Shortly after the November election, Republican leaders came up with a plan for Obamacare: They would repeal the law quickly upon President Trump taking office, and then delay its enactment so they’d have time to develop a replacement.
The strategy became known as “repeal-and-delay,” and it was catching on with Republican lawmakers, particularly on the right, until it ran into a blockade led by two powerful men: Senator Rand Paul of Kentucky and soon after, Donald Trump.
“I just spoke to @realDonaldTrump and he fully supports my plan to replace Obamacare the same day we repeal it,” Paul tweeted on January 6. “The time to act is now.” The soon-to-be-president picked up the ball and ran, vowing in tweets and interviews that there would be no gap between repeal and replace; Republicans in Congress, he said, would do the deed in the same week, or the same day. Heck, Trump even suggested repeal-and-replace “could be the same hour.”
Repeal-and-delay was dead. The concern, then as now, was that Republicans would never get around to a replacement, that it would need Democratic votes to pass, and that in the meantime, the insurance markets would collapse and millions would lose coverage or face sharply higher prices. On Trump’s orders, GOP leaders on Capitol Hill began working on a plan to roll back and replace the Affordable Care Act simultaneously, in one piece of legislation. And that remained the strategy through Friday morning, when repeal-and-delay shot back to life thanks to the two men—with help from a third—who killed it in the first place.