The Promise: Repeal and Replace Obamacare, Cover Everyone, Preserve Entitlements

“Repeal and replace with something terrific,” Trump said of the Affordable Care Act, telling crowds repeatedly that whatever insurance plan he came up with would be way better than the current program, which he trashed for rising premiums.

Additionally, he promised in an interview with the Washington Post that “we’re going to have insurance for everybody,” and also vowed to tackle drug costs by dealing with pharmaceutical companies. 

Trump's pledge to dismantle the ACA, at least, made for a rallying cry that even mainstream Republicans could wholeheartedly get behind, but the GOP has struggled to move forward. Any health care system passed by Republicans would earn the party blame for any problems that arose from its inevitable flaws. A replacement, Trump said over and over again, would have to be immediate to avoid a coverage gap that would leave millions uninsured, but Republicans have yet to offer up a clear alternative. 

Trump also insisted during his bid that he would not to touch entitlements like Social Security and Medicare, breaking with much of his party who advocate reforming entitlements. 

We'll watch to see how Trump sticks to his promise to leave entitlements alone — particularly since his party has long supported reforms to the programs — and whether he's able to push through a new health care law at the same time as he repeals Obamacare that truly covers "everybody."

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Trump Urges Senate to Keep Working on Health Care Bill to Replace Obamacare

Republican Senators filed onto a bus Wednesday for a short trip to the White House for lunch where they heard President Donald Trump urge them to keep working to both repeal and replace Obamacare after their health care bill collapsed earlier this week.

"I'm ready to act," Trump said at the outset of the lunch, noting that he has his "pen in hand" to sign legislation. "For seven years you promised the American people that you would repeal Obamacare. People are hurting. Inaction is not an option and, frankly, I don't think we should leave town unless we have a health insurance plan, unless we can give our people great health care."

After he spent late Monday night and Tuesday endorsing a plan to just repeal Obamacare and then a plan to just let it fail on its own, Trump emphasized that he is supporting both a repeal and a replacement in the same bill.


Image: US President Donald Trump speaks alongside Republican Senators during a meeting to discuss the health care bill
US President Donald Trump speaks alongside Republican Senators during a meeting to discuss the health care bill in the State Dining Room of the White House in Washington on July 19, 2017. Saul Loeb / AFP - Getty Images

Insurers Fear Latest Chaos Over Health Care

Health insurers expressed concern Tuesday over the uncertainty surrounding Senate Majority Leader Mitch McConnell's efforts to repeal the Affordable Care Act and President Donald Trump's most recent call to let Obamacare "fail."

"With open enrollment for 2018 only three months away, our members and all Americans need the certainty and security of knowing coverage will be available and affordable for them," said Justine Handelman, senior vice president for policy at Blue Cross Blue Shield, one of the nation’s largest insurers.

Insurers’ most immediate worry is the federal cost-sharing subsidies they’ve relied on to help make plans in the ACA’s exchanges more affordable. Trump has dubbed those funds "ransom money" and threatened to withhold them to hasten the collapse of Obamacare.


NBC News/WSJ Poll: Just 12% in Key Trump Counties Back GOP Health Care Effort

Just 12 percent of Americans living in the counties that fueled Donald Trump's win in the 2016 presidential election support the Republican Party's efforts on health care, according to results from the NBC News/Wall Street Journal poll of these "Trump counties."

Asked their views on the health care legislation passed by the House of Representatives in May and backed by President Trump, 12 percent of the respondents in these counties — consisting of Republicans, Democrats and independents — called the bill a good idea, while 41 percent said it was a bad idea. Forty-seven percent had no opinion or say they’re not sure.

Trump Drops Key Campaign Promise to 'Repeal and Replace'

In the wake of the latest health care bill failure, President Trump dropped a key campaign promise and announced his support for letting the American health care system collapse before trying to reform it again.

"I think we're probably in that position where we'll just let Obamacare fail. We're not gonna own it. I'm not gonna own it," he told reporters on Tuesday. "We'll let Obamacare fail and then Democrats are going to come to us."

This new promise comes after two years of promising to repeal and replace Obamacare with something "terrific," and hours after voicing his support for another promise-breaking proposition: a simple repeal of the Affordable Care Act without a replacement, a proposition that would leave 18 million uninsured in the first year. By 2026, the non-partisan Congressional Budget Office estimated a simple repeal would double premiums for consumers buying insurance on their own while leaving 32 million uninsured.

“Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in!” Trump said on Twitter, though that plan quickly lost Republican support. 

Hours later, Trump tweeted that he had "always said" Obamacare should be allowed to fail first. He has previously said letting Obamacare fail and blaming Democrats for the consequences would be politically smarter, but it is far from one of his stalwart positions. 

To wit: Watch the president’s many promises to repeal — and replace — Obamacare during the campaign. 

The Senate Health Care Bill Would Break Just About All of Trump's Promises

President Donald Trump said his health care would be better and cheaper than Obamacare.

But that's not how things are turning out.

Based on the president's previous statements, people would enjoy lower premiums and deductibles. A replacement would cover everybody, including those with pre-existing conditions. There would be no cuts to Medicaid.

Now, as Senate Republicans finalize their legislation while Trump advocates for its speedy passage, the question is: Does the bill keep the president’s promises?

Here's how Trump's vows on the campaign trail and after taking office stack up against the findings from the non-partisan Congressional Budget Office report.

Medicaid Cuts Grow Even Deeper After 10 Years, New CBO Score Shows

WASHINGTON — The Senate health care bill’s Medicaid cuts would grow even deeper after a decade, according to a new report Thursday by the nonpartisan Congressional Budget Office, leaving more people without coverage under the government program.

The new report complements the CBO’s main analysis of the Senate bill, known as the Better Care Reconciliation Act, which found Medicaid would spend 26 percent less and cover 15 million fewer people in 2026 if the bill passed.

The Senate bill caps Medicaid spending and, starting in 2025, grows it at a rate of inflation that’s expected to be less generous than either current law or the House bill, which included major cuts as well.

74 Percent. Your Health Care Premium Could Go Up That Much

The Senate bill, backed by Senate Majority Leader Mitch McConnell, R-Ky. and President Donald Trump, encourages customers to buy insurance with higher deductibles, reduces subsidies that lower deductibles for low-income customers, allows insurers to charge older customers more, and provides more generous subsidies for young people than older people.

Just About Every Major Medical Group Hates the GOP Health Care Plans

Senate Health Care Bill Includes Deep Medicaid Cuts

GOP Health Plan Doesn’t Address the Biggest Health Care Problems