Sens. Bill Cassidy of Louisiana and Susan Collins of Maine unveiled a bill that they are describing as an "Obamacare replacement plan." The duo is promising that the proposal would give more power to the states on health care policy, increase access to affordable insurance and help cover millions of Americans who are currently uninsured.
At the core of their proposal: Any state that likes Obamacare can keep it.
"Republicans think that if you like your insurance, you should keep it. And we mean it," Cassidy said. "They could opt to stay in Obamacare or they could opt for no federal help. So, California and New York, you love Obamcare? You can keep it."
It is not clear whether the legislation, which is based on a measure Collins and Cassidy introduced in 2015 and has a companion bill in the House from Rep. Pete Sessions, would garner backing from party leadership.
But it is another sign that Republican lawmakers are increasingly feeling the heat to show how they would replace what they roll back the Affordable Care Act. Former President Barack Obama's signature health care law covers some 20 million people and emerged as one of the most politically divisive issues of his presidency.
The fear is that taking action to repeal the law would create deep instability in the insurance markets and potentially result in millions of people's coverage being disrupted or taken away.
Collins, a moderate Republican, has been particularly vocal in insisting that Republicans should not vote to repeal major parts of Obamacare until there is clarity on a replacement plan.
She said Monday that it is imperative for Republicans lawmakers to ensure that patients don't experience "needless and avoidable gaps in coverage," and that the party must put forth legislation to replace Obamacare now.
"We recognize that our bill is not perfect. It is still a work in progress. I expect that we will get many ideas from my colleagues for further refinements and we are completely open to that," Collins said. "But if we do not start putting specific legislation on the table that can be debated, refined, amended and enacted, then we will fail the American people."
The Cassidy-Collins bill, the Louisiana Republican said, would allow states to implement the replacement plan of their choice by 2019: "By the time 2020 rolls around, everything's done," Cassidy said.
Democrats are quickly objecting to the new proposal.
Senate Minority Leader Chuck Schumer said Monday afternoon that the Cassidy-Collins bill was "a far cry from the full replacement plan (Republicans) have promised for years."
"Millions of Americans would be kicked off their plans, out-of-pocket costs and deductibles for consumers would skyrocket, employer-based coverage for working families would be disrupted, and protections for people with pre-existing conditions, such as cancer, would be gutted. All while the wealthiest few get a tax cut," Schumer said in a statement. "It is nearly impossible to keep the benefits of the Affordable Care Act without keeping the whole thing."
Republicans in Congress have already begun the legislative process of overhauling the law. On Day One of the new Congress, Republican senators used a budget maneuver to start the repeal process, although a final repeal bill is not likely to land on President Donald Trump's desk for some weeks, even possibly months.
And within hours of being sworn in as president, Trump issued an executive order
that could eventually have wide-ranging impact on Obamacare. Among other things, it directs the secretary of health and human services and agencies to interpret regulations as loosely as allowed under the law to minimize the burden on individuals, insurers, health care providers and others.
Collins called the executive order "very confusing" and difficult to interpret.
"I think that the executive order is very confusing, we really don't know yet what the impact will be," she said.