insurance that has caught the eye of White House officials. Cassidy, who like Barrasso is a physician, was one of the lead authors of GOP health-care legislation in 2017 that would have turned money for Medicaid and ACA subsidies into block grants for states, which could then use the money for any health-care system to their liking.
The president has praised Barrasso to other aides as someone who should be in the conversation, while indicating his interest in the block-grant bill developed by Cassidy and Graham.
Meanwhile, Scott has been focused on a narrower health-care effort targeting the cost of prescription drugs and is close to introducing legislation. He spoke privately on the phone with Trump on Wednesday, when the two men both expressed interest in taking on health care, Scott recalled.
“Look, I’m going to try to get something done,” Scott said. “But I think it accelerates everything if the White House had a plan.”
Indeed, there is little indication any health-care plan will materialize — or advance in Congress.
A senior White House official directly involved in the discussions said there was no specific proposal. McConnell also has no plans to put together a working group of Republican lawmakers to draft a health-care blueprint as he did in 2017, according to one official familiar with party strategy.
Grassley said no hearings are planned on replacing Obamacare in his committee, and Sen. Lamar Alexander (R-Tenn.), who leads the Senate’s major health panel, said his focus is working on “reducing health-care costs” and emphasized bipartisan efforts to do so.
Although Rep. Mark Meadows (R-N.C.), a close Trump ally, is working on a health-care plan to present to the president, several GOP officials said they want the president to just drop it.
“We are very eager to see what the White House submits for Congress to consider,” said one senior Republican aide, who spoke on the condition of anonymity because they were not authorized to speak publicly. “Until then, Republicans will focus instead on their legislative agenda and confirming Trump appointments.”
Operatives at the committees charged with electing GOP lawmakers — the National Republican Congressional Committee and the National Republican Senatorial Committee — have privately warned that the issue is not helping Republicans up for reelection next fall. Brad Parscale, the president’s campaign manager, has told others involved in the 2020 effort that he does not want health care to be the main issue in the race, people familiar with his comments say.
The GOP has been eager to highlight divisions among Democrats over various proposals for a Medicare-for-all type system, which Republicans characterize as a dangerous lurch toward socialism. Instead, they now confront questions about how exactly they would draft an ACA replacement — allowing Democrats to go on the offensive and tout the now-popular nine-year-old law.
About 20 million Americans would lose their health coverage if the law was overturned, according to an analysis by the Urban Institute, an economic and social policy think tank. Tens of millions more with workplace plans could also be affected, as employers would be allowed to scale back certain medical benefits and people with preexisting conditions buying coverage on their own would no longer be guaranteed access to coverage at no extra cost.
“They’re trying to take away health-care coverage from tens of millions of people, to take away protections for people who have preexisting conditions, to take away protections for 25-year-olds who are on their parents’ insurance policies, to take away protections so that people don’t get cheated by their insurance companies,” Sen. Elizabeth Warren (D-Mass.) told reporters Friday while campaigning in Marshalltown, Iowa. “That’s where the Trump administration is. That’s where their values lie.”
Yet Trump has viewed his new health-care push as a way to correct what he sees as his biggest political vulnerability, aides say. Trump has occasionally brought up the issue as one of his main frustrations as president, according to a senior administration official, and still complains frequently in private that the late senator John McCain (R-Ariz.) — who died last August — voted against the last Obamacare repeal effort in 2017.
“A lot of the squeamish Republicans will say they campaigned on this, and it’s a losing issue. But in 2018, they basically campaigned without Republicans putting forth an alternative,” said Marc Short, chief of staff to the vice president. “We should welcome a debate about whether more freedom and more choices lowers costs relative to Democrats’ march toward socialism.”
Annie Linskey in Marshalltown, Iowa, contributed to this report.