WASHINGTON (KTVU AND AP) President Trump's lunchtime meeting scheduled with Senate Republicans Wednesday highlights the internal battle over health care reform that has paralyzed and frustrated the Republican Party's efforts to deliver on their seven-year promise to "repeal and replace" Obama's Affordable Care Act health reform law.
"When we finally get a chance to repeal and replace, they don't take advantage of it. So that's disappointing," said President Trump Tuesday. He and other Republican leaders were caught by surprise by the defection of two additional GOP Senators, making it evident that Senate Republicans would not be able to bring their Republican health care bill to a vote.
The Senate bill faced sudden death about 8;30 p.m. Monday, after Senators Mike Lee of Utah and Jerry Moran of Kansas unexpectedly announced they were joining two other Republican Senators Susan Collins of Maine and Rand Paul of Kentucky in opposing the bill.
"It wasn't a decision that was made just on the spur of the moment or just last evening. I've had conversations with Kansans, with healthcare providers with patients over a long period of time," said Moran.
Moran says he wanted to protect rural hospitals, and his staff has been in regular contact with the Kansas Hospital Association, which has been critical of GOP proposals so far.
Moran called for a "fresh start" and an "open legislative process." His position also received support from the hospital association, which projects GOP proposals will cost the state federal funds. More than 30 community hospitals are considered financially vulnerable, many in rural areas of the state. The hospital association noted Tuesday that the senator has visited all 127 community hospitals in the state.
"He's always had an ear to listen to the concerns of our members," said Cindy Samuelson, the association's spokeswoman.
Lee said the GOP bill does not go far enough in repealing all the Obamacare tax increases or lowering middle class families' premiums.
Senate Majority leader Mitch McConnell announced Tuesday that he plans to move ahead with a vote early next week on another option, a straight repeal of Obama's Affordable Care Act, just as the GOP senators did in 2015.
"At the request of the president and the vice president and after consulting with our members we will have the motion to proceed to the Obamacare repeal bill early next week," said McConnell.
The repeal would take effect in two years, giving Congress a deadline for passing a replacement plan.
The Republican right wing praised the idea.
"I'm in favor moving forward with partial repeal and continuing to try and get rid of the rest of the bad elements of Obamacare that have driven prices up," said Kentucky Senator Rand Paul.
Four moderate Republicans said they would not support a repeal without an alternate plan to replace health coverage.
"The Affordable Care Act is so interwoven in our healthcare system that to repeal it completely with no idea what it's going to be replaced with is not the right approach," said Sen. Susan Collins of Maine.
Three other Republicans from Alaska, West Virginia and Ohio agreed.
"We now have 19 counties with not a single insurer. In 2015 we had insurers in every county," said Sen. Rob Portman of Ohio.
"President Trump wants to throw up his hands rather then roll up sleeves and solve problem," Senate Minority Leader Charles Schumer of New York said Republicans need to sit down with them at the table.
"It's time to move on. It's time to start over," Schumer said.
Gregory Cochran is associate director of the health law and policy program at UC Hastings. He says the Republicans' campaign promises to repeal the Affordable Care Act are at odds with the political reality.
"Historically in the United States when a social program has been implemented, it's never been able to be repealed," said Cochran.
Cochran says the best path forward is finding bipartisan ways to improve the ACA, because a straight Republican repeal could mean tens of millions of people, both Democrats and Republicans, losing their insurance.
"Once it's implemented...they start losing concerns about whether it's a Republican or Democratic policy," said Cochran.
President Trump reportedly wants a repeal of the ACA by the August recess.