The approach laid out at the party’s annual retreat stands in contrast to that outlined by Trump, who has urged a replacement ‘very quickly’ after repeal

House Republicans seem poised to use a three-part process to repeal and replace Obamacare, as laid out to members in the party’s annual retreat.



The first involves repealing the Affordable Care Act through the reconciliation process, a mechanism that allows only budget bills to be passed in the Senate without being subject to the filibuster. This would effectively change the threshold for passage in the upper chamber from the 60-vote super majority to a simple majority of 51.

The second involves executive actions through the Department of Health and Human Services following the confirmation of Georgia congressman Tom Price, who has been nominated by President Trump to lead the department. The third would be a separate standalone bill.

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This three-pronged approach stands in contrast to that outlined by Trump who has urged a replacement “very quickly” after repeal. Pennsylvania Republican Charlie Dent noted to reporters this was “a little different than what leadership had represented at the time”.

Repealing and replacing the Affordable Care Act has long been a top Republican priority and has been a standard feature of the GOP’s platform over the past two election cycles. However, the process of dismantling Obamacare has proved to be challenging as Republicans have struggled to find an effective mechanism to do so without depriving millions of health insurance. A report from the non-partisan Congressional Budget Office (CBO) last week estimated that up to 18 million Americans would lose their health insurance if the Affordable Care Act was repealed without any replacement, leaving 32 million people without health coverage.

Trump started the process of repealing Obamacare in an executive order issued last Friday, which ordered executive agencies to grant exemptions and avoid compliance with the legislation “to the maximum extent permitted by law”.

In addition to healthcare, a number of other priorities are on the agenda for the president’s first 200 days, including tax reform and infrastructure.

Republican congressman Chris Collins of New York, a close Trump ally, told reporters that infrastructure was only a priority because of Trump’s personal pressure. “The president asked that the infrastructure piece be included in the 200-day plan and the impression that I got was that the speaker recognized the importance of that to the president and that that is now part of our 200-day plan,” said Collins. “But ... initially without the president’s input that would not have been in the plan.”

Discussions will continue at the retreat on Thursday as both the president and the vice-president will speak at the retreat in addition to British prime minister Theresa May.