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Two top Republicans long expected to lead the Senates role in repealing the Affordable Care Act said publicly this week that they are open to repairing former president Barack Obamas landmark health-care law ahead of a wholesale repeal, which has been a GOP target for eight years.

Coming one week after a closed-door strategy session in which Republicans expressed frank concerns about the political ramifications of repealing the law and the practical difficulties of doing so, statements this week by Sen. Orrin G. Hatch (R-Utah) and Sen. Lamar Alexander (R-Tenn.) brought into public view the political and policy challenges the GOP is facing.

Alexander, chairman of the Senate Committee on Health, Education, Labor and Pensions, said at a hearing Wednesday: I think of it as a collapsing bridge. ... You send in a rescue team and you go to work to repair it so that nobody else is hurt by it and you start to build a new bridge, and only when that new bridge is complete, people can drive safely across it, do you close the old bridge. When its complete, we can close the old bridge, but in the meantime, we repair it. No one is talking about repealing anything until there is a concrete practical alternative to offer Americans in its place.

And Hatch, chairman of the Senate Finance Committee another panel with a crucial role in the effort to repeal the ACA said Thursday that he could stand either repealing or repairing the law. Im saying Im open to anything. Anything that will improve the system, Im for, he said.

The comments come one month after Republicans in Congress first set out to immediately repeal and replace the Affordable Care Act. While an increasing number of them have expressed concern about how feasible it is, many others, including House Speaker Paul D. Ryan (R-Wis.), remain committed to a wholesale repeal and replacement.

On Thursday, Ryan tried to right the partys message on health care by insisting that repair is the same thing as replace.

Theres a miscommunication going on, he said Thursday morning on Fox & Friends. If were going to repair the U.S. health-care system ... you must repeal and replace Obamacare.

Although Alexander has advocated a go-slow approach for weeks, Hatch has aggressively pushed to repeal the ACA, including the tax provisions that help pay for subsidies that help low-income individuals pay for insurance.

His comments Thursday seemed to contradict a statement the day before, when he told an audience at the U.S. Chamber of Commerce that he wanted to quickly repeal as much of the law as possible.

I believe that we need to repeal Obamacare immediately, and provide for a stable transition period, Hatch said. In my view, we need to advance replacement policies in tandem with the repeal process. And then we can keep working on the other parts of the system.

Yet Hatch has also consistently warned conservatives that there are limitations to what Congress can do to unwind the law. The Senate has chosen to use a special budget process to walk back as many provisions as possible, but they will be limited to tackling the parts of the ACA that deal with spending, taxes and the deficit.

Concerns over those limitations have created frustration and consternation within the GOP, as was clear on a recording obtained last week by The Washington Post and other news outlets.

(Obtained by The Washington Post)

[Behind closed doors, Republican lawmakers fret about how to repeal Obamacare]

On the recording, made last week at a GOP retreat in Philadelphia, a number of Republicans worried that they would be blamed if the health-care system implodes in the wake of their repeal plans.

Among those most concerned was Alexander, who said: The word repair is a lot better than the word repeal. ... Saying were going to repair the damage is more accurate.

Other Republicans in the House and Senate besides Ryan have tried to regain control of the message in recent days by saying that repair is just another way to explain their replacement plans. Whats less clear is whether concrete plans are underway to dismantle the law.

Sen. John Cornyn (R-Tex.), the No. 2 Republican leader, said Thursday that the procedural process in the Senate and the words used to describe it can be complicated but goal is still the same: getting rid as much of the Affordable Care Act as they can.

It gets a little confusing, Cornyn said. I dont think even if we wanted to repair Obamacare we could do it. Thats why I believe were going to do repeal and replace.

In the House, the messaging has been no less complicated. While the word repair has held appeal for moderates who are wary of repealing Obamacare root and branch, it has raised alarms among fervent conservatives who see in it a potential betrayal of their campaign promises.

If youre talking about repairing the Affordable Care Act, its unrepairable, said Rep. Mark Meadows (R-N.C.), chairman of the hard-right House Freedom Caucus. We need to repeal it. We need to replace it. If you want to call that a repair, so be it, but I dont know that that makes it any more palatable to the folks back home.

Ryan later told reporters on Capitol Hill, Our job is to repair the American health-care system and rescue it from the collapse that its in. And the best way to repair a health-care system is to repeal and replace Obamacare. Its not an either/or.

Rep. Greg Walden (R-Ore.), chairman of the House Energy and Commerce Committee and a key architect of GOP health-care plans, has favored yet another R-word in recent days: rebuild.

