President Donald Trump is making a weekend push to get a Republican Senate bill to repeal and replace former President Barack Obama's health care law "across the finish line," Trump's top legislative aide said Sunday, maintaining that a repeal-only option also remained in play if Republicans can't reach agreement.
Marc Short, the White House's legislative director, said Trump was making calls to wavering senators and insisted they were "getting close" on passing a bill.
But Short said Trump continues to believe that repeal-only legislation should also be considered after raising the possibility last Friday. Senate Majority Leader Mitch McConnell, R-Ky., has dismissed that suggestion and said he intended to proceed with legislation being negotiated over the July 4 recess.
"We hope when we come back, the week after recess, we'll have a vote," Short said. But he added: "If the replacement part is too difficult for Republicans to get together, then let's go back and take care of the first step of repeal."
Trump on Friday tweeted the suggestion of repealing the Obama-era law right away and then replacing it later, an approach that GOP leaders and the president himself considered but dismissed months ago as impractical and politically unwise. But the tweet came amid continuing signs of GOP disagreement among moderates and conservatives over the bill. Republicans hold a 52-48 majority in the Senate. Just three GOP defections would doom the legislation, because Democrats are united in opposition.
Republicans returned to their home districts late last week, bracing for a flood of phone calls, emails and television advertising from both conservative and liberal groups aimed at pressuring senators. Sen. Bill Cassidy held a town hall meeting last Friday to talk about flood recovery in Baton Rouge, Louisiana's capital city, but audience members angry over the GOP health care bill at times chanted over Cassidy's answers and criticized the secretive legislative process.
"I wish we weren't doing it one party," Cassidy said Sunday, adding he remains undecided on how he will vote.
Trump's suggestion had the potential to harden divisions within the GOP as conservatives complain that McConnell's bill does not go far enough in repealing Obama's health care law while moderates criticize it as overly harsh in kicking people off insurance rolls, shrinking the Medicaid safety net and increasing premiums for older Americans.
"It's not easy making America great again, is it?" McConnell said late Friday. He has previously indicated that if Republicans fail to reach agreement, he will have to negotiate with Democrats, who want to fix Obama's health care law without repealing it.
Short said the White House remained hopeful after Senate Republicans submitted two versions of the bill to the Congressional Budget Office for scoring over the weeklong recess. Texas' Sen. Ted Cruz is pushing a conservative version that aims to aggressively reduce costs by giving states greater flexibility to create separate higher-risk pools. The other seeks to bolster health care subsidies for lower-income people, perhaps by preserving a tax boost on high earners.
Health and Human Services Secretary Tom Price said negotiations over the Senate bill were focusing on ways to address the issue of Medicaid coverage so that "nobody falls through the cracks," combating the opioid crisis, as well as giving families more choice in selecting their insurance plan.
"We think that Leader McConnell and his senators within the Senate are working to try to get this piece of legislation on track," Price said.
But conservative Sen. Rand Paul, R-Ky., said he didn't think a repeal-and-replace bill could win 50 votes. Both he and Sen. Ben Sasse, R-Neb., have been urging McConnell to consider a repeal-only bill first.
"I don't think we're getting anywhere with the bill we have. We're at an impasse," Paul said. He criticized Senate leaders, saying they were seeking to win over moderates with multibillion dollar proposals to combat the opioid epidemic and boost tax subsidies to help lower-income people get coverage.
"The bill is just being lit up like a Christmas tree full of billion-dollar ornaments, and it's not repeal," Paul said. "I think you can get 52 Republicans for clean repeal."
Even before Trump was inaugurated in January, Republicans had debated and ultimately discarded the idea of repealing the overhaul before replacing it, concluding that both must happen simultaneously. Doing otherwise would invite accusations that Republicans were simply tossing people off coverage and roil insurance markets by raising the question of whether, when and how Congress might replace Obama's law once it was gone.
But at least nine GOP senators expressed opposition after a CBO analysis last week found that McConnell's draft bill would result in 22 million people losing insurance over the next decade, only 1 million fewer than under the House-passed legislation that Trump privately told senators was "mean."
Paul said he believes that Senate Republicans can do a repeal-only bill concurrently with a bill "they can call 'replace.'"
Sasse said he would like to see a bill that would repeal Obamacare "with a delay."
"If we can do a combined repeal and replace over the next week, that's great," Sasse said. "If we can't, though, then there's no reason to walk away."
"I would want a delay, so that we could get straight to work. And then I think the president should call on the Senate to cancel our August" recess, Sasse said.
Short and Paul appeared on "Fox News Sunday," Price and Cassidy were on NBC's "Meet the Press," and Sasse spoke on CNN's "State of the Union."