Senate Majority Leader Mitch McConnell has rejected President Donald Trump's advice to first repeal Barack Obama's health care law and then replace it later with something else.
McConnell told reporters after an event Friday in his home state of Kentucky that the current health care bill remains challenging but "we are going to stick with that path."
Earlier in the day, Trump tweeted that if Republicans could not reach a consensus on the current bill, they "should immediately REPEAL, and then REPLACE at a later date!" Several Republican senators signed on to Trump's plan, including Sen. Rand Paul of Kentucky.
But McConnell showed no interest in that strategy. He told a gathering of Republicans in Elizabethtown, Kentucky, that "failure has to be possible or you can't have success."
Trump's early-morning tweet embraced a sequential approach favored by only a handful of conservatives eager to take quick action on one of the party's foremost priorities — repealing Obamacare, something Republicans have long promised to do. But his suggestion threatened to sharpen divisions between conservatives and moderates, who are leery of stripping coverage from millions of constituents without something to substitute for it.
The White House said it remains "fully committed" to pushing through a health care plan in the Senate but is "looking at every possible option" to repeal and replace the Obamacare law.
White House spokeswoman Sarah Huckabee Sanders said Friday that Trump "hasn't changed his thinking at all" about the struggling health care bill.
Supporters of that idea include Sens. Ben Sasse, R-Neb., and Rand Paul, R-Ky.
House and Senate leaders long ago abandoned initial thoughts of first erasing Obama's law, and then replacing it.
Such a step-by-step approach would leave Republicans vulnerable to Democratic accusations that they were simply tossing people off coverage without helping them obtain medical care. It could also roil insurance markets by prompting insurers to flee or boost premiums because of worries over whether, when and how Congress would replace the statute.
And the idea would leave unresolved the quandary stumping lawmakers today — how to replace Obama's system of online insurance markets, tax subsidies and an expanded Medicaid with something that will get enough Republican votes to pass Congress.
Underscoring the fissures within the GOP, conservative group leaders welcomed Trump's suggestion but said it didn't go far enough because it could open the door to a subsequent bipartisan compromise to replace Obama's law. They accused McConnell of not wanting to go far enough and protecting GOP moderates who want to keep parts of the statute, such as insurance coverage requirements.
"It's distressing to see so many Republicans who've lied about their commitment to repeal. Mitch McConnell wants to amend Obamacare," Ken Cuccinelli, president of the Senate Conservatives Fund, said in a conference call. Mimicking a southern accent, the New Jersey-born Cuccinelli said, "Root and branch, root and branch," repeating an expression McConnell once used about how thoroughly he wanted to repeal the Obama law.
On Thursday, Senate Republicans were considering breaking a stalemate over what their replacement bill should do by preserving a tax boost Obama's law imposed on high earners. Keeping that tax increase in place was a bid to woo party moderates and rescue their sputtering push to repeal his health care overhaul.
The break from dogma by a party that has long reviled tax boosts — and most things achieved by Obama — underscores McConnell's feverish effort to rescue the Senate legislation from the brink of possible defeat.
The money from the tax boost would instead be used to bolster proposed health care subsidies for lower-income people.
The change, proposed by Sen. Bob Corker, R-Tenn., would give a more populist flavor to the bill. The nonpartisan Congressional Budget Office says that as the legislation now is written, it would boost out-of-pocket costs for many poor consumers and produce 22 million uninsured people while cutting around $700 billion in taxes over a decade — largely for richer people and the health care industry.
"You're increasing the burden on lower-income citizens and obviously alleviating the burden on the wealthy. That is not an equation that works," Corker said. He said he was "very confident" that leaders would address the issue in the updated bill.
Top Republicans also considered an amendment pushed by conservatives to let insurers offer plans with low premiums and scant benefits. To do so, a company would also have to sell a policy that abides by the consumer-friendly coverage requirements in Obama's 2010 statute, which the GOP is struggling to repeal.
Both proposals were encountering internal Republican opposition, and it was uncertain either would survive.
McConnell postponed a vote on an initial version Tuesday because of opposition from conservatives and moderates alike. By this week's end, he wants to nail down changes that would assure the bill's passage after Congress' weeklong July 4 recess. No more than two of the 52 GOP senators can oppose the measure for him to prevail, and there were no indications he'd achieved that margin as senators left town Thursday.
"We're kind of at a stalemate right now, I'd say," said Sen. Shelley Moore Capito, R-W.Va., who with Ohio GOP Sen. Robert Portman and others wants to forestall reductions the measure would make in Medicaid.
Under Corker's proposal, the bill would retain Obama's 3.8 percent tax increase on investment income for married couples making more than $250,000 a year and individuals making more than $125,000. Keeping that increase would save $172 billion over 10 years, and moderates want to use that money to make coverage more affordable for poorer consumers.
Conservatives said they opposed the idea, along with the chairmen of Congress' two tax-writing committees: Senate Finance chairman Orrin Hatch, R-Utah, and House Ways and Means chairman Kevin Brady, R-Texas.
Associated Press writers Erica Werner, Mary Clare Jalonick, Kevin Freking and Stephen Ohlemacher contributed to this report.