Republican senators are closing in on a draft proposal to repeal and replace the Affordable Care Act.

But that’s about all lawmakers will say about their plan to overhaul the American healthcare system – an effort that will affect millions of Americans and impact one-sixth of the US economy.



For weeks, since the House passed legislation to dismantle major pieces of the Affordable Care Act, a coterie of Republican senators – initially, an all-male group – have met privately to hammer out their version of a healthcare overhaul plan.

On Tuesday, Donald Trump invited 15 Republican senators to a luncheon at the White House to discuss their progress on the healthcare bill.

During the meeting, Trump told the senators that he believed the House plan was “mean” and urged them to craft one that is “more generous”, according to the Associated Press.

CNN reported that Trump also called the bill “cold-hearted” and a “son of abitch”.

The president’s critique is a sharp departure from his position only last month, when he lauded the bill as “incredibly well crafted” in a ceremony at the White House rose garden to mark its passing the House. But the sentiment does fit with statements he made as a candidate and as president-elect that he favors a plan that provides “insurance for everybody” and saves Medicare and Medicaid.

Under the House plan, 23 million Americans would lose health insurance over the next decade and some of the nation’s sickest could face significantly higher premiums and out-of-pocket costs, according to an analysis by the nonpartisan Congressional Budget Office. The Republican plan is widely unpopular with the public, a number of surveys have shown.

The president’s shift in tone suggests a willingness to embrace a healthcare proposal that does not go as far in rewriting the 2010 law.

“Obamacare is broken and it’s been a broken promise,” Trump told reporters at the start of the luncheon.

Trump praised the work of the senators in the room. “I really appreciate what you’re doing,” he said, “to come out with a bill that’s going to be a phenomenal bill to the people of our country: generous, kind – with heart. That’s what I’m saying.”

John Thune, a Republican senator for South Dakota who attended the meeting with Trump, said the president conveyed to the assembled group “that it’s OK that the Senate is going its own direction”.

“He was happy to hear that we’re making good progress and is hopeful that we’ll be able to get this done soon because I think there is a sense of urgency,” Thune said.

But the shape and substance of that plan remain a mystery as senators have refused to share details about the negotiations publicly despite a determination to hold a vote on the bill before the Fourth of July recess – and if not by then, before the August recess a few weeks later.

Following the meeting with the president on Tuesday, Republicans sought to downplay expectations that they might finalize the bill by the end of the week. During the press conference, GOP Senate majority leader Mitch McConnell avoided answering a question about whether there would be a vote before the July Fourth recess.

“Our goal is to move forward quickly,” McConnell said.

Orrin Hatch laughed when asked if there would be a final draft this week. “I don’t think so,” he replied.

“We’re still a work in progress, we’ve got a long way to go yet,” Mike Rounds, a Republican from South Dakota, told reporters.

Senate Republicans, who hold a majority with 52 seats, have a small margin for success and a delicate balance to strike between lawmakers in states where Obamacare remains popular and conservatives who want a complete overhaul.

Meanwhile Republicans are holding daily, closed-door sessions to craft a plan that appeals to at least 50 members of the party, a process John Cornyn once quipped was like “group therapy” and Thune has compared to having a baby.

Republicans are pressing ahead with the secretive approach despite repeatedly complaining during the debate over the Affordable Care Act (ACA) – popularly known as Obamacare – that Democrats were rushing the bill and not allowing for sufficient discussion or analysis. Republicans held limited public hearings on the first version of the House bill – and none on the final version – and are not expected to hold any hearings in the Senate. By comparison, the ACA was the subject of record-long work sessions and dozens of public hearings.

On Tuesday, McConnell parried questions about the transparency of the process, including why there are no plans to hold public hearings on the legislation once it’s released.

“We’ve been dealing with this issue for seven years. It’s not a new thing,” McConnell said, arguing that there was little new left to be discussed in a public forum.

“Nobody’s hiding the ball here,” he said. “You’re free to ask anybody anything. But there have been gazillions of hearings on this subject, when they were in the majority, when we were in the majority. We understand this issue pretty well and we’re now working on coming up with a solution.”

Senate minority leader Chuck Schumer laughed when a reporter repeated McConnell’s comments to him. He called McConnell’s refusal to make the bill public “legislative malpractice” and called for a more open process.

“Complete transparency for a few hours? A CBO score just before? No hearings? No chance to make amendments? I take total issue with it,” Schumer said.

“They’re just ashamed of the bill,” Schumer said. “And they’re totally, totally at odds with what they thought a bill should be like.”

Not all Republicans are comfortable with the process that leaves Americans in the dark on the debate over their healthcare.

“I’ve said from day one and I’ll say it again: this process is better if you can do it in public, and the people get buy-in along the way and understand what’s going on,” said Bob Corker, a Republican senator for Tennessee.

“Obviously that’s not the route that is being taken. But hopefully what’s going to happen is that once a piece of legislation is produced it’s going to be out there for public perusal and it’s going to be out there for CBO-scoring so that before a vote takes place, all of you and people across our country will know what’s in it.”