The battle over the fate of the Affordable Care Act dominated Capitol Hill Wednesday as Democrats rallied in one corner to receive encouragement from its architect, President Barack Obama.
Obama came armed not with a specific plan to halt Republican repeal efforts, but rather encouragement for Democrats to engage in a massive public relations push aimed at capitalizing on the law's more popular provisions. Democratic leaders pounced on a new slogan — "make America sick again" — and they are gearing up for two weekends of large, campaign-style rallies in cities across the country to defend the law beginning Saturday.
According to a Democratic source in the room, Obama also advised members to avoid working with Republicans on replacement legislation. Lacking a majority in either the House or the Senate, Democrats can do little to stop a repeal that only needs a simple majority. They can, however, make efforts to replace it difficult, since any replacement could need 60 votes in the Senate — more than the GOP has on their own.
As Obama was firing up the opposition, Republicans received assurances from incoming vice president Mike Pence that repealing and replacing the law is priority number one for the new administration and that the new president would issue executive orders to "smooth the transition" from the current health care structure. Just one day into the repeal process, lawmakers have been confronted with the political challenges and potential consequences of changes to a law that gave 20 million people access to health care.
In a series of tweets that showed the fragility of Republican efforts, President-elect Donald Trump cautioned his party to "be careful" in a series of tweets Wednesday, just minutes before Pence urged House Republicans to move full speed ahead.
During his more than 90 minutes with House and Senate Democrats, Obama took some of the blame for not doing a better job of marketing and selling the health care law to the public. He also said he's envious that he's no longer going to be in the political and policy fight, according to several members who attended the meeting.
Democrats emerged from the meeting seemingly poised to take his advice, insisting that Republicans will own any negative impacts from undoing the current health care system.
"They want to repeal it and then try to hang it on us. Not going to happen. It's their responsibility, plain and simple," Senate Minority Leader Chuck Schumer, D-N.Y., said.
He also said Democrats aren't going to bail out Republicans as they try to come up with a new plan. "We did already," and it has covered 20 million Americans, he said.
"We have the court of public opinion," said Rep. Joseph Crowley, D-New York. "The Affordable Care Act is a lot more popular than President Trump and our Republican colleagues would like you to believe."
Pence, however, didn't discuss Trump's tweets of caution in his meeting with House Republicans.
Instead, he gave his own pep rally to motivate Republicans to stay on track. He was joined by presidential adviser Kellyanne Conway, incoming White House Chief-of-Staff Reince Priebus and other top aides.
Pence told the caucus that Trump would enact executive orders to help "smooth out the transition process" from Obamacare, according to Rep. Mike Coffman, R-Colorado.
But what executive orders would be enacted are unclear. Pence gave no specifics.
"Executive actions would be part of us moving forward with no details whatsoever," said Rep. Chris Collins, R-New York, who the first member of Congress to publicly support Trump.
"Just so things could continue in the health care market place," he added about the executive orders. But Pence offered no roadmap or specifics on how Republicans could successfully pass a health care replacement.
House Speaker Paul Ryan said the current health care law is "failing" and that they must help the American people.
"We're starting today on our work to deliver relief to Americans struggling under Obamacare," Ryan said. "We need to reverse the damage that has been done. Then once we repeal this law, we need to make sure there is a stable transition to a truly patient-centered system."
He added: "We want every American to have access to quality affordable health coverage."
Sen. Joe Manchin, D-West Virginia, a moderate Democrat from a state that overwhelmingly voted for Trump, said that Republicans are going to find making changes to a program that gave nearly 175,000 people in his state health insurance risky.
"Now, a lot of the people didn't know, and they really still don't know, how they got health care called the Affordable Care Act or Obamacare. But I will assure you one thing, they'll know who did it and got rid of it for them," he said on MSNBC's "Morning Joe."
Even though Manchin, who is up for re-election in 2018, said he thinks repeal is not a good idea, he also said he disagreed with the advice to stonewall Republicans on a replacement
"If I break it, we gotta fix it," he said, indicating that Republicans could have a Democratic ally in any replacement effort.
The senator didn't attend Wednesday's meeting with Obama, but did meet with Pence on Tuesday.
The Senate voted to open debate on Wednesday on the budget resolution that starts the two-step repeal. Sen. Rand Paul, R-Kentucky, was the only Republican to vote against the procedural measure, in part citing his dissatisfaction with how the repeal and replace process is being handled by his party.
Senator Bernie Sanders, I-VT, who has said Democrats need to talk more aggressively about the needs of working people, brought an oversized Trump tweet to the Senate floor to illustrate his opposition to the repeal efforts, encouraging members to organize rallies around the country on Sunday, January 15. He's calling it "Our First Stand: Save Health Care" day of action.
Sanders noted that throughout the early parts of Trump's presidential campaign, he promised not to cut entitlement programs such as Medicare and Social Security, which he points out Republican plans would do.
"Donald Trump has got to come forward, maybe through one of his tweets, and say clearly that Donald Trump, he will veto any legislation that cuts Medicare, that cuts Medicaid, that cuts Social Security," Sanders said.