Trump’s ObamaCare pivot, repeal first? What you need to know

As Republicans in the Senate struggle to coalesce around a plan to repeal and replace the Affordable Care Act, President Donald Trump appeared to back an alternative idea Friday morning: repeal first, replace later.

While some might be worried about the potential consequences of repealing the bill without having an agreed upon replacement in the works, former New York State Lt. Gov. Betsey McCaughey said she doesn’t foresee this causing Americans to lose coverage and in fact, it could have the opposite effect.

“I think repeal [first] will be terrific because it will remove insurance regulations that are preventing insurers from offering affordable plans,” McCaughey told FOX Business, while adding it would be an important legislative win for the administration that has struggled so far to get its major agenda items passed.

Ideally, ObamaCare would be repealed and replaced at the same time, but a repeal-first strategy would be better than passing either the current House or Senate bill, according to the Cato Institute’s Michael Tanner.

“Repeal alone would be better than the status quo. In part, because Congress could not stop there. It would have to come back and enact additional reforms,” Tanner told FOX Business. “If Republicans actually repeal ObamaCare, their conservative base will turn out for them in the midterm elections. If they pass a phony repeal bill, their base will stay home, and they will lose Congress.”

The idea has support from Sen. Ben Sasse (R-Neb.), who has been pushing to separate the two items after it became clear that deep divides within the GOP would prevent any near-term agreement on a replacement bill. Sen. Sasse sent a letter to the president Friday suggesting that if McConnell cannot reach a consensus when lawmakers return from recess, they should vote to repeal right away and then use August to work on a replacement.

Another proponent? Sen. Rand Paul (R-Ky.), who tweeted Friday that he had spoken with the president and Senate leadership about the proposal.

This comes after the GOP introduced a draft bill to repeal and replace the Affordable Care Act last Thursday, which has since been met with some intraparty opposition over a number of different items, including the continuation of ObamaCare subsidies, changes to Medicaid and a Congressional Budget Office estimate that 22 million Americans would lose insurance under the proposal over the next decade.

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Gradually slowing the expansion of Medicaid has been a big sore spot for Senate Republicans, as critics argue this measure would endanger America’s most vulnerable populations. However, McCaughey said it’s the Affordable Care Act's mandated expansion that has actually restricted health care access among this demographic.

“Obama says that the Republicans are trying to destroy Medicaid. No, his law destroyed Medicaid – it turned it from a safety net into way of life for half of America.It’s unaffordable and it’s endangering access … for the truly poor,” she said.

Another major piece of the bill that has slowed approval is a 3.8 percent ObamaCare tax on high earners’ investment income. Critics viewed removal of this tariff as a way to use health care to disguise a tax cut for the richest Americans, so this week lawmakers discussed including it instead in legislation at a later date.

Senate Majority Leader Mitch McConnell (R-Ky.) said earlier this week a vote on the draft proposal, originally scheduled for this week, would be delayed until after the July 4 weekend. Senator John Thune (R-SD) confirmed to Fox News on Wednesday that Republicans were aiming to amend the bill by Friday and send the fresh draft to the CBO for scoring over the July 4 recess. The chamber had intended to hold a vote when lawmakers returned to Capitol Hill the week of July 10.

White House senior advisor Kellyanne Conway told Fox News Friday the president and his staff remain confident health care will get done this summer followed by tax reform by year’s end.