Trump Exhorts Republican Lawmakers to Overhaul Health Care Law

WASHINGTON — 

U.S. President Donald Trump is telling Republican lawmakers they have "a last chance to do the right thing" and overhaul the country's health care law after years of campaign promises saying they would.

Trump, in a Twitter comment Monday, exhorted the Republican-controlled Senate to repeal and replace the law championed by former President Barack Obama that is commonly known as Obamacare. Trump is speaking about health care and the repeal effort later in the day.

The Senate is headed toward crucial votes this week on whether to repeal the seven-year-old law, which national surveys show Americans view more favorably than Republican proposals to replace it.

But with unified Democratic opposition to repealing Obamacare, it is unclear whether Republican Senate leaders have enough votes to even formally start debate on changes in the law.

Republicans hold a narrow 52-48 edge in the chamber, meaning they can only lose two dissenting votes, with Vice President Mike Pence casting the deciding repeal vote in the event of a 50-50 tie.

Several Republican lawmakers, despite Trump's campaign vow to upend Obamacare, have announced their opposition to starting debate on the repeal effort, either because they contend that the changes do not go far enough to undermine the law or go too far and would curb health insurance coverage for millions of people, particularly impoverished Americans.

During the past month, the Senate has looked at two versions of health care bills, one that would both repeal and replace Obamacare and another that would repeal the law, with a two-year delay to give lawmakers time to figure out a replacement.

Both bills face total opposition from Democrats and so far enough resistance from Republicans that neither measure has advanced far in the legislative process.

Republican Senator John Thune said Sunday that Majority Leader Mitch McConnell will hold a procedural vote sometime this week on a health care bill that would open up the measure to debate and amendments.

What is not clear is which bill will be voted on. The House of Representatives passed its own repeal-and-replace legislation in May, a bill Trump applauded at a White House rally after its passage and then later described as "mean." He instead called for the Senate to approve legislation with more "heart."

"We don't know whether we're going to be voting on the House bill, the first version of the Senate bill, the second version of the Senate bill, a new version of the Senate bill, or a 2015 bill that would have repealed the Affordable Care Act," said Republican Senator Susan Collins of Maine.

Trump's health care speech comes after the latest of his administration's meetings with what the White House calls "victims of Obamacare."

Trump also used Twitter late Sunday to continue publicly pressuring Republicans in Congress to meet his campaign promise of revamping the health care system that critics say is too expensive and unfairly requires Americans to buy health insurance or pay a fine if they do not.

"If Republicans don't Repeal and Replace the disastrous ObamaCare, the repercussions will be far greater than any of them understand!" the president wrote.

Democrats were in control of Congress when they approved the law in 2010, without a single Republican vote. About 20 million people gained insurance coverage under the law, which prevented insurance companies from denying coverage to people based on pre-existing medical conditions and required insurers to include a range of medical services in their plans.

During Obama's remaining years in office, Republicans dozens of times attempted to repeal the law and once succeeded in passing repeal legislation, which Obama quickly vetoed. He told Congress that if it sent him something that improved the law or the health system, then he would support it.

The non-partisan Congressional Budget Office has concluded that if Obamacare is repealed without a replacement, 17 million Americans would lose their health insurance next year and 32 million by 2026. Under a Senate Republican repeal-and-replace proposal, the CBO said 22 million would lose their coverage in the next decade, but the plan would save the government $420 billion.

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