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POLITICS

Senate Republicans Open

Fight Over Obama Health
Law
By THOMAS KAPLAN and GLENN THRUSH

JAN. 4, 2017

WASHINGTON Congress opened for battle over the Affordable Care Act on
Wednesday as Republicans pushed immediately forward to repeal the health care
law and President Obama made a rare trip to Capitol Hill to defend it.
The bitterness that has long marked the fight intensified as Republicans seized
the opportunity to make good on a central campaign promise to get rid of the law, a
pledge reinforced on Wednesday by Vice President-elect Mike Pence, who met with
House Republicans not far from where the president gathered with Democrats.
The Affordable Care Act, Mr. Obamas signature health care law, has created
online insurance marketplaces, offered new protections to people seeking health
insurance, and provided coverage to millions of people near the poverty line
through expanded Medicaid. Health policy experts say that system could collapse if
Republicans cut off funds for the expanded coverage and end penalties for people
who go without health insurance.
The American people voted decisively for a better future for health care in this
country, Mr. Pence said, and we are determined to give them that. He suggested
that President-elect Donald J. Trump would use his executive authority to help
dismantle the law, but did not offer specifics.
Democrats vowed aggressive resistance, however, and said they would not
participate in drawing up a replacement for the law after the swift efforts to

unravel it. Senator Chuck Schumer of New York, the new Democratic leader,
playing off Mr. Trumps campaign slogan, said repealing the law would make
America sick again.
Republicans are using a procedural approach that will allow them to repeal
substantial parts of the health care law without Democrats being able to mount a
filibuster in the Senate.
By a vote of 51 to 48 on Wednesday, the Senate took the first step, agreeing to
take up a budget resolution, or blueprint, that would clear the way for legislation
repealing major provisions of the law. But even as they spoke of moving quickly to
repeal the law, it remained far less clear how and when they would go about
replacing it.
Senate debate on the budget measure is expected to continue for several days,
and the House plans to take up the budget resolution once the Senate has approved
it.
As Republicans charged ahead, both sides seemed cognizant of the fallout
from unwinding the law, which has become deeply enmeshed with Americas
health care system and has provided insurance for about 20 million people.
Mr. Trump weighed in with several Twitter posts. He advised that Republicans
needed to be careful in that the Dems own the failed Obamacare disaster, and
added, Dont let the Schumer clowns out of this web.
Mr. Trump predicted that the health care law would fall of its own weight.
Representative Chris Collins of New York, a Republican who is one of Mr.
Trumps top supporters in Congress and is part of his transition team, said it was
important to be sure that Democrats bear responsibility for the failings of the
health care law. Republicans say that premiums and deductibles have skyrocketed
and that consumers in many states have fewer choices of health plans.
We have to make sure we keep reminding America, we are repealing it
because it failed, we are repealing it because they all but demanded that we repeal
it, he said. And that was a key piece of Donald Trumps campaign.

But as Republicans spoke of moving quickly to repeal the law, they

acknowledged that replacing it would take more time. It is also unclear how the
insurance companies will react during this period and whether they will continue
to offer the marketplace plans that millions of people have come to rely on.
There will naturally be a reasonable transition period, said Senator Ted Cruz,
Republican of Texas. You cant adopt new reforms all at once.
Senator John Cornyn of Texas, the No. 2 Senate Republican, noted that it had
taken six years to get into the ditch we find ourselves in now.
When your truck or car is in a ditch, the first thing you need to do is get out of
the ditch, Mr. Cornyn said. And sometimes that takes a lot of hard work.
To that, Senator Debbie Stabenow, Democrat of Michigan, parried that when a
car goes into a ditch, the first thing I dont do is dismantle the car.
That doesnt help me get anywhere in terms of transportation, she said.
Democrats signaled little interest in helping Republicans determine what to do
after repealing major parts of the health care law.
Mr. Schumer predicted that Republicans would eventually regret that they
came out so fast out of the box. He said Democrats would consider working on a
replacement only after Republicans presented their own plan.
If you are repealing, show us what youll replace it with first, Mr. Schumer
said. Then well look at what you have and see what we can do.
Later, Mr. Schumer said of Mr. Trump, Its his and their responsibility, plain
and simple name calling isnt going to get anything done. He added, They
really need to calm things down a little.
Speaker Paul D. Ryan tried to offer assurance that no change in coverage
would be abrupt.

The point is, in 2017, we dont want people to be caught with nothing, he
said. We want to make sure that theres an orderly transition so that the rug is not
pulled out from under the families who are currently struggling under Obamacare
while we bring relief.
Mr. Obama huddled with Congressional Democrats for about 90 minutes in
what was billed by the White House as a strategy session to forge a unified
Democratic response to the Republicans rollback effort.
In reality, the session was essentially a going-away party for a man who passed
his signature legislative accomplishment under long-extinct majorities in Congress
and a pep rally for Affordable Care Act defenders, in the words of an attendee,
Representative Hank Johnson, Democrat of Georgia.
The gathering, which could be Mr. Obamas last trip to the halls of Congress
that have been the site of alternating triumph and defeat, had a two-weeks-beforegraduation air, with numerous Democratic senators and congressman, including
Mr. Johnson, sneaking out to attend to business more pressing than hearing the
presidents words.
Mr. Obama, for his part, did not ask his allies to block all efforts to alter the
law, but warned Democrats against rescuing Republicans by defecting on votes
that would dismantle it.
The president provided an array of arguments for keeping the Affordable Care
Act and offered a mild mea culpa for his shortcomings as a salesman over the
years.
Senator Jeff Merkley, Democrat of Oregon, said, He acknowledged the
failures in selling the law in its entirety to the American people.
Robert Pear and Emmarie Huetteman contributed reporting.

2017 The New York Times Company