Paul, Trump upend GOP's Obamacare repeal plans

After Rand Paul spent the last week urging the GOP not to repeal Obamacare without having a replacement plan ready, his phone rang on Friday night with a call from a new supporter: Donald Trump.

“He called after seeing an interview that I had done [talking about] that we should vote on Obamacare replacement at the same time,” Paul said in an interview on Monday. “He said he was in complete agreement with that.”


With Trump going out of his way to bless the Kentucky senator’s approach, Paul’s week-long campaign to hold a vote on replacing Obamacare alongside a simultaneous repeal measure has seemingly upended the GOP’s long-sought plans for a cathartic and immediate vote to gut the health care law. As news broke that Trump backed Paul's play, several other Senate Republicans were also beginning calls for a new strategy — threatening the trajectory of the party’s rush to repeal the law.

On Monday in New York City, Trump said he’s “not even a little bit” worried about how Republicans will replace Obamacare. “That’s gonna all work out,” said Trump, whose campaign pledge was to immediately repeal and replace President Barack Obama’s signature health care law.

Paul said he wasn’t trying to slow the process down, but instead said it’s a “matter of speeding up” the replacement efforts. He’s putting together an initial proposal containing the GOP’s best ideas and will ship them this afternoon to Trump’s administration after getting buy-in from the president-elect.

Still, he admitted that there are now enough critics in his conference to put the brakes on any effort to repeal the healthcare law before there’s broad GOP buy-in around an alternative. Influential Republicans including Tom Cotton (R-Ark.) and Bob Corker (R-Tenn.), have also called for simultaneous repeal-and-replace, complicating plans to quickly pass a repeal bill by a majority vote in the narrowly split Senate.

“We need to work through the discussion. I think there are enough voices in the caucus that are saying we should do replacement when we repeal. So it could get to that point,” Paul said, adding that he’d still likely support a standalone repeal bill. “I still would but I’d feel a lot better about it if we voted on replacement on the same day.”

The GOP-controlled Congress is aiming at repealing the law as soon as it can, potentially shortly after Trump is sworn in. But on Sunday, Senate Majority Leader Mitch McConnell and Trump’s top staffers did not present a clear-cut roadmap to a replacement plan, or a timeline for when one might be unveiled that has the support of the leadership.

McConnell said on CBS that he hadn’t “heard Senator Paul's plan to replace it. But we will be replacing it rapidly after repealing it.” Pressed twice on the timely, McConnell would only say that replacement would happen “quickly.”

McConnell visited Trump Tower on Monday morning, telling reporters afterward that he had talked to Trump about "repealing and replacing Obamacare."

“It would be ideal if we could do it all in one big action. But look. It may take time to get all the elements of the replace in place,” said Reince Priebus, Trump’s incoming chief of staff, on “Face the Nation.” “The full replacement may take more time than an instantaneous action.”

But that’s not what Paul says Trump conveyed to him on Friday evening.

“I’d hate to characterize his opinion on it other than he agreed with me that we should do it that at the same time,” Paul said. “There is momentum growing for it.”

Paul’s bill will be something of a “greatest hits” of Republican proposals. He is aiming to allow for more inexpensive insurance plans to get buy-in from young people (which would likely have higher deductibles), making Health Savings Accounts cover more services like diet and exercise and allow groups of small businesses to establish health insurance associations.

He said whatever Republicans do to replace the law will just be the beginning, predicting it would take many subsequent changes to the law for Congress to get its hands around the problem. But he said part of his effort is about dispelling the notion that Republicans have no ideas to improve the law.

“Some in the media have done a disservice to Republicans saying we don’t have a plan,” Paul said. “That’s not true. We have an abundance of plans.”

Paul said the framework of his replacement bill will be introduced as soon as Monday, with the bill text to follow shortly thereafter.

Nolan McCaskill contributed to this story.