Pence said the administration will use both legislation and executive action to replace Obamacare. (Image: iStock)

(Bloomberg) — President Donald Trump said the process for coming up with a replacement for Obamacare could stretch into 2018, a longer time frame than he previously indicated.

Trump’s comments came in an interview with Fox News’ Bill O’Reilly that aired on Sunday during the Super Bowl pregame show. O’Reilly asked the president whether he would introduce a health plan this year to replace Obamacare, which Trump has long vowed to quickly repeal as one of his top priorities.

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“Maybe it’ll take till some time into next year, but we are certainly going to be in the process,” Trump said in the interview. “I would like to say by the end of the year, at least the rudiments, but we should have something within the year and the following year.”

Speakers are not always clear when they are using the term “Obamacare” whether they are referring to all of the Affordable Care Act package or just part of the law. Trump did not say how he defines the term.

Trump said in January that he’d put forward his plans for replacing Obamacare, once Tom Price, his pick to run the U.S. Department of Health and Human Services, is confirmed. The Senate is expected to vote on Price later this week.

“We’re going to be submitting, as soon as our secretary is approved, almost simultaneously, shortly thereafter, a plan,” Trump said at a Jan. 11 press conference. “It’ll be repeal and replace. It will be essentially simultaneously.”

Trump’s remarks are the latest sign of the challenges Republican lawmakers are facing as they work to figure out how to de-fund, change, repeal or replace the Affordable Care Act, after seven years of calling for Barack Obama’s health law to be scuttled. Congress held several hearings last week on aspects of the law, while insurers have pressed for certainty so they can draw up business plans for next year.

‘Repair’?

Some Republicans have begun discussing “repairing” Obamacare, rather than simply repealing and replacing it, as they work to figure out how to make sure insurance coverage isn’t jeopardized for the roughly 20 million people who’ve gained it under the law. Sen. Lamar Alexander, a Tennessee Republican, said late Sunday that a vote to begin repealing Obamacare will take place this year, though it may not take effect until later.

“While Congress will vote to repeal and replace Obamacare this year, the repeal of Obamacare finally will become effective when our reforms are implemented and we have concrete, practical alternatives,” he wrote in a blog post. “We will repair the damage that Obamacare has caused millions of Americans. We will do that by replacing Obamacare with better, lower-cost alternatives and repealing the parts of Obamacare that have caused the damage.”

Orderly transition

Vice President Mike Pence said in a Sunday interview that the president remains committed to an “orderly transition” from Obamacare to its as-yet-unnamed replacement. Pence said he interprets the “repair” language being used by Alexander and others as referring to that orderly transition.

“At the same time that we repeal Obamacare, we’re going through both executive action and through legislation, set into motion a replacement of Obamacare,” Pence told George Stephanopoulos on ABC’s “This Week.” “We can lower the cost of health insurance without growing the size of government with mandates and with taxes. The president’s committed to that.”

The House Energy and Commerce Committee’s health panel examined drafts of four bills on Thursday that could serve as a basis for some of the earliest moves by Republicans to replace pieces of the law.

Meanwhile, insurance industry representatives told a Senate panel led by Alexander that they need to know the rules for 2018 during the next few months or they may not be able to offer individual major medical insurance plans for the year. Compounding the difficulties for insurers, a preliminary enrollment report shows that enrollment in ACA public exchange health plans declined this year, compared to 2016. Insurers had hoped that climbing sign-ups could improve their exchange plan financial results.

In the interview with O’Reilly, which aired Sunday, Trump said little about his plans to replace Obamacare. He said that the health law is a “disaster” and “doesn’t work.”

“We are putting in a wonderful plan,” Trump said.

Related:

CBO, Trump add to pressure for bipartisan ACA deal

Five Republican senators seek ACA action delay

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