Trump May Not Try to Replace ACA Till After 2020 Elections

President Donald Trump said Republicans would wait until after the 2020 election to hold a vote on a replacement for Obamacare, abruptly halting a push he began just last week and guaranteeing that the issue will take center stage in his re-election campaign.

He made the shift in a series of Twitter posts late Monday night.

"Vote will be taken right after the Election when Republicans hold the Senate & win back the House," the president said in a Monday night tweet.

"Everybody agrees that ObamaCare doesn't work," the president said in another tweet.

The postings ended a week-long scramble by GOP lawmakers to come up with an Obamacare alternative after the administration unexpectedly changed its position in a lawsuit by arguing that all of the Affordable Care Act — a two-law statutory package that includes the "Obamacare" Medicaid and major medical coverage provisions, along with many other health care and health finance provisions — should be entirely struck down. Trump's Justice Department had previously said that the courts should overturn only the ACA provisions that deal directly with major medical insurance underwriting and pricing.

A final court ruling in that case is likely to come before June 2020. If Trump wins in court, there could be swift and widespread chaos and uncertainty in American health care — at least until an alternative system is put in place — as the array of changes to industry regulations, subsidies for low-income individuals and delivery system reforms would be undone.

A ruling permanently overturning all of the ACA could also eliminate the ACA provisions that have narrowed the Medicare Part D prescription drug plan "donut hole" coverage gap, increased funding for health care professional education, and promoted efforts to teach health care professionals how to care for older patients.

Some lawmakers were critical of Trump's announcement.

"From his very first day in office, his goal has been to get rid of" Obamacare, Sen. Tim Kaine, D-Va., told CNN on Tuesday.

Kaine advocates a plan called Medicare X, which he said is a "Medicare-produced policy that can be bought on the exchange." It's different from "Medicare for All" proposals in that it merely provides an option rather than replacing most private coverage.

Republican Rep. Mark Green of Tennessee said Tuesday on Fox Business Network's "Mornings With Maria" program that he doesn't believe Trump is planning to wait until 2020 to devise an alternative to Obamacare because he's a "leader" who doesn't shy away from problems.

"We have to tackle this issue, we can't run from it just because it's a political hot potato," Green said.

Trump rekindled the long-running political conflict over health care last week when he ordered his Justice Department to shift its position on a Texas lawsuit seeking to invalidate parts of the Affordable Care Act, agreeing with U.S. District Judge Reed O'Connor's ruling that the law itself is unconstitutional and should be scrapped entirely.

The president then urged Senate Republicans to come up with a "spectacular" health care proposal to replace the Affordable Care Act, which was enacted under the Obama administration.

"We are going to be the Republicans, the party of great health care," Trump told reporters last week. "The Democrats, they let you down. They came up with Obamacare and it is terrible."

Most congressional Republicans, however, are in no mood to return to the battlefield. Although they had fiercely opposed the law since 2010, it gradually became more popular with voters and was considered a chief factor in last November's Democratic victories that cost the GOP control of the House of Representatives.

In the House elections, health care ranked as the top issue for voters. Those voters preferred Democratic candidates by a striking margin of 75% to 23%, according to exit polls published by CNN. Democrats won 40 seats and captured the majority after eight years.

Republicans, on the other hand, have been eager to run against "Medicare for all," a favorite proposal of progressive Democrats that Trump referred to in his tweets, and equally eager to avoid the Obamacare debate after the trouble it caused them last fall.

"Dear GOP: When Democrats are setting themselves ablaze by advocating for the destruction of American health care, try to resist the temptation of asking them to pass the kerosene," tweeted Josh Holmes, a former chief of staff to Senate Majority Leader Mitch McConnell.

The White House had no immediate comment late Monday night.

—With assistance from Alyza Sebenius and Kathleen Miller.

— Read 5 Possible Weird Effects of the Texas Anti-Health Law Ruling, on ThinkAdvisor.

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