On President Trump’s ‘day one,’ GOP Congress eyes Medicaid block grants in Obamacare replacement

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On what President Trump has deemed his first day in office, a GOP-led Congress moves to act on the 45th commander in chief’s “day one” priority of repealing the Affordable Care Act — commonly known as Obamacare.

Hours after taking his oath of office, Trump took his first step in dismantling Obamacare as he signed an executive order instructing federal agencies to grant relief to constituencies affected by the Affordable Care Act.

President Obama’s signature health care law has been a point of contention between Republican and Democratic lawmakers since it was signed into law in 2010. Congressional leaders are now planning to use a budget vehicle to overhaul the nation-wide law, in hopes of replacing the Affordable Care Act with legislation that includes what conservative think tank The Heritage Foundation calls “free market principles.”

Rachel Bovard, Director of policy services for The Heritage Foundation, says congressional leadership must prioritize repeal, at least at first, before they debate different stances on a sound replacement plan.

RELATED: Protests for and against Obamacare

Tea Party Patriots supporters hold signs protesting the Affordable Care Act in front of the Supreme Court as the court hears arguments on the health care reform bill on Tuesday, March 27, 2012.

(Photo By Bill Clark/CQ Roll Call)

Affordable Care Act supporters wave signs outside the Supreme Court after the court upheld court’s Obamacare on Thursday, June 25, 2015.

(Photo By Bill Clark/CQ Roll Call)

A man holds signs during a protest on the second day of oral arguments for the Patient Protection and Affordable Care Act in front of the U.S. Supreme Court building on March 27, 2012 in Washington, DC. Today is the second of three days the high court has set aside to hear six hours of arguments over the constitutionality President Barack Obama’s Patient Protection and Affordable Care Act.

(Photo by Mark Wilson/Getty Images)

Sister Caroline attends a rally with other supporters of religious freedom to praise the Supreme Court’s decision in the Hobby Lobby, contraception coverage requirement case on June 30, 2014 in Chicago, Illinois. Oklahoma-based Hobby Lobby, which operates a chain of arts-and-craft stores, challenged the provision and the high court ruled 5-4 that requiring family-owned corporations to pay for insurance coverage for contraception under the Affordable Care Act violated a federal law protecting religious freedom.

(Photo by Scott Olson/Getty Images)

An Obamacare supporter counter protests a Tea Party rally in front of the U.S. Supreme Court in the morning hours of March 27, 2012 in Washington, DC. The Supreme Court continued to hear oral arguments on the Patient Protection and Affordable Care Act.

(Photo by Alex Wong/Getty Images)

Affordable Care Act supporters hold up signs outside the Supreme Court as they wait for the court’s decision on Obamacare on Thursday, June 25, 2015.

(Photo By Bill Clark/CQ Roll Call)

Ron Kirby holds a sign while marching in protest of the Patient Protection and Affordable Care Act in front of the U.S. Supreme Court on March 26, 2012 in Washington, DC. Today the high court, which has set aside six hours over three days, will hear arguments over the constitutionality President Barack Obama’s Patient Protection and Affordable Care Act.

(Photo by Mark Wilson/Getty Images)

A protester waves his bible in the air as he overpowered by cheers from supporters of the Affordable Care Act as they celebrate the opinion for health care outside of the Supreme Court in Washington,Thursday June 25, 2015. The Supreme Court on Thursday upheld the nationwide tax subsidies under President Barack Obama’s health care overhaul, in a ruling that preserves health insurance for millions of Americans.

(Photo By Al Drago/CQ Roll Call)

Nuns, who are opposed to the Affordable Care Act’s contraception mandate, and other supporters rally outside of the Supreme Court in Washington, D.C., U.S., on Wednesday, March 23, 2016. On Wednesday morning, the Supreme Court is scheduled to hear oral arguments in Zubik v. Burwell, a consolidated case brought by religious groups challenging a process for opting out of the Affordable Care Act’s contraception mandate.

(Drew Angerer/Bloomberg via Getty Images)

Supporters of contraception rally before Zubik v. Burwell, an appeal brought by Christian groups demanding full exemption from the requirement to provide insurance covering contraception under the Affordable Care Act, is heard by the U.S. Supreme Court in Washington March 23, 2016.

(REUTERS/Joshua Roberts)

Protestors hold placards challenging ‘Obamacare’ outside of the US Supreme Court on March 4, 2015 in Washington, DC. The US Supreme Court heard a second challenge to US President Barack Obama’s Affordable Care Act. The US Supreme Court faces a momentous case Wednesday on the sweeping health insurance reform law that President Barack Obama wants to leave as part of his legacy. The question before the court is whether the seven million people or more who subscribed via the government’s website can obtain tax subsidies that make the coverage affordable. A ruling is expected in June.

(MANDEL NGAN/AFP/Getty Images)

 Linda Door (L) protests against President Obama’s health care plan in front of the U.S. Supreme Court Building on March 26, 2012 in Washington, DC. Today the high court, which has set aside six hours over three days, will hear arguments over the constitutionality President Barack Obama’s Patient Protection and Affordable Care Act.

