House Minority Leader Nancy Pelosi (D-Calif.) on Tuesday expressed strong doubts that Donald Trump Donald John TrumpBiden on Trump's refusal to commit to peaceful transfer of power: 'What country are we in?' Romney: 'Unthinkable and unacceptable' to not commit to peaceful transition of power Two Louisville police officers shot amid Breonna Taylor grand jury protests MORE and the Republicans can pull off ObamaCare repeal.

The president-elect and GOP leaders have vowed to prioritize repeal in the first 100 days of Trump's administration.

But Pelosi, who ushered the sweeping healthcare reform law through Congress in 2010, said internal GOP disagreements — combined with cost concerns surrounding the repeal effort — have a good chance of forcing Trump and the Republicans to balk.

"There's division among the Republicans within their own ranks as to timing and substance," Pelosi told a group of reporters gathered in her office in the Capitol.

"I don't think they're going to repeal the Affordable Care Act."

ADVERTISEMENT

The reason, Pelosi said, is not political but economic. The Republicans want to repeal the ObamaCare provision requiring almost everyone to obtain health insurance — the individual mandate — but many are also vowing to keep some of the law's central benefits, like the stipulation that insurers cannot refuse coverage based on preexisting conditions.

Pelosi said that strategy simply won't work, because eliminating the mandate while keeping the benefits would shift the balance of insurance pools toward sicker people, causing premium costs to skyrocket.

"You can't keep them. You can't afford them, because the costs would be so astronomical," she said.

Those extra costs on constituents, Pelosi predicted, will discourage the Republicans' repeal effort much more than the threat that 20 million people newly insured under ObamaCare — many of them low-income people benefiting from the law's Medicaid expansion — might lose coverage.

"The one thing ... that I think the Republicans are more interested in — not the 20 million or whatever — are costs," she said. "What are the costs going to be to their constituents?"

Pelosi emphasized that she has no special window into the Republicans' strategy for repealing ObamaCare. She's spoken to Trump once since the election, but they didn't broach the topic. And she's warning that Rep. Tom Price (R-Ga.), Trump's nominee to head the Health and Human Services Department, poses a stark threat to Medicare and other government healthcare programs.

Still, she seems encouraged by the Republican voices — including that of Trump — vowing to retain some of ObamaCare's benefits.

"At first I thought, 'Oh, my gosh.' But watching their behavior, I think there's reason for reason to prevail," she said.

On the topic of family planning, however, she's not so optimistic. Obama, through an administrative maneuver, had made birth control cost-free for all plans participating in the ObamaCare exchanges. It's a stipulation many Democrats fear the incoming Trump administration will reverse.

Trump will also have the opportunity to seat at least one new justice on the Supreme Court, leaving abortion rights advocates like Pelosi fearing the effects on a woman's right to choose.

"I'd be very, very afraid, very, very scared about what they might do to family planning," she said. "I would be very, very afraid, not only of the president, but of the Congress, on that score."