Trump Hints At ACA Repeal Without Replace

President Donald Trump on Friday said he may support legislation that would repeal the Affordable Care Act while holding off on a Republican replacement for the 2010 healthcare law.

Trump's announcement on Twitter comes four days after Senate Republicans put off a vote on legislation drafted by Majority Leader Mitch McConnell, R-Ky., that would overhaul the Affordable Care Act, also known as Obamacare. Opposing factions of the Republican majority have argued the effort does not go far enough to repeal all the elements of the ACA, or that it offers no viable replacement for the 22 million Americans who, the Congressional Budget Office estimates, would lose health coverage under the GOP alternative.

"If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!" Trump wrote on Twitter Friday morning.

Trump's statement echoes ones made by some conservative holdouts eager to make good on the longstanding pledge by Republicans to do away with former President Barack Obama's signature domestic achievement. Public support for the current health care law peaked in a Gallup Poll published this spring.

By contrast, polling has shown intense opposition to the Republican legislation that would replace it.

Republican senators in 2015 voted in near lock step to repeal the ACA, but that vote was largely symbolic because they knew they did not have enough votes to override Obama's veto.

Under McConnell's bill, the federal government would begin rolling back the ACA's large Medicaid expansion in three years and would trim subsidies for middle-income Americans who are presently granted significant tax breaks to help them afford health insurance.

A full repeal of Obamacare would end all federal subsidies for individuals and health insurance companies that made individual plans more affordable and would halt Medicaid expansions for dozens of states, resulting in millions of Americans losing their coverage. Depending on how the repeal legislation would be written, those phase-outs could happen over months or years, giving Republican lawmakers time to draft and implement a replacement plan of their own.

That tactic has potential pitfalls. Under Senate rules, McConnell can tweak existing budget bills with a simple majority. Crafting new healthcare legislation, however, would likely face a higher threshold of 60 votes to overcome a Democratic filibuster. Republicans hold a 52-seat majority.

Democrats have said they are willing to negotiate changes to the ACA to address rising premiums and a dwindling number of insurance companies participating in government-run insurance exchanges, but have been united in their opposition to the Republican-led effort to repeal the law in its entirety.