Updated at 2:32 p.m. ET
President Trump's decision to kick off a renewed battle to dismantle President Barack Obama's health care law stunned lawmakers on Capitol Hill, who will face the reckoning from voters if the administration's efforts to overturn the law succeed this time around.
Democrats overwhelmingly support the Affordable Care Act and introduced legislation this week to strengthen it, so the administration's decision to try to repeal it entirely was a political gift for a party eager to go on offense after the conclusion of special counsel Robert Mueller's investigation.
Signaling a reversal of its earlier legal strategy, which was focused on only fighting parts of the health care statute, the Department of Justice late Monday filed a two-sentence letter in a pending federal case that now argued the entire law should be struck down.
Senate Minority Leader Chuck Schumer, D-N.Y., announced plans Wednesday to try to force a vote on an amendment to a disaster aid bill, under debate in the Senate this week, that would block funding for the Justice Department's work on that lawsuit aimed at dismantling the ACA. "Let's see how our Republican colleagues will vote on this," he said.
Health care was the No. 1 motivating issue in the 2018 midterm elections that delivered Democrats a House majority. According to a Washington Post analysis of exit poll data from 69 battleground districts, health care emerged as the top issue for voters — besting Trump, the economy and immigration as priorities.
For Republicans, the renewed effort threatened to pick the scab of old political wounds. Maine Sen. Susan Collins, who is up for re-election in 2020, was one of the three Republican senators who helped defeat a last-ditch GOP effort in 2017 to repeal Obamacare. Collins told reporters Wednesday that she is "vehemently opposed" to the administration's decision. A spokeswoman said Collins is drafting a letter to Attorney General William Barr to voice her opposition to the effort.
While Republicans and Trump campaigned for the better part of a decade against the health care law — the signature domestic achievement of the Obama presidency — the party never coalesced around an alternative policy that would provide insurance coverage to more Americans and protect coverage for those with pre-existing conditions.
The president continues to pick a fight on Twitter and at political rallies with the late Sen. John McCain, R-Ariz., for his role in derailing the GOP's repeal effort, but his attacks do not accurately reflect the reality that there was never an alternative health care bill to vote on that could have passed Congress. McCain, Collins and Sen. Lisa Murkowski, R-Alaska, were all deeply skeptical of a strategy that threatened to negatively affect health care for millions of Americans without a clear plan to fix the damage uprooting the law would cause in practical terms.
Health care is an issue the president still wants to pursue. Trump huddled privately with Senate Republicans this week and told them it's an area in which the party has fallen short and he wants a win. "The Republican Party will soon be known as the party of health care," Trump told reporters on Capitol Hill on Tuesday.
On Wednesday the president repeated his prediction that the GOP would be "the party of great health care." He slammed the current law as a "disaster" and referred to the court case underway in federal court. He asserted that the case would do very well in the Supreme Court. And if the high court scrapped the law, he vowed, "we will have a plan that's far better than Obamacare."
Some GOP political strategists are skeptical. "Dear GOP: When Democrats are setting themselves ablaze by advocating for the destruction of American health care, try to resist the temptation of asking them to pass the kerosene," tweeted Josh Holmes, a former chief of staff to Senate Majority Leader Mitch McConnell, R-Ky., who is advising GOP campaigns in the 2020 elections.
"It is a top of mind issue for voters, and for Republicans having a health care plan is very important. I'm not sure that this was the right move to win back suburban voters who are obviously very concerned about pre-existing conditions, and what does that mean for them. But if this lights a fire under us to have a really good health care plan, maybe that's the silver lining here, " another veteran Republican campaign strategist told NPR.
Whit Ayres, a GOP pollster, maintained the 2018 midterm results were driver more by demographic trends than the health care issue.
"Democrats had made it clear that they wanted to make health care a major issue in the 2020 election and this decision heaps them in that effort. We will see how successful they are in absence of a court ruling. But it does help to shine a spotlight back for an issue that they believe will be helpful to them. "
- NPR's Jessica Taylor contributed to this story