As more Republican lawmakers grow wary about their party’s plans for the Affordable Care Act, President-elect Donald Trump has not yet said definitively whether he approves of repealing the law before replacing it.
Top Trump adviser Reince Priebus said on CBS’ “Face the Nation” that the president-elect would prefer to repeal and replace the law simultaneously, but understands if it’s not possible.
"I will tell you that it would be ideal if we could do it all in one big action," he said. "But look. It may take time to get all the elements of the replace in place."
Earlier in the show, Senate Majority Leader Mitch McConnell confirmed that by the end of the week, the Senate will take its first step to repeal the ACA through budget reconciliation. Republicans will “rapidly” replace it after repealing it, he added, though he did not give specific details.
Last week, House Speaker Paul Ryan said the GOP will work out a replacement plan this year. But Sen. Rand Paul, who has been one of the more vocal conservative dissenters about the GOP’s plan, indicated in a tweet last Friday that Trump supports his position to repeal and replace at the same time.
I just spoke to @realDonaldTrump and he fully supports my plan to replace Obamacare the same day we repeal it. The time to act is now.
— Senator Rand Paul (@RandPaul) January 7, 2017
Trump himself has tweeted criticism of the ACA and called on members of both parties to come up with a better healthcare plan, FierceHealthPayer has reported, but has not commented publicly on the timing of Republicans’ repeal and replace plans.
Meanwhile, at least five other Senate Republicans have expressed uneasiness about their party's strategy, including Bob Corker, Lamar Alexander, Susan Collins, Tom Cotton and John McCain, according to the Wall Street Journal. And in the House, some conservatives are worried about the effect that ACA repeal legislation will have on federal spending.
Republicans will also have to grapple with whether to eliminate the ACA’s taxes, another WSJ article noted. While they have pledged to do so, saying they drive up healthcare spending, it would make it more difficult to fund the transition period between repealing and replacing the law.