The vice president-elect and Paul Ryan said ending healthcare law is ‘first order of business’ as congressional Democrats met with Obama to strategize its defense

Barack Obama and Donald Trump launched the first big battle of the next American presidency on Wednesday as they made fiercely opposing cases over the future of US healthcare.

The outgoing president made a rare visit to Capitol Hill to rally Democrats to defend the Affordable Care Act (ACA) and “encouraged us to fight”, one congressman said.

Trump, meanwhile, fired off on Twitter at “the failed ObamaCare disaster” as his vice-president-elect, Mike Pence, met House and Senate Republicans and promised immediate steps to dismantle it.

The duelling events on Capitol Hill illustrated the high stakes over healthcare reform, seen as Obama’s proudest domestic policy achievement but now facing demolition by a unified Republican government.

Not for the first time, events in Washington were somewhat upstaged by Trump himself, who tweeted that Republicans “must be careful” to ensure that Democrats shoulder the blame for the “failure” of Obamacare. “Don’t let the Schumer clowns out of this web,” he wrote, referring to Democratic Senate minority leader Chuck Schumer.

In another tweet, the president-elect said: “Dems are to blame for the mess. It will fall of its own weight – be careful!”

Later the Senate took its first step toward repealing the health law. In a 51-48 vote mostly along party lines, the Senate approved a procedural motion to open the debate on a budget resolution that Republicans hope to use as a vehicle to dismantle the law. The debate is expected to carry into next week.

All Democrats voted against the bill and only Rand Paul, a Republican from Kentucky, broke ranks with his party because the resolution would not balance the budget deficit.

Earlier Pence, a frequent conduit between Trump and lawmakers, urged Republicans to unite in condemnation of Obamacare but offered few clues as to what its replacement will look like.

He said the administration would keep Trump’s campaign promises to end illegal immigration, build a wall along the Mexican border and rebuild the US military. “But the first order of business is to repeal and replace Obamacare,” he told reporters. “The American people voted decisively for a better future for healthcare in this country and we are determined to give them that.”

Along with House speaker Paul Ryan, he sought to portray Obamacare as a disaster from which Americans needed immediate “relief” as soon as Trump takes office on 20 January.

Barack Obama and Mike Pence slated for healthcare showdown Read more

“We’re going to be in the promise-keeping business,” Pence said. “It will literally begin on day one. Before the end of the day, we can anticipate that the president-elect will be in the Oval Office taking action, to both repeal executive orders and also set into motion through executive action promises that were made on the campaign trail.”

He did not specify whether these executive orders would include changes to the healthcare system but, in New York, Trump’s incoming press secretary Sean Spicer reportedly suggested that they would. The orders will come “within hours of being sworn in”, he was quoted as saying.

Pence, a former six-term congressman, had been on Capitol Hill when Obamacare was signed into law in 2010, he continued. “I remember all those promises. We were told if you like your doctor, you can keep him: not true. We were told if you like your health insurance, you can keep it: not true. We were told the cost of health insurance would go down: not true.”



He added: “The American people have sent new leadership here because Obamacare has failed. It has been rejected by the American people.”

Democrats hope to exploit Republican divisions over how to replace Obamacare and at what speed. But Pence seems determined to make criticism of Obamacare a rallying point, with a PR offensive imminent.



“As the president-elect said today, and as I admonished members of the House Republican conference today, it’s important that we remind the American people of what they already know about Obamacare, that the promises that were made were all broken, and I expect you’ll see an effort in the days ahead to talk about the facts around Obamacare,” Pence said.

Ryan also argued that Obamacare was in urgent need of repair, but sought to quell fears that millions of people would lose heath insurance. He told the press conference: “So much damage has already been done to the country.



“Obamacare is a story of broken promise after broken promise after broken promise, followed by failing programmes, higher premiums, higher deductibles, so we want to make sure that as we give relief to people from Obamacare we do it in a transition that doesn’t pull the rug out from anybody during that transition period. That’s the point that we’re all trying to make.”

Asked for specifics, however, Ryan replied: “We have a plan to replace it. We have plenty of ideas to replace it and you’ll see as the weeks and months unfold what we’re talking about replacing it with: how you can get better choices with lower prices by not having a government taking over our healthcare which is causing all this problem in the first place.”

Josh Earnest, the White House press secretary, later claimed that Ryan had clearly failed to provide an alternative plan, demonstrating why Republicans felt “queasy” about a root and branch overhaul.

Earnest said Obama, who spent more than an hour and a half with Democrats, was received “warmly” and expressed “envy” for the opportunity that party members have to keep up the effort. “The president is confident that the kind of arguments Democrats can put forward is a winning one,” he said.

Obama “encouraged us to fight”, Democratic representative Elijah Cummings told reporters of his colleagues’ meeting with the outgoing president.

Fresh from the meeting, Schumer, standing next to a sign that read “make America sick again” – a slogan several leaders later repeated – said Democrats were united in defending the legislation, which helped drive down the rate of Americans without insurance to historic lows.

Schumer told reporters: “Our Republican colleagues don’t quite know what to do. They’re like the dog who caught the bus. They can repeal but they have nothing to put in its place. And that means so many good things go which was the summary of the meeting.”

He added: “Republicans will soon learn that you can’t keep the good parts of the ACA and remove the rest of the law and still have it work. That’s what they’re struggling with. That’s why they’re not getting anywhere. What they would do would throw the entire insurance marketplace into chaos, plain repeal.”

House minority leader Nancy Pelosi called the Republicans’ plan to repeal the law but delay its removal an “act of cowardice” and slammed their other option, “repeal and replace”.

Pelosi, who described the meeting with the president as “transformative”, said Obama asked if Democrats were steeled for the fight.

“He didn’t have to ask us that,” she said.

But the president also encouraged Democrats to be open to Republicans’ ideas on how to improve certain provisions of the law, she said.

Democrats acknowledged that there is little they can do to stop Republicans from repealing the Affordable Care Act, a top priority for the party that has so far failed to bring forward a plan to replace the law. But Pelosi said explicitly that Republicans will need their help to replace the law, and the Democrats at the press conference vowed to make that process difficult.

Democrats are gearing up for an aggressive messaging campaign to try to rally the public around the law, which has helped cover roughly 22 million previously uninsured voters.

“They want to repeal it and then try to hang it on us,” Schumer said. “Not gonna happen.”

Senator Bernie Sanders began his remarks by quoting from one of Trump’s tweets from May 2015 in which the president-elect promised supporters that if he was elected there would be “no cuts” to social security, Medicare and Medicaid.

This promise was a “cornerstone” of Trump’s campaign and to renege now would mean one of two things, said the Vermont senator, who campaigned for universal healthcare: “either Donald Trump simply lied to the elderly and the working people of this country”, or he should “come forward, maybe through tweets, one of his tweets, and say clearly that Donald Trump will veto any legislation that cuts Medicare, that cuts Medicaid or that cuts social security”.

Despite constant criticism from Republicans that the healthcare law is too costly, a new analysis found that a wholesale repeal of the law would cost roughly $350bn over the next decade, according to a new analysis by the Committee for a Responsible Federal Budget, a bipartisan group that advocates for fiscal restraint.







