President Donald Trump seemed to suggest on Sunday that the Republicans’ replacement for the Affordable Care Act might not materialize until 2018.
The statement, which Trump made in an interview with Bill O’Reilly of Fox News, could signal a significant setback in the effort to repeal and replace the 2010 law, which has helped 20 million people obtain health insurance ― and which is suddenly showing some political resiliency.
Trump has stated previously that Congress should pass its Obamacare replacement plan at roughly the same time that it acts to repeal the law ― in part, so that people who now depend on it for coverage will know what they’re getting instead.
Trump has also said that he wants both steps to take place this year, ideally “very quickly.” At one time, both he and congressional leaders were suggesting that they hoped the repeal could take place within weeks, if not days, of Trump taking office.
That period is passing quickly, with no GOP health care plan in sight. And on Sunday, Trump was talking as if the party still needs a lot more time.
Toward the end of the Fox News interview, which aired in part just before the Super Bowl, O’Reilly asked Trump whether Americans can “in 2017 expect a new health care plan rolled out by the Trump administration ― this year?”
Here was Trump’s full response:
Yes, in the process and maybe it’ll take till sometime into next year, but we’re certainly going to be in the process. Very complicated ― Obamacare is a disaster. You have to remember Obamacare doesn’t work, so we are putting in a wonderful plan. It statutorily takes a while to get. We’re going to be putting it in fairly soon. I think that, yes, 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.
The usual caution applies here. Trump could have been talking about the time necessary to implement a new health care plan, rather than simply pass the blueprint through Congress. And even if he was talking about the time to pass legislation, he could have been speaking off the cuff.
It may be only a matter of time before his aides or allies rush to the microphones to “clarify” the president’s remarks and insist that the introduction and enactment of a Republican alternative to the Affordable Care Act is imminent.
But there’s good reason to think that Trump really did mean it would take longer to produce a bill ― and that, in this instance, he was reacting to information he’s received from leaders on Capitol Hill and from his own advisers.
Even before Trump spoke to O’Reilly, it was becoming clear that the effort to wipe away President Barack Obama’s signature domestic policy accomplishment was running into serious trouble. Despite nearly seven years of promising to come up with an alternative health care plan, Republicans are nowhere near agreement on how to craft one.
The problem for Republicans is that they’ve committed themselves to several goals that are almost certainly impossible to reconcile with one another. At various points, they have vowed to come up with a system that can provide, as Trump has put it, “great health care for much less money.”
Nearly any health care system that offers substantially less spending by the government is likely to lead to fewer people insured, less generous coverage for people who have it, or both of those things.
While the Affordable Care Act has plenty of shortcomings and no lack of people unhappy with its results, it has also provided financial and medical security to millions. Republicans have yet to produce a plan that could replicate those gains.
Within a few weeks of the November election, the Republicans who knew the most about health policy, such as Sen. Lamar Alexander (R-Tenn.), began to warn about this problem ― and to suggest that perhaps the party should move slowly on replace and repeal. At a GOP retreat in Philadelphia a little more than a week ago, lawmakers talked openly about their confusion on how, or even when, to proceed.
Meanwhile, Republicans have faced an increasingly intense political backlash from Obamacare’s defenders. Just this weekend, two GOP congressmen from relatively conservative districts confronted loud protesters at town hall meetings in which the Affordable Care Act was a major topic of discussion.
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