Republican leaders on March 28 sent mixed messages about whether repealing and replacing the Affordable Care Act was a priority for the party after their bill failed to garner enough votes to pass the House.
"I know that we are going to make a deal on healthcare; that's such an easy one," President Donald Trump declared to a room full of U.S. senators at a bipartisan White House evening reception, where his remarks on the topic brought some chuckles. "I have no doubt that that's going to happen quickly."
Earlier in the day, House Speaker Paul Ryan, R-Wis., told reporters his chamber planned to continue its repeal-and-replace pursuit. But Senate Majority Leader Mitch McConnell, R-Ky., signaled the fight was over for the time being.
"I want to thank the president and the speaker. They went all out to try to pass repeal and replacement. Sorry that didn't work," McConnell told reporters, declaring that the "status quo" with the ACA would remain in place.
But on the other side of the Capitol, Ryan told reporters that "Obamacare was collapsing," and it was "just too important" not to "get it right."
A few days earlier, Ryan said Republicans were ready to move on to other legislative tasks on their "ambitious" agenda, like tax reform, after he pulled the American Health Care Act from the House floor minutes before its scheduled vote.
"The votes were not there yet" to pass the measure, House Majority Leader Kevin McCarthy, R-Calif., acknowledged to reporters during the March 28 news conference.
"That doesn't mean that we're not going to get there," he said, although he provided no timeline or details about what course the House Republicans planned to take.
A day earlier, however, Ryan told Republican donors during a teleconference he would "lay out the path forward on healthcare and the rest of the agenda" at a party meeting in Florida later in the week, according to a report in the Washington Post.
A path forward
Trump's top spokesman, Sean Spicer, told reporters March 28 that discussions were ongoing with Ryan and other members of Congress on a potential path forward on healthcare, but said the White House was not involved in planning an immediate strategy "at this time."
Trump repeatedly said throughout his campaign and after entering the White House he had his own strategy for repealing and replacing the ACA, and in February said he planned to unveil it by mid-March.
But the administration has yet to release a plan.
In a response to questions about the status of Trump's repeal-and-replace plan, White House spokesman Ninio Fetalvo told S&P Global Market Intelligence that the "president fully supported the American Health Care Act and worked with members of Congress to ensure his core principles were incorporated into it."
Fetalvo provided no other details about whether the White House had devised a separate policy proposal.
When Spicer was asked during his March 27 daily briefing whether the Trump administration planned to continue regulatory and administrative actions by Health and Human Services Secretary Tom Price to dismantle the ACA — what Republicans earlier dubbed the second prong of their three-phase repeal-and-replace effort — he told reporters there were "a lot of options" on the table to try to "get some of that stuff out the door."
But Spicer said nothing had been decided on "whether we wait for the revival of legislation before we put it up."
If Trump, however, was serious about getting some Democrats on board to fix the problems plaguing the U.S. healthcare system, as he and other White House officials said they wanted to do following the failure of the House bill, proceeding with any administrative and regulatory action would most certainly hamper any future opportunities for bipartisanship, Julius Hobson — a senior policy adviser at the Washington, D.C., offices of Polsinelli PC, a law and consulting firm — told S&P Global Market Intelligence.
Democrats signaled they would be on the lookout for attempts from the Trump administration to interfere administratively with the ACA.
"After the collapse of Trumpcare, we must ensure that the Trump administration does not sabotage the ACA out of spite," House Minority Leader Nancy Pelosi, D-Calif., said in an email to her Democratic colleagues.
The other problem with trying to take the ACA apart outside of legislation, Hobson said, is any actions by Price at HHS would be inviting lawsuits.
"The Affordable Care Act is the law of the land," and if it is not faithfully executed by the Trump administration, lawsuits are "virtually guaranteed," Hobson said.
"It is the law and you have to carry it out. There's just no way around it," he said.