After saying ACA is 'law of the land,' Ryan says GOP is reviving repeal efforts

House Speaker Paul Ryan on Tuesday said Republicans would continue trying to repeal and replace the Affordable Care Act (ACA) but declined to offer a timeline or strategies for reviving debate on the matter.

The remarks contributed to a murky picture about the GOP's future health reform efforts. Senate and White House officials have indicated they would halt ACA repeal efforts for now, Associated Press/ABC News reports—but President Trump on Tuesday called on lawmakers to reach a bipartisan "deal on health care" and said that he thinks that will happen "very quickly."

In the House: 'Still trying to get to yes,' one moderate GOP leader says

Ryan's statement Tuesday appeared to contradict remarks he made last Friday, shortly after the House cancelled a vote on the GOP's American Health Care Act (AHCA). At the time, Ryan said the conference would move on from health care to other issues, Bloomberg reports. At the time, Ryan said the ACA would remain "the law of the land ... for the foreseeable future." 

But on Tuesday, Ryan arranged a meeting with members of the Tuesday Group of moderate Republicans and the conservative House Freedom Caucus to reopen the conversation about repealing and replacing the ACA.

Still, Ryan did not provide any details on the GOP's plan or a timeline for health care reform, saying the party needs "to work together and listen together until we get this right." He added the GOP conference would also focus on other priorities, such as tax reform.

House GOP Whip Steve Scalise (La.) seemed optimistic about the renewed talks. He called Democrats' celebration over the failed AHCA vote on Friday "premature," adding, "I think we're closer today to repealing Obamacare than we’ve ever been before, and surely even closer than we were Friday."

But Tuesday Group Co-Chair Rep. Tom MacArthur (R-N.J.) cautioned that nothing had been settled yet. "We as a conference are still trying to get to yes," he said. MacArthur added that the "framework would largely be the same" as the AHCA.

Freedom Caucus Chair Mark Meadows (R-N.C.) also suggested he was open to a renewed repeal push, saying he has been talking with HHS Secretary Tom Price since Friday and that he was hoping to speak with more moderate Republicans later on Tuesday. "Everybody wants to get it done," he said.

In the Senate: GOP leaders signal shift to other priorities

However, Senate Majority Leader Mitch McConnell (R-Ky.) on Tuesday appeared ready move on to other issues. "It is pretty obvious we were not able in the House to pass a replacement," he said, adding, "Our Democratic friends ought to be pretty happy about that because we have the existing law in place and I think we're just gonna have to see how that works out."

Nonetheless, McConnell reiterated his support for repealing and replacing the ACA, saying on Tuesday he was "sorry" the president and speaker's efforts to repeal and replace the ACA were unsuccessful.

Separately, when asked if it was realistic for the House to revive the repeal effort, Sen. Pat Roberts (R-Kan.) said simply, "No. I'm about health-cared out."

But Sen. John Thune (R-S.D.) on Tuesday said he expects the House will take up legislation to repeal the ACA at some point in the future, saying, "It's not a question of if, it's a question of when."

Where Trump stands: 'I have no doubt that that's going to happen very quickly'

White House officials on Tuesday also appeared ready to drop ACA repeal efforts for now, though Trump himself said Republicans are not ready to give up, AP/ABC News reports.

After a meeting with Senate Republicans on Tuesday, White House legislative affairs director Marc Short said, "We understand there's probably members in Congress who feel like, 'Look, we probably need to revisit this, and we need to make an effort to get it done,' and if that's the case, if the legislation reaches the president's desk, I'm sure he'll look to sign it." But Short added a caveat on timing, saying, "But at this time, at this time today, there are other things that we have on our priority list that we're moving on to."

Later on Tuesday, though, Trump told a bipartisan group of lawmakers, "I know that we're all going to make a deal on health care. And that's such an easy one. I have no doubt that that's going to happen very quickly."

Where Democrats stand: 'I don't know how [Republicans] … find any Democratic votes'

Democrats, meanwhile, reiterated their refusal to help pass any ACA repeal plan, but they again said they would be willing to work with GOP lawmakers to improve the ACA, AP/ABC News reports. House Minority Leader Nancy Pelosi (D-Calif.) in a letter to House Democrats asked them to propose ways to "improve and update" the law.

Separately, Rep. Jim McGovern (D-Mass.) expressed doubts about GOP efforts to revive the push to repeal and replace the ACA. "I don't know what has changed" since Friday, he said. "The [AHCA] went down because it was too bad for Republican moderates and not bad enough for their conservatives. I don't know how they reconcile the divides within their own conference, never mind find any Democratic votes."

Hospitals shared fall amid health care debate

In related news, U.S hospital shares dropped on Tuesday following Republicans' comments that they are considering reopening the health care debate.                                                          

Shares of Community Health Systems dropped 7.6 percent and Tenet Healthcare dropped 4.8 percent in mid-day trading, Reuters reports. Meanwhile, HCA Holdings, Universal Health Services, and Envision Healthcare Corp were down around 2 percent.

Hospital stocks had gained on Friday after Republicans pulled the bill. Les Funtleyder, health care portfolio manager for E Squared Asset Management, said, "The Republican health care reform is perceived to be bad for hospitals," meaning "any inkling of a rebirth is going to lead to that reaction."

But some observers were skeptical of the Republican effort, Reuters reports. Julius Hobson, a health care lobbyist and attorney with the law firm Polsinelli, said a "full blown push at the repeal and replace is going to be extremely difficult to pull off," adding, "I can't see how they achieve that" (Pear/Peters, New York Times, 3/28; Conway, Politico, 3/24; Nather, Axios, 3/29; House/Wasson, Bloomberg, 3/29; Werner, AP/ABC News, 3/28; Reuters, 3/28).

What you need to know about the post-AHCA health policy outlook

After canceling a vote on the AHCA, Republican lawmakers continue to discuss possible paths to repealing the ACA, but they are also shifting focus to administrative changes to the ACA as well as to discussions of other key health policy issues.

Join our panel of experts to hear the latest developments in ACA-related policy, an overview of other policy issues that may arise, and what this all means for provider strategy.

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