Health and Science

Trump still wants a deal on Obamacare replacement, but it has to be 'a good deal'

President Donald Trump speaks to members of the media as Vice President Mike Pence looks on, in the Oval Office in Washington, D.C., on March 27, 2017.
Olivier Douliery | Pool via Bloomberg | Getty Images

President Donald Trump still wants Obamacare replaced — but it's got to be done with "a good deal," not "a bad deal."

White House spokesman Sean Spicer, when asked how realistic it is to expect an Obamacare replacement effort to be successfully "resurrected" by Trump, said Wednesday "I think he'd like to get it done."

But Spicer said any replacement plan would have to include Trump's stated goals of "lowering costs" of health insurance for Americans, and giving them "more options" to choose from than is now the case under the Affordable Care Act.

"So we're not going to create a deal for the sake of creating a deal that ends up not being in the best interests of the American people," Spicer said at a White House press conference.

"You got to to know when to walk away from a deal that is going to end up bad," the spokesman said. "He wants to have a good deal."

"We're not trying to jam that down anyone's throat right now," Spicer said.

Trump and GOP House leaders last Friday cancelled — after less than three weeks of effort — a planned vote in the House on the American Health Care Act, the Republican plan to repeal and replace key parts of Obamacare.

That bill, which had abysmally low approval ratings among the public, would have failed if the vote went ahead as scheduled due to total opposition by House Democrats, as well as "no" votes from 30 or so conservative and moderate Republicans.

Since the cancelled vote, Trump and Republican leaders have been vague about what, exactly, they plan or expect to happen next.

On Saturday, Trump tweeted "ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry!"

On Monday, House GOP leaders promised to keep working within their own caucus on a plan to replace Obamacare, saying they are "more resolved than ever" to accomplish that goal.

But House Speaker Paul Ryan, R-Wisc., refused to commit to a timeline for a new version of the replacement plan.

On Monday night, during a bi-partisan gathering with senators at the White House, Trump said, "we are all going to make a deal on health care."

Trump said, "That's such an easy one."

"I have no doubt that that's going to happen very quickly."

Despite Trump's rosy prediction, crafting a plan that will win enough votes to pass in both the House and the Senate is not considered easy by most observers.

Trump is confronted on one side by Democrats who are united in their opposition to any plan that would roll back gains in health insurance coverage by an estimated 20 million people under Obamacare.

On the other side, Trump faces conservatives who want a total, or near-total repeal of Obamacare. Such a move could lead to up to 30 million people losing insurance coverage, an unpalatable idea for many moderate Republicans whose support is required to pass a bill.

Several moderate Republican senators have said they oppose scaling back coverage gains made through Medicaid, the nation's insurance program for the poor, or that they oppose a defunding of the contraception support group Planned Parenthood, as the prior bill would have done.

Spicer said on Wednesday that "it's possible, sure," that a deal to replace Obamacare would win support from some Democrats, who could provide the votes necessary to pass a bill even if some Republicans vote against it.

The Washington Post early Wednesday reported that 44 members of the Senate Democratic caucus signed a letter to Trump saying that they are "ready and willing to work with you on policies that would improve the stability of the individual insurance market."

But, the senators also wrote, "Your administration must commit to putting an end to all efforts to unravel the ACA, undermine the health care system, increase costs, or hurt patients, providers and families."