AFP Washington, DC, United States
Mar 10, 2017, 08.06 PM
Donald Trump has thrown his full weight behind a contested plan to repeal and replace Obamacare, battling to overcome resistance from the Republican Party's right wing and meet a key campaign pledge 50 days into his presidency.
With Democrats expected to unite against the new health care plan, Trump can ill afford defections from within as he seeks to drive through the top legislative priority of his new administration.
While the bill winds its way through Congress in the coming weeks, Trump is using his bully pulpit, powers of persuasion, and deal-making savvy to try and salvage the controversial plan.
On Friday Trump met in the White House with senior House Republicans to discuss the way forward on the repeal and replacement of Barack Obama's signature health care law.
"We must act now to save Americans from the imploding Obamacare disaster," Trump said as he sat down with the lawmakers.
"This is the time we're going to get it done."
The president has spent much of the week huddling with key health care players, including Republican lawmakers who support and oppose the bill, known as the American Health Care Act.
On Wednesday he hosted several conservative groups that have expressed concerns about how the plan to use tax credits for people to buy insurance on the free market is too similar to the subsidies in Obamacare.
Trump dispatches Vice President Mike Pence to Kentucky Saturday to talk up the bill. It could be an arm-twisting gesture of sorts, as Kentucky's Senator Rand Paul is one of its chief Republican critics.
The president has signalled he is open to "negotiation" on the AHCA -- a potentially critical acknowledgement as some conservatives in his party warn that the bill will not pass Congress without significant changes.
At the heart of the debate, Trump wants to repeal Obama's landmark reforms and remove the federal government from its role as health care architect, while maintaining the high levels of coverage for Americans entitled to Obamacare.
Trump has stated he ultimately wants a plan in place that allows for "insurance for everybody."
The chief champion of the plan in Congress, House Speaker Paul Ryan, claimed that millions of US taxpayers would benefit from a rollback of Obamacare's subsidy system.
In a crisp rolled-up-sleeves presentation Thursday, Ryan also sounded a clear warning to Republicans who are considering bucking the president.
"This is the closest we will ever get to repealing and replacing Obamacare," the charismatic 47-year-old said, describing the path forward as "a binary choice" between reform and the status quo.
House Republican Steve Scalise reiterated the us-versus-them approach Friday on CNN. "Members are going to have to pick a side: (House Democratic leader) Nancy Pelosi or President Trump."
Polls show that Obama's Affordable Care Act, which helped 20 million Americans gain coverage, remains popular. About half of those people are covered through Obamacare's expansion of the Medicaid insurance program covering the poorest Americans -- an expansion that would phase out by 2020 under the new plan.
Several health-related interest groups, including the American Medical Association, are opposed to the Republican reform, fearing millions could lose their coverage.
According to the Washington Post, citing figures from New York University research, the Republican plan would strip away vital drug addiction or mental health treatment benefits from as many as 1.3 million people.
The new legislation's cost remains a major unknown. Next week the Congressional Budget Office is expected to release its "score" on the bill's costs and the estimate on the number of people who could lose or gain coverage.
A preliminary analysis by Standard & Poor's concluded that between six million and 10 million people could lose coverage if the Republican plan replaces Obamacare.
Ryan told his footsoldiers in Congress to gird for battle, as he framed the fight as between the free market and government mandates -- which under Obamacare required people to take out health insurance.
"Our goal is not to show a pretty piece of paper that says we're mandating great things for Americans," he told the conservative radio host Hugh Hewitt.
"Our goal is to get a vibrant health care system that's patient-centered, that brings down costs (and) that increases choices."