(Photo by Mark Wilson/Getty Images)

Supporters of the Affordable Care Act celebrate after the Supreme Court up held the law in the 6-3 vote at the Supreme Court in Washington June 25, 2015. The U.S. Supreme Court on Thursday upheld the nationwide availability of tax subsidies that are crucial to the implementation of President Barack Obama’s signature healthcare law, handing a major victory to the president.

(REUTERS/Joshua Roberts)

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“Republicans have a lot of ideas, they’ve been sitting there for eight years trying to figure out how to repeal Obamacare,” said Bovard in an interview with AOL News. “They can’t make the same mistake the Democrats did in 2009, which was to jam through a huge bill that no one knew what was in it.

In an interview with CNN, Sen. Rand Paul said there are “about 50 replacement bills” for Obamacare that have been out there for years.

President Trump recently claimed “insurance for everybody” relative to his idea of replacing Obamacare, but later walked back that statement saying, “Well, we want people taken care of … There will be nobody dying on the streets in a Trump administration.”

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In a Sunday interview with NBC News’s Willie Geist, senior Trump adviser Kellyanne Conway announced that an Obamacare replacement will transition Medicaid to a block grant program — meaning federal government would give money to states to implement and disperse Medicaid funding as they see fit.

“President Trump has said that people will not go without coverage. And he means that,” Conway said to NBC News. “That is certainly part of the official plans that are being worked on.”

The Medicaid program grew during Barack Obama’s presidency — when he gave states the option to expand eligibility for the program to millions of people living above the poverty line. Since that move, a reported thirty-one states the District of Columbia have expanded their coverage programs.

While many Republican lawmakers have been integral in crafting a game plan for the next wave of health care reform, Tennessee Congresswoman Marsha Blackburn has been exceptionally vocal in her advocacy around rebuilding insurance legislation, saying Obamacare is “a broken system.”

“A lot of it will be done through reconciliation — and the rest will be more of a cleaning up and restoring people’s access to health care — increasing their options,” said Blackburn, commenting on the repeal process. “We are well served by having a speaker who is an orderly process person, and we will move through this in a diligent manner.”

The reconciliation process — the replacement vehicle Congress is hoping to use in repealing the ACA — is one known to those familiar with the legislative history of the health care law.

SEE ALSO: White House says media delegitimizing Trump, won’t ‘take it’

Reconciliation came out of the Congressional Budget Act of 1974, and it expedites Senate consideration of bills relative to the budget. Reconciliation requires 50 votes to pass, as opposed to most Senate processes which require 60, and constrains debate on these bills to 20 hours — eliminating the chance of a lengthy Senate filibuster.

“They have worked on this and wanted this for the past four decades,” said Rep. Blackburn in responding to Democratic resistance to Obamacare repeal. “Make our hospitals and our providers whole. Let’s make Medicare whole. Let’s get a product where everyone can afford it.”

RELATED: The history of Obamacare

Pamela Hurst, center, speaks to the media as her husband Douglas Hurst, a plaintiff in King v. Burwell, right, looks on in front of the U.S. Supreme Court with Michael Carvin, lead attorney for the petitioners and partner at Jones Day, left, in Washington, D.C., U.S., on Wednesday, March 4, 2015. A U.S. Supreme Court argument over Obamacare’s tax subsidies divided the justices along ideological lines, potentially leaving two pivotal justices to decide the law’s fate. Photographer: Andrew Harrer/Bloomberg via Getty Images

Demonstrator Nell Robinson, a medical student from George Washington University, holds a sign in favor of to U.S. President Barack Obama’s health-care law, Obamacare, in front of the U.S. Supreme Court in Washington, D.C., U.S., on Wednesday, March 4, 2015. A U.S. Supreme Court argument over Obamacare’s tax subsidies divided the justices along ideological lines, potentially leaving two pivotal justices to decide the law’s fate. Photographer: Andrew Harrer/Bloomberg via Getty Images

UNITED STATES – JULY 10: From left, Sen. Mark Udall, D-Colo., Charles Schumer, D-N.Y., Senate Majority Leader Harry Reid, D-Nev., Senate Majority Whip Richard Durbin, D-Ill., and Sen. Patty Murray, D-Wash., conduct a news conference in the Capitol’s Senate studio, July 10, 2014, on legislation regarding the Supreme Court decision to allow employers to opt out of the contraception mandate in the Affordable Care Act. (Photo By Tom Williams/CQ Roll Call)

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As Bovard of The Heritage Foundation says the repeal process is not a “one and done” process, she believes the debate portion of replacement needs to be debated “transparently” so the American people know what their options.

“Obamacare dictated to the states a lot of policies that didn’t work,” said Bovard, quoting that 70 percent of counties across the U.s. having one or two options in the market because insurance companies are pulling out of Obamacare.

“Health care is a critical element of policy in america, it needs time for people to understand what’s being debated,” said Bovard. “

Bovard also says that Tom Price — Trump’s cabinet pick for the Department of Health and Human Services — will likely play a strategic role in dealing with some of the federal regulations at HHS that have come out of Obamacare.

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