Paul, citing deficit, is among small but potentially pivotal group of GOP senators who want Obamacare replaced when repealed

This story was updated Monday, Jan. 9.

Kentuckian Rand Paul is among a small but growing and potentially pivotal group of Republican senators who say the Patient Protection and Affordable Care Act should be replaced at the same time it is repealed. And now President-elect Donald Trump appears to be with them.

“He called after seeing an interview that I had done [talking about] that we should vote on Obamacare replacement at the same time,” Paul said told Burgess Everett of Politico on Monday. “He said he was in complete agreement with that.”

“With Trump going out of his way to bless the Kentucky senator’s approach, Paul’s week-long campaign to hold a vote on replacing Obamacare alongside a simultaneous repeal measure has seemingly upended the GOP’s long-sought plans for a cathartic and immediate vote to gut the health care law, Everett reports. “As news broke that Trump backed Paul’s play, several other Senate Republicans were also beginning calls for a new strategy — threatening the trajectory of the party’s rush to repeal the law.”

Paul says repealing parts of the law in a budget resolution, the only way around the Senate’s 60-vote requirement for most major votes, would add too much to the federal budget deficit and the national debt.

“He’s putting together an initial proposal containing the GOP’s best ideas and will ship them this afternoon to Trump’s administration after getting buy-in from the president-elect,” Everett reports. “He’s putting together an initial proposal containing the GOP’s best ideas and will ship them this afternoon to Trump’s administration after getting buy-in from the president-elect.”

Paul was the only Republican to join Democrats on a procedural vote Wednesday that allowed the Senate to consider the resolution, but “at least five other Senate Republicans have signaled they are uneasy over repealing the law without having settled on its replacement,” Kristina Peterson and Stephanie Armour of The Wall Street Journal. “GOP leaders have said they plan to develop replacement legislation this year, which would go into effect after a transition period of two to three years.”

Senate Majority Leader Mitch McConnell of Kentucky, who discussed Obamacare with Trump Monday in New York, can afford only two dissenters in his 52-member Republican caucus, because 50 votes are needed to pass a budget resolution, with a tie-breaking vote from Mike Pence after he becomes vice president and president of the Senate. Until Jan. 20, 51 votes are needed.

Aware of that, “Sens. Ted Cruz of Texas, Mike Lee of Utah and Marco Rubio of Florida wrote Tuesday in a joint letter to GOP Senate leaders that while they understood the budget was “primarily a mechanism to advance [the health law’s] repeal,” the Senate should still abstain from any budget devices that they oppose,” the Journal reported.

Paul said on MSNBC‘s “Morning Joe,” “Everybody is hot and heavy to vote on this budget because they want to repeal Obamacare. But the budget they’re going to introduce will add $8.8 trillion to the debt over the next 10 years. So I told them look, I’m not going to vote for a budget that never balances.”

Paul later said he would support a stand-alone repeal measure, and Arkansas Sen. Tom Cotton expressed views similar to Paul’s. But on the moderate side of the Republican caucus, Sen. Susan Collins of Maine “wants Republicans to both repeal and replace the law at the same time,” at least with what she calls “a detailed framework,” and both Tennessee senators have taken similar stands.

The latest was Bob Corker, who said Friday that it “would be best for our country to go ahead and replace it with something that works and repeal at the same time.” He called immediate repeal “a flawed concept.”

Corker “noted that President-elect Donald Trump voiced support during the campaign for moving the two together and told ’60 Minutes’ in November that he backed repealing and replacing ObamaCare simultaneously,” Jordain Carney reports for The Hill. Corker said, “I think the president-elect’s position is the right position.”

Paul tweeted Friday that he had just spoken with Trump, “and he fully supports my plan to replace Obamacare the same day we repeal it.” But Trump adviser Kellyanne Conway said on CNN‘s “State of the Union” said only that “He is committed to replacing Obamacare with something that actually is affordable and accessible and allows you to buy health insurance over state lines and allows people to have health savings accounts.”

Asked about Paul and Obamacare Sunday on CBS’s “Face the Nation,” McConnell said he hadn’t seen a replacement plan from Paul but said Congress would pass one “rapidly.” he declined to be more specific.

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