WASHINGTON — President Trump, meeting with the nation’s governors, conceded Monday that he had not been aware of the complexities of health care policy-making: “I have to tell you, it’s an unbelievably complex subject. Nobody knew that health care could be so complicated.”
The president also suggested that the struggle to replace the Affordable Care Act was creating a legislative logjam that could delay other parts of his political agenda.
Many policy makers had anticipated the intricacies of changing the health care law, and Mr. Trump’s demands in the opening days of his administration to simultaneously repeal and replace President Barack Obama’s signature domestic achievement made the political calculations far more complicated.
Governors of both parties added still more confusion on Monday when they called for any replacement to cover all the people already benefiting from the landmark law.
Of course I am concerned,” said Gov. Brian Sandoval, the Republican governor of Nevada, where about 300,000 people have gained Medicaid coverage. “I am someone who elected to expand Medicaid. That’s been very beneficial to my state, and I want to be sure those individuals can keep their coverage.”
“Governors are all in agreement,” said Gov. Terry McAuliffe of Virginia, a Democrat who is the chairman of the National Governors Association. “We do not want one single one of our citizens to lose access to quality health care. We are all unified on that. Actually, we want to expand, so everybody has access to quality health care.”
Mr. Trump brushed aside opinion polls suggesting that the 2010 health law was becoming somewhat more popular. “People hate it,” the president said, “but now they see that the end is coming and they’re saying, ‘Oh, maybe we love it.’ There’s nothing to love. It’s a disaster, folks.”
Because of the intricate procedures that govern budget legislation and the inherent complexity of health care, Republicans appear unlikely to undo the health law as quickly as they had hoped. Mr. Trump said Congress must tackle the Affordable Care Act before it can overhaul the tax code, also a high priority for Republicans. And those delays could slow work on other priorities like a trillion-dollar infrastructure push.
“Statutorily and for budget purposes, as you know, we have to do health care before we do the tax cut,” Mr. Trump told governors.
GRAPHIC
How Republicans Propose Changing Obamacare
A comparison between House Republicans’ outline to repeal and replace Obamacare, and the current law.
After his session with the governors, Mr. Trump met on Monday with executives from health insurance companies. He apparently hopes they will stay in or return to the Affordable Care Act’s insurance marketplaces, where more than 10 million people obtained coverage last year.
If the governors’ meeting in Washington was supposed to clarify the future of the health law, it fell short. If anything, it exposed deep divisions among state executives, especially Republican leaders.
Gov. Gary R. Herbert of Utah, a Republican, said: “We did not expand Medicaid. Many states are divided on what the right approach is to take under the Affordable Care Act.” Some Republican governors, he said, are concerned about the “sustainability” of the Medicaid program, which covers more than 70 million low-income people.
And no governor was ready to say publicly that he or she could accept a replacement health law covering fewer people than the Affordable Care Act, which has extended coverage to 20 million Americans.
A bill drafted by House Republicans could cover fewer people. It would roll back the heath law’s expansion of Medicaid, eliminate tax penalties for people who do not have health insurance and end taxes imposed by the Affordable Care Act on certain high-income people, insurers, drug companies and manufacturers of medical devices.
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