Comparing the timeline of Trump's health care push to Obama's

A look at the obstacles Obama cleared before Trump had his turn.

ByABC News
July 18, 2017, 5:45 PM

— -- The latest push to overhaul the U.S. health care system has suffered a major blow after the GOP announced it does not have enough support in the Senate to repeal and immediately replace "Obamacare."

Here is a look at the steps that the Obama administration took to get the Affordable Care Act (ACA) signed into law in 2010, as compared to the efforts made during the Trump administration to replace it with a new version.

’Obamacare’ passage

Jan. 24, 2009: Then-President Barack Obama launched what would become more than a year of testy negotiations, making his intention to focus on health care clear during his first weekly video address. He reiterated the sentiment in his address to Congress just over a month after his inauguration.

June 24, 2009: Obama fields questions about his plans for health care overhaul during an ABC News forum at the White House. This was one example of ways that Obama actively campaigned for the overhaul effort.

July 15, 2009: The Senate Health, Education, Labor and Pensions Committee approved the Affordable Health Choices Act, according to The New York Times.

Nov. 7, 2009: The House of Representatives passed the Affordable Care Act with a 220-215 vote. It was then sent to the Senate, which had been working on its own amendments to the bill, and dealing with a shifting headcount that came after Sen. Al Franken, D-Minn., was elected in a special election in Minnesota and longtime Sen. Ted Kennedy, D-Mass., died in August.

PHOTO: President Barack Obama speaks during a meeting at the American Association of Retired Persons (AARP) headquarters to discuss his health care plan and its effects on senior citizens, July 28, 2009, in Washington, D.C.
President Barack Obama speaks during a meeting at the American Association of Retired Persons (AARP) headquarters to discuss his health care plan and its effects on senior citizens, July 28, 2009, in Washington, D.C.

Dec. 24, 2009: The Senate passed its similar, but not identical, version of the Affordable Care Act by a 60-39 vote, with all the Senate Democrats voting for it along with two independents and no Republicans, according to The Hill.

Jan. 19, 2010: There's an upset in the Massachusetts special election, with a victorious Scott Brown going on to fill Kennedy's vacant Senate seat, flipping the seat from Democratic to Republican and giving Republicans the vote they needed to sustain a filibuster in the Senate.

March 11, 2010: Then-Senate Majority Leader Harry Reid says Democrats will use reconciliation so they only need 51 votes to pass, not 60. In a letter to Senate Minority Leader Mitch McConnell, the Democrats explained that, "Reid said he will seek a democratic, up-or-down simple majority vote to revise the health reform bill already passed by a supermajority of 60 Senators last December."

March 21, 2010: The House took a version of the ACA that the Senate passed in December and passed it with a vote of 219-212, with all Republicans and 33 Democrats voting against it.

March 23, 2010: Obama signs the Patient Protection and Affordable Care Act into law. Republicans introduced a bill to repeal the law the day after it was signed, and have tried similar moves more than 60 times since.

PHOTO: President Barack Obama is applauded after signing the Affordable Care Act into law in the East Room of the White House on March 23, 2010.
President Barack Obama is applauded after signing the Affordable Care Act into law in the East Room of the White House, March 23, 2010.

March 25, 2010: The Senate passed The Health Care and Education Reconciliation Act by reconciliation, with a vote of 56-43. Later that day, the House passed this modified bill by a 220-207 vote.

March 30, 2010: The Health Care and Education Reconciliation Act was signed into law by Obama.

Trump's health care push

Trump called for the Affordable Care Act, Obama's landmark health care legislation, to be repealed and replaced throughout the campaign and carried that concept through his transition but began to suggest that the sweeping changes he proposed may not affect every part of the law.

Throughout the campaign, he had regularly called for an "immediate" effort to "repeal and replace" Obamacare.

March 6, 2017: House Republicans unveiled the American Health Care Act and were met with criticism from some conservative groups who complained that it fell short of a campaign pledge to repeal and replace Obamacare, while liberals blasted it as potentially leaving too many people uninsured.