Working with the Trump administration, well take a multi-step, multi-pronged approach to deliver relief and rebuild our health care system so it works for patients, he wrote with fellow committee member Rep. Michael C. Burgess (R-Tex.) in an op-ed published by Morning Consult on Tuesday.

Meanwhile, the Trump administration is working on its initial changes in federal rules under an executive order the president signed his first night in office to ease the ACAs regulatory impact on consumers and segments of the health-care industry.

The possible rule changes, under review by the Office of Management and Budget, would be aimed at helping health insurers keep the laws marketplaces functioning while Congress and the White House try to design new health policies.

According to Edmund Haislmaier, a senior fellow at the Heritage Foundation and member of the Trump transition team for the Department of Health and Human Services, the proposed rules being considered could further restrict Americans ability to sign up for ACA health plans outside of the annual open-enrollment season.

They also could require more extensive checks of applicants eligibility for marketplace coverage and prohibit consumers from enrolling in health plans for another year if they are behind on their premium payments.

Amy Goldstein contributed to this report.

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Two top Republicans open to repairing Obamacare ahead of repeal - Washington Post

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The icy relationship between President Trump and congressional Republicans showed signs of thawing on Thursday after the White House spent days trying to assuage GOP lawmakers distressed and surprised by controversial moves the administration made during its tumultuous first week.

At the start of the week, Republican senators were outwardly annoyed with the White House for failing to consult them before issuing a temporary ban on refugees and foreign nationals from seven predominantly Muslim countries. But by Thursday, some of the same Republicans were heartened after meetings and conversations with administration officials and the president, as well as his nomination of Judge Neil Gorsuch to the Supreme Court.

Ive been feeling pretty good. I had a good day over there yesterday, said Senate Foreign Relations Committee Chairman Bob Corker (R-Tenn.).

Corker, who was not happy with the lack of communication from the White House earlier in the week, said he met with national security adviser Michael Flynn about Iran and other topics and ended up wandering down the hallway to see President Trump. Flynn was on Capitol Hill on Thursday and told senators he planned to visit regularly.

Vice President Pence visited a closed-door lunch meeting of Republican senators on Tuesday to deliver a conciliatory message about the White Houses mistakes rolling out the executive order banning refugees. Well do better, Pence told them, according to senators in attendance. In addition, senior administration officials have stepped up their outreach to lawmakers.

The damage control underscored the increasingly tense dynamic driving a wedge between Congress and Trumps White House. But it was unclear to some Republican lawmakers whether the breakthrough heralded a new phase in the so-far rocky relationship or a short-lived detente. It remains to be seen how well the president and Republicans can work together on issues such as health care, tax restructuring and foreign policy as Trumps turbulent first fortnight as president neared its conclusion.

The tone and substance of Corkers comments in particular marked a stark turnabout from Monday, when he stood just outside the Senate chamber and told reporters he received no heads-up on Trumps executive order banning refugees and that it was not well done.

On Thursday, Corker warned that things could return to a more bitter state. Today, feeling pretty good talk to me next week, he said.

In addition to the headaches the refugee ban caused Hill Republicans, Trump has complicated life for them in other ways. He has applied public pressure on Senate Republican leaders to go nuclear to confirm Gorsuch if Democrats do not cooperate. Trumps chief spokesman stirred confusion with remarks about how to finance the U.S.-Mexico border wall, and the presidents comments about quickly replacing the federal health-care law after repeal have upped the pressure on lawmakers to quickly deliver an alternative.

Sen. Lindsey O. Graham (R-S.C.), an outspoken Trump critic, said his interactions with the administration have improved in recent days.

Ive talked to Mike Pence a couple of times, Ive had the legislative liaison, people have reached out on executive orders, so yeah, its good. Much more collaborative, Graham said. He added that the administration asked him for advice this week on a forthcoming cybersecurity executive order.

Pence and other administration officials have intensified their efforts to brief lawmakers and their staffs ahead of major decisions or actions by Trump, such as executive orders.

Two senior White House aides deputy chief of staff Rick Dearborn and legislative affairs director Marc Short have been reaching out personally to key GOP lawmakers to foster more trusting relationships on both ends of Pennsylvania Avenue.

Aside from behind-the-scenes outreach, Trumps nomination of Gorsuch also went a long way toward healing the early wounds, several Republicans said.

That was good, said Sen. Jeff Flake (R-Ariz.), who was among the many Republicans critical of Trumps refugee ban.

