Trump's latest message: Senators must cancel recess to pass repeal-and-replace bill

President Donald Trump says Republican senators shouldn’t leave town before passing a bill to repeal and replace the Affordable Care Act—his third change of opinion this week about which healthcare overhaul strategy to pursue.

“People are hurting; inaction is not an option,” Trump said in his public remarks before a lunch Wednesday at the White House to discuss healthcare strategy with Republican senators.

“And frankly, he added, “I don’t think we should leave town unless we have a health insurance plan, unless we can give our people great healthcare.”

Trump also indicated he would prefer the Senate to stick to its original plan of repealing and replacing the ACA simultaneously, saying, “we can repeal it, but the best is repeal and replace.”

As recently as Monday night, however, Trump was pushing for a different tactic: repeal-and-delay.

Senate Majority Leader Mitch McConnell also embraced that tactic, but when it became clear on Tuesday that such a plan also wouldn’t have enough votes to pass, Trump said publicly and on Twitter that Republicans should simply let the ACA fail.

Finally, on Wednesday, Trump appeared to once again support the idea of pushing through a repeal-and-replace bill, tweeting the following before his lunch with GOP senators:

During his remarks before the White House lunch on Wednesday, Trump also noted that the ACA’s public exchanges could fail if cost-sharing reduction (CSR) payments to insurers are halted.

“We pay hundreds of millions of dollars a month in subsidies that the courts don’t even want us to pay,” he said, referencing a lawsuit against the CSR program originally brought by House Republicans. “And when those payments stop, it [the ACA] stops immediately,” he added.

Those remarks are likely to further concern groups like the Blue Cross Blue Shield Association, which recently renewed calls for lawmakers to ensure “immediate, certain funding” for the subsidies.  

Trump reserved another veiled threat, meanwhile, for recalcitrant GOP senators.

“Any senator who votes against starting debate is really telling America that you’re fine with Obamacare,” he said.

And in reference to Nevada Sen. Dean Heller—who was seated next to Trump and had been rumored to be on the fence about supporting the Better Care Reconciliation Act—Trump joked that retaining his seat might depend upon his support of the party’s agenda.

“Look, he wants to remain a senator, doesn’t he?” Trump said.