March 7, 2017: The day after the bill was introduced, House Freedom Caucus member Rep. Jim Jordan, R-Ohio, slammed the bill as “Obamacare in a different form.”

House Speaker Paul Ryan, House Majority Leader Kevin McCarthy and Health and Human Services Secretary Tom Price worked to defend the bill, with Speaker Ryan even holding a PowerPoint presentation to explain the AHCA.

PHOTO: Speaker of the House Paul Ryan, R-Wis., conducts a presentation of the American Health Care Act, the GOP's plan to repeal and replace the Affordable Care Act, March 9, 2017, in Washington D.C.
Speaker of the House Paul Ryan, R-Wis., conducts a presentation of the American Health Care Act, the GOP's plan to repeal and replace the Affordable Care Act, March 9, 2017, in Washington D.C.

March 13, 2017: The Congressional Budget Committee released its report estimating that about 14 million more people would be uninsured next year if the original AHCA were enacted. In the next nine years or so, the number of uninsured would jump to 24 million more, according to the CBO.

After the release of the CBO report, several moderate House Republicans announced opposition to the bill because of the increase in Americans without health care coverage.

Despite the CBO report, the bill seemed to be on course as it cleared two hurdles, moving forward with approval from the Ways and Means Committee and the House Budget Committee.

March 20, 2017: A number of tweaks were made to the original legislation in an effort to muster votes. The amendments included changes to Medicaid funding, an optional work requirement for Medicaid and instructions for the Senate to construct a $75 billion fund that would provide additional tax credits to help people buy insurance.

March 24, 2017: At Trump's request, House Speaker Paul Ryan pulled the American Health Care Act (AHCA) off the floor moments before a scheduled vote.

Divisions within the Republican Party ultimately led to the bill’s being yanked as lawmakers failed wrangle enough votes on their side of the aisle for passage in the House. Members of the conservative House Freedom Caucus, along with a few moderate Republican lawmakers, planned on opposing the bill if it went to a vote.

"Obamacare is the law of the land... and we're going to be living with Obamacare for the foreseeable future," Ryan conceded a short time after the bill was dropped.

A spokesman for Ryan released a statement March 26 making it clear that the intention is to move on.

"The speaker and president talked for an hour yesterday about moving forward on the agenda and their relationship is stronger than ever right now," the spokesman said.

May 4, 2017: Republicans in the House of Representatives passed what they said was their plan to repeal and replace Obamacare, after several fits and starts, sending the measure to the Senate, where it is expected to be significantly revised.

The bill passed the House in a narrow 217-213 vote. All Democrats opposed the bill.

PHOTO: President Donald Trump gathers with Vice President Mike Pence, right, and Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Healthcare Act, May 4, 2017.
President Donald Trump gathers with Vice President Mike Pence, right, and Congressional Republicans in the Rose Garden of the White House after the House of Representatives approved the American Healthcare Act, May 4, 2017.

At a celebratory news conference in the White House's Rose Garden, Trump congratulated House Speaker Paul Ryan and praised House Republicans for coming together.

"What we have is something very, very incredibly well-crafted," Trump said of the bill.

"As much as we've come up with a really incredible health care plan, this has brought the Republican Party together. We're going to get this finished.”

May 24, 2017: The nonpartisan Congressional Budget Office released a report on the House Republicans' health care plan, saying that it would reduce the federal deficit by $119 billion over 10 years and leave 23 million more Americans without health insurance, compared with the current law under the Affordable Care Act.

The bill, known as the American Health Care Act, had narrowly passed the House and the Senate planned to rewrite the measure before holding a vote.

House Republicans dismissed some of the CBO report's conclusions, while touting the proposed savings.

"This CBO report again confirms that the American Health Care Act achieves our mission: lowering premiums and lowering the deficit. It is another positive step toward keeping our promise to repeal and replace Obamacare," House Speaker Ryan said in a statement.

June 13, 2017: Even though the House bill passed, Trump made it clear to Senators that he wasn't thrilled about it.

