Republican Senators are reacting cautiously after Donald Trump said over the weekend that he might try to repeal the Affordable Care Act if he returns to the White House, with some suggesting another push to fully scrap the health law was unlikely.
At the same time, GOP lawmakers didn’t close the door on attempting to enact conservative reforms to the program.
“I don’t think that’s going to happen,” Sen. Susan Collins of Maine, one of three Republicans who voted in 2017 against eliminating Obamacare, told reporters on Monday when asked about full repeal. “Clearly the program could be improved, and I’m always open to improvement.”
GOP Sen. Bill Cassidy of Louisiana, who led a last-ditch effort to replace the law, told Semafor he was only learning about Trump’s remarks for the first time and declined to comment. Other senators said they were willing to hear the former president out if he introduced a plan.
“I think the ACA has been a fraud committed on the American people,” Sen. John Cornyn of Texas told Semafor, adding he’d be “interested to see” how Trump proposes replacing it.
On Saturday, Trump wrote in a Truth Social post that he was “seriously looking at alternatives” to the law since “the cost of Obamacare is out of control.”
But it’s unclear how much appetite exists among Republicans to try and fulfill a campaign promise that animated their party a decade ago. Sen. J.D. Vance of Ohio, a Trump ally in the Senate, said key planks of Obamacare are “broadly popular” with the American public including Republicans, such as rules barring insurers from denying coverage to individuals with pre-existing conditions or charging sick people more for healthcare.
“I don’t think there’s any effort to try to change them. I think there is a recognition though that we spend a lot of money and we don’t get a whole lot out of our healthcare system relative to some of our peer countries,” Vance told Semafor. “So that provides some pretty ripe ground for reform.”
It’s not a surprise that Republicans are treading carefully, given how their last attempt to repeal Obamacare sank the party during the 2018 midterms. But it could get harder for lawmakers to shrug off questions about the issue as next year’s election gets closer. Even an effort to merely “reform” the law, without fully tearing it down, could have profound consequences for parts of the health insurance market. And no matter what, Congress will also have to decide whether to extend President Biden’s beefed up subsidies for Americans who purchase coverage on the ACA’s exchanges, which are set to expire after 2025.
The View From Democrats
As Semafor’s Shelby Talcott reported, the Biden campaign is already seizing on Trump’s comments to underscore their message that he will rip away people’s health coverage. And Biden brought it up as well on Monday: “My predecessor has once again, god love him, called for cuts that could rip away health insurance for tens of millions of Americans and Medicaid.”
And Democratic strategists will ensure it filters on down to House and Senate races.
“It lines up with our current message of them constantly trying to take away individual health freedoms and access to care,” one Democratic strategist involved in Congressional campaigns told Semafor. “Who’s ready to hear the phrases ‘pre-existing conditions’ and ‘lifetime spending caps’ in 2024?”