House and Senate Republican leaders are forging ahead with plans to repeal Obamacare then replace it later — dismissing mounting pressure from their own party to delay the repeal vote until they have a fully formed alternative.

But they’re hoping to ease internal concerns that Republicans will be attacked for acting hastily — worries that accelerated after libertarian-leaning Sen. Rand Paul (R-Ky.) bucked party leadership on the matter last week and received a blessing from President-elect Donald Trump. Speaker Paul Ryan (R-Wis.), Senate Majority Leader Mitch McConnell (R-Ky.) and their top lieutenants in both chambers are now considering a strategy that includes adding some replacement provisions to the repeal bill, according to lawmakers and aides.


One option being considered for the repeal bill is to expand the use of health savings accounts and allow states to set up high-risk pools for chronically sick patients. Republicans are also planning to take up less controversial replacement bills as soon as repeal passes and are discussing an effort to unite the party around a set of health care principles before the repeal vote.

Leaders hope the strategy will prevent GOP defections on a repeal vote by giving Republicans something to point to when critics say they’re simply canning President Barack Obama’s health care law and hanging 20 million Americans out to dry without health insurance. Senior Republicans will still likely need to take additional measures to placate the health insurance market, which has warned of a doomsday scenario if Congress tries to undo Obamacare without a stable replacement.

Their plans aren’t final, but Republican leadership hopes to repeal Obamacare in the first 100 days of Trump’s administration; some bullish Republicans say a vote could occur in March or perhaps even sooner. But lawmakers just don’t think they’ll have the full replacement ready to go by then.

“It’s possible, but you’ve got to bring people together, which is always tough,” Senate Finance Committee Chairman Orrin Hatch (R-Utah) said in an interview. “It would be good to do so, but I’d rather have it be a good replacement and have it done right than something slap-dashed together.”





The ongoing discussions come as Trump threw a wrench into Republicans’ Obamacare repeal strategy, sending mixed messages to Capitol Hill about what he wants. Paul tweeted Friday that Trump agreed with him during a phone call that a full replacement vote should coincide with the repeal vote. And Trump did nothing over the weekend to counter that claim.

Proponents of the simultaneous strategy said it would be helpful for Trump to be more forthcoming about what he wants. He’s almost certain to be asked about the matter at a news conference on Wednesday.

“If it is his view, it would be really good if he would consider tweeting it out very clearly,” said Sen. Bob Corker (R-Tenn.), who supports having a replacement in hand alongside repeal.

Corker said he will offer legislation to delay the current date of an Obamacare repeal bill via the budget reconciliation procedure from Jan. 27 until March 3, to give the party more time to craft a health care plan.

“There’s more and more concerns about not doing it simultaneously,” Corker said. “You would think after six years we would have a pretty good sense of what we would like to do.”

At the same time, incoming Trump officials have been working with Hill Republicans on their current plan to repeal now, then replace later, suggesting the transition is not on the same page. Vice President-elect Mike Pence met with Senate and House Republicans last week on the matter but did not offer a specific opinion.

Even Trump’s incoming chief of staff, Reince Priebus, seemed to be on leadership’s side, saying Sunday on TV that “it would be ideal if we could do it all in one big action,” but “it may take time to get all the elements of the replace in place.”

“Kellyanne Conway was on a couple Sunday shows and she wasn’t real clear on that, either. So I don’t know what the plan is there,” said Sen. Deb Fischer (R-Neb.). “I think the administration’s going to step forward and work with us. That’s the message we had from the vice president-elect.”





Trump, meanwhile, told reporters in Trump Tower on Monday that’s he’s “not even a little bit” worried about Republicans replacing Obamacare.

“That’s gonna all work out,” he said. After his election, Trump told CBS’ “60 Minutes” that he’d like to have a replacement ready to go when lawmakers repealed the law.

That hasn’t transpired, however. Ryan last week suggested that he expected to have a replacement finished by the end of the year. McConnell, in a Fox News op-ed Monday, reiterated the “repeal now, replace later” mantra. And some prominent Republicans are satisfied with plans to repeal immediately, but with a a two- to three-year transition period to develop a replacement.

“There’s going to be a period of time built in for adjustments for that. So I’m confident that before that period of time expires we’ll have the alternative in place,” said Sen. Marco Rubio (R-Fla.).

It’s not that GOP leaders don’t want to move quickly, but they simply have not coalesced around a health care vision and presented it as an alternative.

“It’s going to take us more time,” said Senate Majority Whip John Cornyn (R-Texas). “The practical challenge will take some time to make a transition. Having said that, we’re still working.”

The Senate on Wednesday night or Thursday will take the first official steps toward repealing Obamacare. The chamber will pass a fiscal 2017 budget that will unlock the reconciliation fast-tracking procedure allowing Republicans to repeal Obamacare with a simple majority. The House is set to clear the bill by the close of the week.

GOP insiders expect the fiscal blueprint to pass easily, despite Paul’s last-minute efforts to get House Freedom Caucus members to join him in protest votes against the budget. The group was to meet Monday night to decide whether or not to support the budget, but Freedom Caucus members agree with Paul that a replacement vote should coincide with repeal.

It’s unclear whether including some elements of replacement in the repeal bill will appease Paul, Freedom Caucus members or the growing number of Senate Republicans who have sided with them on replacing simultaneously. Republican leaders are acutely aware that Senate procedures could complicate their hopes of adding replacement provisions in the repeal bill using budget reconciliation.

That mechanism is best suited for scrapping laws rather than writing them, Cornyn said. But Republicans are exploring what they can add to a repeal bill that would pass muster with the Senate parliamentarian.

Those familiar with leadership’s plans hope that allowing Republicans to vote for some replacement provisions at the same time as repeal would allow them to project a message that they’re for something, not simply opposed. Still, Republican leaders are operating under the assumption that few Republicans would actually be willing to vote against an Obamacare repeal no matter the status of their replacement plan.

They just might be right.

“I would lean in the direction of having a firmer idea of what our replacement’s going to look like, too,” said Sen. Shelley Moore Capito (R-W.Va.). “I’m going to vote for repeal. Would [having a replacement] make it easier? Probably. But at this point, I don’t know that it’s a deal killer.”

Jennifer Haberkorn contributed to this report.

