TAYLOR, Associated Press
WASHINGTON (AP) —
Congressional Republicans are taking the first steps toward dismantling
President Barack Obama's health care law, facing pressure from
President-elect Donald Trump to move quickly on a replacement.
"We have a
responsibility to step in and provide relief from this failing law," Speaker
Paul Ryan, R-Wis., told reporters Thursday. "And we have to do it all at the
same time so that everybody sees what we're trying to do."
Yet Ryan said there
are no "hard deadlines" for a GOP replacement in tandem with the repeal
effort, underscoring the difficulty for Congress despite the
president-elect's call to both repeal the law and replace it with
legislation to "get health care taken care of in this country."
That will be
challenging, to say the least, considering the complicated web of Congress,
where GOP leaders must navigate complex Senate rules, united Democratic
opposition and substantive policy disagreements among Republicans.
By a near
party-line 51-48 vote early Thursday, the GOP-run Senate approved a budget
that eases the way for action on subsequent repeal legislation as early as
next month. The Republican-controlled House planned to complete the budget
on Friday, despite misgivings by some GOP lawmakers.
Trump took to
Twitter to praise the development: "Congrats to the Senate for taking the
first step to #RepealObamacare — now it's onto the House!"
Republicans are not
close to agreement among themselves on what any replacement would look like.
The 2010 law extended health insurance to some 20 million Americans,
prevented insurers from denying coverage for existing conditions and steered
billions of dollars to states for the Medicaid health program for the poor.
Republicans fought the effort tooth and nail, and voter opposition to the
law helped carry the GOP to impressive victories in 2010, 2014 and last
The health care law
does have problems, but independent experts say it's an exaggeration to call
it a total failure. Republicans are focusing most of their criticism on the
shortcomings of private plans sold on health insurance exchanges, but many
support the expansion of Medicaid coverage to millions of low-income people.
procedural vote will set up special budget rules allowing the repeal vote to
take place with a simple majority in the 100-member Senate, instead of the
60 votes required to move most legislation.
That means Republicans, who control 52 seats, can push through repeal
legislation without Democratic cooperation. They're also discussing whether
there are some elements of a replacement bill that could get through at the
same time with a simple majority. But for many elements of a new health care
law, Republicans are likely to need 60 votes and Democratic support, and at
this point, the two parties aren't even talking.
Kentucky Sen. Rand
Paul, unhappy that the measure endorsed huge budget deficits, was the sole
Republican to vote against it.
of Republicans have expressed anxiety over obliterating the law without a
replacement to show voters.
Sen. Susan Collins,
R-Maine, said she wants at least to see "a detailed framework" of a GOP
alternative health care plan before voting on repeal. She said Republicans
would risk "people falling through the cracks or causing turmoil in
insurance markets" if lawmakers voided Obama's statute without a replacement
Separately, Sen. Bernie Sanders, I-Vt., whose Democratic run for White House
last year struck a chord with young people and the party's progressive wing,
has teamed up with top Democratic leaders to organize about 50 rallies this
weekend to trumpet support for the law.
"A good, strong
political party needs obviously an inside-the-Beltway strategy, but it also
needs an outside-the-Beltway strategy," Sanders said. "There are very few
people who will tell you that the Democrats have done a good job in terms of
an outside strategy, in terms of standing up with working families and the
middle class and lower-income people."