Republican senators and GOP aides said that if President Donald Trump wants them to move forward with big changes, he needs to propose them himself. | Alex Wong/Getty Images Congress ‘We need a plan’: GOP shaken by Trump’s health care demands The last time the party tried to get rid of Obamacare, it cost them control of the House and several state capitols.

President Donald Trump says the GOP is now the “party of health care.” But Republicans have no real plan to deliver on that.

Trump’s unexpected demand that Republicans take another crack at replacing Obamacare came on the heels of his Justice Department backing a lawsuit intended to gut the entire law. The last time the party tried to get rid of Obamacare, it cost them control of the House and several state capitols.


Those lessons aren’t lost on Republicans. They know the more they talk about repealing Obamacare, the more likely it is that the battle over the health law and the popular protections for people with pre-existing conditions drags into the 2020 elections, damaging vulnerable Republicans. They’d rather slow-walk the issue while sticking to health care topics that have appeal on both sides of the aisle.

“We’re going to be involved in health but most of it is going to be very, very bipartisan, unlike the issue you’re bringing up, which would not be very bipartisan,” said Chuck Grassley (R-Iowa), the leader of the Senate Finance Committee.

That could include addressing “surprise” medical bills that hit insured people who end up with an out-of-network doctor even when they’ve chosen an in-network hospital, as well as more steps to address high drug costs and opioids.

His counterpart on the Health, Education, Labor and Education Committee, Lamar Alexander (R-Tenn.) was singing a similar tune on Wednesday, telling reporters: “We’re working in a bipartisan way.” Alexander has recently turned his focus to health care costs, rather than repeal.

Indeed, Republican senators and GOP aides said not to expect a sweeping new Republican plan in the months ahead, and said that aside from the narrower policy pushes, party leadership will focus on their longstanding message that Obamacare has “failed” and that Democrats’ “Medicare for All proposals pose a threat to the current system. Democrats control the House now, and the GOP’s vision of replacing Obamacare with block grants or other conservative proposals —ideas they couldn’t enact even when they controlled both chambers — appear now to be a pipe dream.

And if Trump wants them to move forward with larger changes, they said, the president needs to propose them himself.

“The president makes very clear that he understands the importance of health care and that he wants the Republican Party to be the party of health care,” said Sen. Susan Collins (R-Maine), whose opposition to repeal efforts in 2017 was critical in stopping the effort. “In order to do that, he has to have a detailed plan that is going to be an improvement over the ACA.”

Even the lawmakers closest to Trump, including Freedom Caucus Chair Rep. Mark Meadows (R-N.C.), acknowledged to reporters that Republicans, still recovering from the toxic fallout from failed repeal attempts in 2017, would be better off tackling more manageable goals like drug pricing reform going into 2020.

“I’ve been through the wars and I have a Ph.D. in health care policy now that was never on my bucket list,” Meadows said. “It’s very difficult to find anything that brings everybody together. But I do think there’s real consensus that could be found on prescription drug prices — in fact, if there’s a sweet spot to be found, it’s that.”

Most Republicans don’t want to openly defy Trump, but many are privately complaining about the president ordering them back in the Obamacare minefield.

“We need a plan, and right now we don’t have one,” said one frustrated Republican senator, who requested anonymity to speak candidly. “I’m not going to just throw this to the whims of our creativity.”

Other lawmakers have tried and failed in the past few days to steer Trump away from the idea, telling him the anti-ACA push is bad for his own reelection campaign.

“[Trump] knows that he made a mistake, but he’s dug in now,” said a person close to the president.

The Trump administration sent lawmakers scrambling this week when the Justice Department abruptly announced that it is backing a lawsuit led by Texas seeking to throw out Obamacare entirely, reversing a far narrower legal strategy.

That case is now pending before the Fifth Circuit Court of Appeals, and it may well end up before the Supreme Court. Trump told Congress he wants a plan at the ready to replace Obamacare if the court voids the law — but Republicans generally expect the legal battle to last another year or so, giving them some breathing room. Grassley, for instance, played down the need for quick action on an Obamacare replacement, saying, “We won’t know for months, and it could go well into next year” what the courts do. The Supreme Court has upheld Obamacare twice, and even many conservative legal experts predict this assault on the law will ultimately fail.

The administration’s move in the court case came just after Trump declared vindication in the Mueller investigation — an odd bit of timing that changed the subject from triumphant “exoneration” to pre-existing conditions, an issue that has been a consistent winner for the Democrats, particularly in the House races in November.

As a second Republican senator put it: “Why would the president do this after the release of the Mueller report?”

“Covering pre-existing conditions was always the political knockout blow,” GOP strategist Rick Wilson told POLITICO. “No matter how much Republicans think people hate Obamacare, they’re much more likely to fear the impact of their dad getting denied cancer treatment because he had an illness once before. Trump’s move now allows Democrats to campaign on a message of ‘We’re the ones who will keep you from being thrown to the wolves.’”

Lawmakers and aides said the White House decision puts much more pressure on Senate Republicans, who remain in the majority, to craft legislation in response to Trump’s demands. Discussions have begun between the President’s team and Senate leadership, but have yielded no breakthroughs, leaving Republicans arguing over whether they should revive one of the bills they failed to pass in 2017 or cut their losses, ignore Trump, and move on.

“We’ve got a new slate. The slates been wiped clean,” said Sen. Johnny Isakson (R-Ga.). “When the slate’s been wiped clean that leaves two things: Go back and do again what you’ve already done that didn’t work or find something that does.”

Other Republicans suggested they focus on strategies to stop the lawsuit itself in its tracks.

“You could probably moot the case if you deleted the individual mandate from the law, since that’s what it all hinges on,” said Rep. Greg Walden, who led House efforts in 2017 to get rid of Obamacare. “So that might be a possibility going forward.”

Democrats, meanwhile, could not be more thrilled by the Trump administration shining a spotlight on what they see a massive GOP liability, and moved swiftly to capitalize on the opportunity.

On Tuesday, they drew a stark contrast between the parties by unveiling a package of bills to shore up the Affordable Care Act and make insurance subsidies available to more middle-class consumers. On Wednesday, Senate Minority Leader Chuck Schumer announced Democrats will try to force a vote on defunding the DOJ’s efforts on the case.

Democrats are confident the public is on their side. A national poll by the Kaiser Family Foundation found that opposition to Obamacare was in February at its lowest point since the law’s implementation. And a Washington Post poll in January found that 62 percent of Americans surveyed — and three-quarters of independents — have a negative view of President Trump’s health care agenda.

Both the president and GOP lawmakers are well aware of this political peril on health policy, but disagree sharply on how to address it. Trump told Republicans on Tuesday that they have to come up with “a plan that is far better than Obamacare” in order to neutralize the Democratic attacks that in part cost the GOP its House majority last year.

Sen. Lindsey Graham (R-S.C.) agreed with the pressing need for Republicans to craft an identity that’s more than being the enemies of Obamacare.

“We’re going to have a 2020 election, and one of the issues will be health care,” he said. “We know what we don’t like, but we owe it to the public to say what we do like.”

Other lawmakers insisted that the onus is on Trump to set that agenda and said they’re waiting for more information from the White House.

But Meadows, who spoke to Trump on Wednesday morning, said the president provided no further guidance on crafting a health care bill other than insisting that they protect people with pre-existing conditions and lower drug costs.

“He sees those two areas as the things that most people are concerned about,” Meadows said. “He told me this morning, ‘We’re going to fix it.’”

Adam Cancryn and John Bresnahan contributed to this report.

