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Trump shakes up GOP health care talks, endorses a plan he opposes

Donald Trump's new contribution to the health care debate is an endorsement of an idea he's already rejected.
US President Donald J. Trump after a group photo on the second day of the G7 Summit at the Hotel San Domenico in Taormina, Sicily, Italy, 27 May 2017.

The Republican effort to overhaul the nation's health care system was already messy, but Donald Trump this morning made matters quite a bit worse.

As Senate negotiations continue over the stalled Republican health care bill, President Donald Trump Friday morning called on senators to pass a simple repeal of Obamacare now and focus on replacing it later this year if no deal is reached.Trump's tweet came just after Sen. Ben Sasse, R-Neb., sent a letter to the White House urging the president to support a repeal-first, replace-later strategy if there is no agreement by the time senators return from their week-long Fourth of July recess on July 10.

There's no reason to assume the president saw Sasse's letter. The Nebraska Republican realizes, however, that to deliver an idea to Trump, it's important to go on television, so Sasse went on Fox News this morning to tout his preferred approach. The president endorsed Sasse's idea on Twitter 18 minutes later.

And why does this make a big mess even messier? Because Trump just threw his support behind a plan he said he opposes.

Let's back for a minute to remember how we got here. Shortly after the 2016 elections, Republicans came up with a health care strategy that GOP leaders had confidence in. It was called "repeal and delay," and it involved repealing the Affordable Care Act quickly, while creating an arbitrary deadline at which point Congress would have to replace the ACA with something new.

This was the official Republican approach, right up until Donald Trump condemned it, repeatedly, insisting that policymakers should repeal and replace "Obamacare" at the same time. Left with no choice, GOP leaders shelved their plan and began working on their own legislative blueprint.

That hasn't gone especially well. The House managed to pass a regressive, unpopular plan in May, which Trump initially embraced before changing his mind in response to media criticism. Senate Republicans, meanwhile, have tried to craft their own alternative, but can't agree among themselves how best to proceed.

Senate GOP leaders still want to come up with some kind of intra-party agreement by this afternoon, submit to the Congressional Budget Office, and then hold a vote in two weeks, but by voicing support for an approach he's previously rejected, Trump just made the process more difficult.

With the benefit of a presidential endorsement, is there any reason to believe "repeal and delay" could make a comeback and actually pass? Don't count on it. There's no reason to believe such a bill could get 50 votes in the Senate -- the idea was unpopular in the chamber back in January -- and when the CBO looked at this model in January, the score was brutal.

The fact that the conversation is even headed in this direction, though, suggests all is not well with the Republicans' health care initiative.