As we reported earlier today, while many items on the Trump agenda for both the “first day” and the rest of 2017, could take a substantial amount of time and effort before they are legislated and implemented, one thing that there was virtually unanimous consensus on, was that Trump would immediately launch the repeal of Obamacare, even if replacing the Affordable Care Law would take considerably longer (as it would require bipartisan support). 
However, it now appears that even the prompt repeal of Obamacare is in question as Trump has now backed waiting to repeal the Affordable Care Act until a replacement proposal is in hand, following in a Friday night phone call with Rand Paul, the Kentucky Republican said Monday, adding to momentum for changing GOP leaders’ strategy on dismantling the 2010 health-care law.
Paul has emerged a vocal leader of a growing group of Republican senators expressing concerns with GOP plans to vote to repeal the health law early this year, then to hammer out over weeks or months what would replace it after a two- to three-year transition. Cited by the WSJ, Paul said in an interview “I believe we should vote on replacement the same day we vote on repeal,” and added that Trump called the senator on Friday night “to say he agrees completely.”
As the WSJ adds, a Trump transition official confirmed that the incoming president spoke with Mr. Paul on Friday, and said meetings are under way to determine how a replacement law could be approved at the same time—or close to it—that a repeal of the law is approved. Last week, Trump personally warned congressional Republicans on Twitter to “be careful” about the political consequences of moving quickly to repeal the law.
The push from both Trump and Paul, as well as at least five other GOP senators, will put pressure on Republican leaders to accelerate the process of crafting a unified GOP replacement plan. Republicans have proposed dozens of ideas over the years for overhauling the health-care system but have yet to coalesce around a plan.
In other words, in a shift on a popular Nency Pelosi statement, the Republicans “will not repeal it eventually come up with a replacement“, but will do both at the same time. The question now is how long such a unified process could take.
Senate Majority Leader Mitch McConnell, who met with Mr. Trump in Trump Tower on Monday morning, appeared to indicate Sunday that Republicans were accelerating the process of settling on a replacement plan.
“We will be replacing it rapidly after repealing it,” the Kentucky Republican said Sunday on CBS. He wasn’t specific about the timing of the drafting of a new health-care system, or what it would entail, but he said, “There ought not to be a great gap between the first step and the second.”
Trump has said before that he wanted to “simultaneously” repeal and replace the health-care law, but GOP leaders on Capitol Hill hadn’t committed to that timeline.
One thing is clear: both repealing and replacing the health law would be complicated legislative maneuvers with sweeping repercussions for both the health-care industry and millions of American consumers. It could also take years, and keep Obamacare in its current form for a long time, contrary to Trump’s campaign promises.
Reince Priebus said on Sunday that a new health plan might not be ready immediately after gutting the Affordable Care Act. “It may take time to get all the elements of the replacement in place,” Mr. Priebus said on CBS. “The full replacement may take more time than an instantaneous action.”
As reported previously, Republicans are planning to use a special process tied to the budget to pass legislation repealing the health law with a simple majority, but they can afford to lose few GOP votes. They would need all Republicans and several Democratic votes to then approve any replacement health-care system, in order to reach the 60 votes needed to clear the chamber’s procedural hurdles. Paul, who has objected to the budget maneuver over its spending levels, said that he would like to see what would replace the health law weeks later, after House and Senate committees have detailed how the ACA would be repealed. The budget specifies that they must produce their legislation by Jan. 27.
Meanwhile, in a separate article, Bloomberg reports that top advisers to President-elect Donald Trump will meet Monday evening with House Speaker Paul Ryan and his policy staff to discuss taxes and other policy issues, according to two people familiar with the plans. Topics on the agenda include tax reform, the budget, infrastructure and Obamacare.
As a reminder, tax reform was the other item that Trump is expected to be able to enact relatively painlessly.
Ryan and his team intend to walk through the tax reform plan House Republicans put forward last year, calling it a “priority issue” for the House and the president-elect, according to the other person, a Republican aide. House Ways & Means Committee Chair Kevin Brady will be the House Republicans’ point person on tax reform, the aide said. According to Bloomberg, though Trump and Ryan agree on plenty, points of contention include tariffs for companies that move jobs overseas, a $1 trillion infrastructure plan, as Trump has called for, and how many people an Obamacare replacement should insure.
Present at the meeting will be all the top economic Incoming White House aides Reince Priebus, Stephen Miller, Stephen Bannon, Jared Kushner and, of course, former Goldman President Gary Cohn.
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