Trump Warms to Old Idea: Kill Health Law Now, and Replace It Later

With Senate Republicans already bogged down over how to dismantle the Affordable Care Act, President Trump on Friday tossed in a new complication with an old idea: The Senate could repeal the health law now, then replace it later.

Mr. Trump gave his blessing in a Twitter post after a Republican dissatisfied with the current repeal bill, Senator Ben Sasse of Nebraska, floated the two-stage approach as a backup plan. Mr. Sasse sent a letter to the president and made a pitch on Fox News on Friday as an agreement on a new version of the Senate’s repeal bill remained elusive.

Other conservatives quickly picked up the idea — including Senator Rand Paul of Kentucky and the advocacy group Americans for Prosperity, backed by Charles G. and David H. Koch — presenting a new headache to Senate leaders who are trying to focus their conservative and moderate troops on finding a compromise.

Days ago, Senate Republican leaders spoke of finishing their revisions to the repeal bill by Friday, clearing the way for the Congressional Budget Office to prepare a new analysis of the bill. That way, after lawmakers return from their Fourth of July recess, the majority leader, Senator Mitch McConnell of Kentucky, could try to move ahead with a vote.

But Friday came and went without any agreement or public show of progress — and with no vote in sight. Instead, Mr. McConnell was dealing with a new dose of uncertainty about whether Republicans should continue on their current course or scrap their bill for a repeal-only measure that would probably have at least as much difficulty garnering enough votes to pass.

The health care debate almost certainly will continue deep into July, when Congress will face other pressing issues, including raising the government’s statutory borrowing limit.

“We need repeal; we need replace,” Mr. Sasse said on Fox News. “Trying to do them together hasn’t seemed to work.”

Asked about the tweet, a White House spokeswoman, Sarah Huckabee Sanders, said, “The president hasn’t changed his thinking at all.”

“We’re still fully committed to pushing through with the Senate at this point,” she said. “But we’re looking at every possible option of repealing and replacing Obamacare.”

Subsidies in the Senate bill were already beginning to look like those in the Affordable Care Act, which are tied to a person’s income and local insurance costs. However, the Senate subsidies are less generous than those under the current law.

The repeal bills written by House and Senate Republicans would provide tens of billions of dollars in assistance to health insurance companies to help stabilize insurance markets and hold down premiums. Many of the same Republicans attacked such payments, when made by the Obama administration, as a bailout for the insurance industry.

But as senators tried to come to agreement, Mr. Trump effectively added a distraction. A clean repeal of the Affordable Care Act would face huge political obstacles in the Senate if it was not accompanied by legislation to provide health coverage in some other manner. Republican senators are already faced with pleas from constituents who want the health law to remain in place. If they approve a repeal-only measure, they will face enormous pressure to explain what comes next.

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