Donald Trump spent nearly his entire 2016 campaign promising to repeal and replace Obamacare. On Wednesday, weeks away from inauguration, he expressed trepidation about doing just that and urged his fellow Republicans to be cautious in their efforts.
As GOP lawmakers begin the process of repealing President Obama’s landmark legislation, it’s worth taking a look at the eight times Trump has changed his position on Obamacare since announcing his bid for president more than a year and a half ago.
These recalculations and shifts aren’t unusual for Trump – he took 141 positions on 23 major issues during his run, and has taken 15 new stances on nine issues since being elected – but it is a particularly illustrative shift in the differences between the rhetoric of a candidate and a leader faced with the realities of governance.
1. Repeal Obamacare. Look to Canada for inspiration.
Two months into his White House bid in August 2015, Trump was asked repeatedly if he still supported the single-payer health care he'd touted in the past. He said America should have a private system but repeatedly praised Canada and Scotland's socialized system.
"As far as single-payer, it works in Canada. It works incredibly well in Scotland. It could have worked in a different age, which is the age you're talking about here," Trump said. "What I'd like to see is a private system without the artificial lines around every state...Get rid of the artificial lines, and you will have yourself great plans. And then we have to take care of the people that can't take care of themselves. And I will do that through a different system."
2. Repeal Obamacare. Cover everybody.
"I am going to take care of everybody," Trump told CBS News a month later in September. "I don't care if it costs me votes or not. Everybody's going to be taken care of much better than they're taken care of now."
3. Repeal Obamacare, but 'I like the mandate'
During a CNN town hall on February 18, 2016, Trump started to answer a question about how he'd replace the Affordable Care Act with health savings accounts, "which are great," but interrupted himself to talk at length about how he's "a self-funder." When pressed by interviewer Anderson Cooper about what would happen when Obamacare is repealed and the mandate disappeared, therefore allowing insurance companies to deny coverage to those with pre-existing conditions, Trump said:
"Well, I like the mandate. OK. So here's where I'm a little bit different. I don't want people dying on the streets and I say this all the time."
4. Repeal Obamacare. Replace it with something.
Trump was mocked in the February 25 debate for being vague about how he would replace Obamacare.
"You'll have many different plans. You'll have competition, you'll have so many different plans," he said, still declining to offer more specificity.
5. Repeal Obamacare. Not everyone will be covered.
His health care plan, released online in March, had far more in common with the kind of boilerplate health care proposals the rest of the Republican party touts than his earlier praise for Canada suggested it might.
It would likely cause 21 million people to lose their health insurance and cost about $270 billion over 10 years, according to the nonpartisan budget advocacy group Committee for a Responsible Federal Budget (CRFB).
It offers up unspecified amounts of grants to states to replace Medicaid, but it's not clear how or what those would look like, or how they would cover the millions of people that Trump's plan lets fall through the cracks. CRFB noted that block grants "could generate a wide range of savings" to the federal budget, but without details on them, it is "impossible to score any savings" from his plan.
6. I do want to keep parts of it, we might just amend it.
In an interview with the Wall Street Journal, Trump said he would be OK with amending Obamacare instead of fully repealing it. He also indicated that he wanted to keep the protections for patients with pre-existing conditions, and the measure that allows parents to keep their children insured until age 26.
“Either Obamacare will be amended, or repealed and replaced,” Trump said in November in one of his first interviews as the president-elect.
If they do repeal it, he said there would be no gap between the repeal of Obamacare and the replacement of it with something else.
7. Begin to repeal on day one.
Vice President-elect Mike Pence told Congressional Republicans that Trump’s efforts to repeal Obamacare would begin day one. It's unclear, however, what if any plan there is for a replacement bill.
8. 'Be careful' -- don't take the blame!
Shortly after Pence indicated that repeal efforts were in the works, Trump warned Republicans to "be careful" about taking on the bill -- and its liabilities -- arguing that it would "fall on its own weight."