US president-elect Donald Trump has pledged to replace Barack Obama's signature healthcare law – one of the centrepiece promises of his presidential election campaign – with a plan to provide "insurance for everybody".
The Affordable Care Act, better known as Obamacare, is emerging as the battleground issue between Democrats seeking to defend one of Mr Obama's biggest achievements that extended health insurance to millions of Americans and Republicans who hold majorities in Congress and want to dismantle the law.
On Friday Republicans in the House of Representatives began the process of unwinding Obamacare through a budget measure that requires only a simple majority in the US Senate. There, Republicans hold 52 seats in the 100-seat chamber and can easily vote down Mr Obama's law.
The more challenging part is trying to draft a replacement plan that crosses the 60-vote threshold, requiring the support of eight Senate Democrats, and would not leave stranded 20 million covered by Obamacare’s insurance exchanges or lower-paid Americans benefiting from expanded Medicaid.
‘Final strokes’
Mr Trump said that his healthcare plan was “very much formulated down to the final strokes”, and that he was ready to present his new Bill to congressional leaders whenever his nominee for health secretary
Tom Price
, a US congressman, was confirmed by the Senate finance committee, which has yet to set a hearing.
"We're going to have insurance for everybody," Mr Trump told the Washington Post in an interview published online late on Sunday night. "There was a philosophy in some circles that if you can't pay for it, you don't get it. That's not going to happen with us."
People covered by the law “can expect to have great healthcare”, he told the newspaper. “It will be in a much simplified form. Much less expensive and much better.”
Mr Trump's proposed universal insurance coverage is at odds with a suggestion by House speaker Paul Ryan, the highest elected Republican, and others in the party to provide "universal access" to health insurance.
‘Repeal and replace’
Congressional Republicans eager to proceed at pace with a “repeal and replace” plan to topple Obamacare are likely to oppose any alternative that would fail to reduce government involvement in public healthcare under Mr Obama’s law that they have described as a “job killer” and a financial burden on businesses and individuals.
Mr Trump has promised to maintain parts of Obamacare including provisions in the law that prevent health insurers from denying coverage to customers with a pre-existing medical condition, and that allow young adults to remain on the insurance plans of their parents until they are 26 years old.
The incoming president, who provided little detail about his alternative scheme, said that he does not plan to reduce benefits for Medicare – government healthcare for older people – under his replacement plan.
Recent tweet
Mr Trump hinted that he is willing to put pressure on Republicans in Congress to pass his plan, pointing to his recent tweet that forced House Republicans to drop plans to reduce the powers of an ethics agency.
“I think we will get approval. I won’t tell you how, but we will get approval. You see what’s happened in the House in recent weeks,” he said, referring to his strong-arming of House Republicans in the opening days of the 115th Congress this month over a proposal that ran counter to his promise to “drain the swamp” of Washington politics.
Democrats have heaped pressure on Republicans as they grapple with the complicated politics around replacing Obamacare by holding rallies around the country highlighting the benefits of the law.