During a meeting with Senators at the White House, Trump lamented the saga that took place on the House side, and said the bill that had passed in the lower chamber was "mean" and the Senate bill should be more "generous."

"He wasn’t prescribing deadlines, because I think he recognized what happened in the House wasn’t good and he wants to make sure that we have a process that proceeds in an orderly way," said Sen. John Thune, R-SD, who attended the meeting at the White House.

Thune acknowledged that Trump was "open to suggestions and didn’t make any pronouncements one way or the other."

"I think he was just sort of conveying that he thinks it’s really important that we get this done and it’s OK that the Senate is going its own direction," Thune said. "I think he was happy to hear that we’re making good progress and is hopeful that we’ll be able to get this done soon because I think there is a sense of urgency."

Republicans were initially hoping to have a bill passed or at least ready by the July 4 recess.

June 26, 2017: A draft of the Senate revision to the House bill was reviewed by the CBO. In another report, the office estimated that 22 million more people would be uninsured by 2026 under the Senate Republican health care plan, called the Better Care Reconciliation Act, than under current law, with 15 million more uninsured people in the next year alone.

The number was only a slight improvement from the CBO's estimate of the health care bill passed by the House of Representatives in May.

June 27, 2017: Senate Majority Leader Mitch McConnell told Republican senators he was delaying a vote on the GOP health care bill until after the Fourth of July recess because he did not have the votes to move it to debate, two senior Senate Republican aides told ABC News.

McConnell confirmed the delay, saying, "We're going to continue the discussions within our conference on the differences that we have."

Sen. John Thune, R-S.D., stressed that the goal was to still replace Obamacare.

"While the schedule may have slipped a little bit, we are intent on rescuing Americans from a failed system that has driven up their cost and made it more difficult for them to find coverage," he said.

Before the delay was announced, Republicans senators were invited to the White House for a meeting with President Trump, who suggested that a delay was not a problem.

"This will be great if we get it done, and if we don't get it done it's just going to be something that we're not going to like, and that's OK," he said while Republican senators were at the White House. "I understand that very well."

July 13, 2017: Republicans unveiled an updated version of their bill in the hopes of addressing some earlier concerns and gaining more support from within their party.

The revised version held on to some Obamacare taxes on the wealthy. It would also allow people to pay for insurance with pre-tax money, and would provide financial support to help low-income people purchase healthcare. It also includes a $45 billion dollar sweetener to fight the opioid epidemic to appease moderates.

In order to appease conservatives, the updated version would allow insurers to offer cheaper bare-bones plans that don’t cover essential health benefits. It could bring down costs for some. but it has also faced serious contention among some moderate senators because it could hurt those with pre-existing conditions.

July 15, 2017: The Senate health care procedural vote was been delayed in light of the announcement that Sen. John McCain, R-Ariz., would be out recovering from surgery to remove a blood clot from above his eye.

Before the delay was announced, two Republican senators had already publicly stated that they would vote against the procedural bill, and Republicans could not afford to lose another vote.

July 17, 2017: Republican Sens. Mike Lee of Utah and Jerry Moran of Kansas effectively killed the Senate health care bill when they announced they would not support the plan.

There were already two Republicans publicly against the bill -- Sens. Rand Paul and Susan Collins -- and in order for the bill to pass, no one else could come out against the bill. Lee and Moran added two more names to the "no" column, making it clear that it would not pass the threshold.

That evening, McConnell announced that they would be moving forward with the goal of repealing Obamacare, but would give themselves more time to come up with the replacement plan.

"Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful," he said in a statement.

McConnell pointed to a plan stemming from a 2015 vote -- which passed the Senate, but was vetoed by then-President Obama -- to repeal Obamacare with a two-year delay "to provide for a stable transition period to a patient-centered health care system that gives Americans access to quality, affordable care."

Editor’s note: This story has been updated to accurately identify the Senate committee that passed a version of the Affordable Care Act on July 15, 2009.

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