Trump says let Obamacare fail as Senate balks — stakes high for Florida

July 19--As support for a Senate health bill collapsed, President Donald Trump tweeted Tuesday he wants to let the Affordable Care Act fail.

"As I have always said, let ObamaCare fail and then come together and do a great healthcare plan," Trump tweeted. "Stay tuned!"

It's a safe bet plenty of people in Florida will stay tuned to see what this means. More than 1 million Floridians receive government subsidies to lower their health costs in the Obamacare marketplace. Trump has threatened to end billions of dollars of such payments as "bailouts" to insurers, though they have been an integral part of the marketplace since it started.

Overall, Florida leads all states using the federal health marketplace with close to 1.5 million customers, in addition to 4 million served by Medicaid.

"President Trump, from all indications, is ready and willing to allow the continued sabotage of the existing law in order to make his self-fulfilling hope of Obamacare failure a reality," Palm Beach County-based advocacy group Florida CHAIN (Community Health Action Information Network) said in a statement.

As votes slipped away, GOP leaders talked of returning to a plan to repeal the health law effective in two years, without an immediate replacement ready.

But there's no such thing as going back in time without consequences including lost jobs, advocacy groups said. Under repeal without a replacement, Florida risks losing 181,000 jobs by 2019, part of 2.6 million lost jobs nationwide, an analysis by George Washington University's Milken Institute School of Public Health found.

The revived repeal-first plan looks a lot like legislation that a GOP Congress passed in 2015 before it was vetoed by then-President Barack Obama. But it too struggled to find enough support to stay afloat by Tuesday afternoon.

This time, it was three GOP women -- Susan Collins of Maine, Lisa Murkowski of Alaska, and Shelley Moore Capito of West Virginia -- who balked.

The defections made clear that despite seven years of promises to repeal the Affordable Care Act, Republicans apparently cannot figure out how to do it. Majority Leader Mitch McConnell insisted he would move forward with a vote on his measure to repeal the law, effective in two years, with a promise to work with Democrats on a plan to replace it in the meantime.

The vote to move ahead to the bill will take place early next week, McConnell announced late Tuesday. Its chances appear dim at this point, but GOP leaders want to put lawmakers on record and move on.

The small-government advocacy group Americans For Limited Government blasted Capito and Murkowski for voting for the same legislation in 2015 but bailing out now.

"This terrible outcome proves Senators Capito and Murkowski were never sincere in their promise to repeal Obamacare," said ALG President Rick Manning. "They were just phonies."

The Congressional Budget Office forecast the consequences of repeal with no immediate replacement could include sharply rising premiums, the threat of collapse in some markets and up to 18 million people losing or choosing to drop coverage in one year.

"This path to repeal is just as dangerous as the Senate's replacement plan," said Betsy Imholz, special projects director for Consumers Union. "The uncertainty created by Congress has scared off insurers, hurting the marketplace and consumers in real time. A full repeal of the Affordable Care Act without any replacement plan would trigger a financial, medical, and public health crisis."

She continued, "By simply repealing the ACA and abdicating their responsibility to consumers, Senators would be causing the same problems they had with their replacement plan -- millions uninsured, skyrocketing premiums, market instability and no protections for those with preexisting conditions are only the beginning of these disastrous consequences."

Trump administration Health Secretary Tom Price said Americans still need relief.

"Obamacare is flawed, failing, and harming the American people with higher costs and fewer healthcare choices," Price said. "The Trump Administration is, and always will be, focused on putting patients, families, and doctors in charge of healthcare."

Price said, "The status quo is not acceptable or sustainable."

Florida has plenty at stake not only in the Obamacare marketplace, but also with millions more people in employer plans. They also could be affected by repealing ACA rules, such as banning insurers from imposing annual and lifetime caps on benefits, requiring essential benefits like emergency, drug and maternity coverage, and other provisions.

Trump vowed to keep working on the most difficult legislative puzzle of his presidency. He said in another tweet, "We were let down by all of the Democrats and a few Republicans. Most Republicans were loyal, terrific & worked really hard. We will return!"

The Associated Press contributed to this report.

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