Gorsuch was on Capitol Hill on Thursday for the second straight day, accompanied by former Republican senator Kelly Ayotte of New Hampshire, who is spearheading the effort to win him confirmation.

Still, there remains skepticism among Republicans both about what Trump is doing and how little Congress has been consulted, particularly on national security and foreign policy matters.

Sen. John McCain (R-Ariz.), for example, placed a call to Australias ambassador to the United States on Thursday following a Washington Post report about Trumps tense phone call with the countrys prime minister.

Of course not, McCain responded when asked whether he was satisfied with the level of input the Trump administration has given Congress in major foreign-policy directives.

Democrats have been even more vocal in criticizing some of the decisions the Trump administration has made, including the refugee ban and the executive order calling for the construction of the border wall.

These are broad-ranging actions, some of which are of dubious legality and constitutionality that are being taken with little legal input and certainly little to no congressional input, said Rep. Adam B. Schiff (D-Calif.), the ranking Democrat on the House Intelligence Committee.

But so far, Republicans have shown little willingness to cross over and join forces with Democrats in using the levers of power to exert influence on the administration.

Sen. Mark R. Warner (D-Va.) is hoping to turn bipartisan frustration at top White House strategist Stephen K. Bannon joining the National Security Council into support for legislation to restrict the bodys membership. But Republicans seem skeptical about his approach.

We should be very cautious about ever trying to micromanage from here, said Sen. Ben Sasse (R-Neb.), despite his assertion that trying to preclude political people from the National Security Council seems like pretty prudent structure to me.

Trumps open invitation to Bannon to attend all NSC meetings, and his addition of Bannon as a permanent member of the Principals Committee where he was seemingly given a more integral role than even the director of national intelligence or the chairman of the Joint Chiefs of Staff has struck many lawmakers as an inappropriate and unprecedented move.

Im hoping that my Republican colleagues wake up to the fact that the country is more important than the party. To let Trump put somebody whos completely unqualified and ideologically driven on the NSC look, we can disagree on some things, but that is too far, said Rep. Keith Ellison (D-Minn).

Warner and a group of Democrats introduced a bill Thursday that would designate the director of national intelligence and chair of the Joint Chiefs of Staff as permanent NSC members and require congressional consent for any administration official not already subject to Senate confirmation.

The national security adviser, homeland security adviser, certain assistants to the president and vice president and their deputies would be exempt from that requirement.

Last year, the Senate Armed Services Committees decided to shrink the size of the NSC from 400 to 200 members. The committees ranking Democrat, Jack Reed (R.I.), said that sets a precedent for the committee to get involved in dictating the NSCs members.

Its within the purview of the defense committee, said Reed, who is alarmed that Trumps changes effectively lose the military nonpartisan professionals, and youre gaining someone whos more of a political operative.

But so far, Republicans disagree.

Thats executive-branch business, said Senate Majority Whip John Cornyn (R-Tex.), when asked whether Congress should have a role in how the president organizes the NSC.

David Weigel and Ed OKeefe contributed to this report.

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Trump's relationship with Hill Republicans is thawing, at least for now - Washington Post

New York Times

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Make the Republicans Go Nuclear - New York Times

At his confirmation hearing, President-elect Trump's Environmental Protection Agency administrator nominee Scott Pruitt outlined his plan for the agency. (Thomas Johnson/The Washington Post)

Senate Republicans on Thursday again used their majority to suspendcommittee rules and push through another Trump administration nominee, Scott Pruitt to lead the Environmental Protection Agency,bypassing Democrats who for the second day had refused to show up for a vote on his nomination.

Elections have consequences, and a new president is entitled to put in place people who will advance his agenda, said Sen. John Barrasso (R-Wy.), who chairs the Committee on Environment and Public Works. We took this extraordinary step because the minority members of the committee took the extraordinary step of boycotting.

Committee Republicans approved Pruitts nomination 11-0 on a roll call vote and sent it on to the full Senatedespite the objections of Democrats, who had alreadyboycotted a Wednesday session in a show of solidarity against someone who has repeatedly sued the EPA in recent years.

The committees move comes a day after Republicans used similar tactics to advance the nominations ofTrumps treasury nominee, Steven Mnuchin, and his selection for health and human services secretary, Rep. Tom Price (R-Ga.).

The committees proceduralrules allow them to be changed or suspended by vote of a majority of committee members at a business meeting if a quorum is present. Barrasso said the Senate parliamentarian had ruledThursdaysprocedure proper under those rules, though the Senator added that the Democrats boycott had put us inuncharted waters.

Democrats specific objections to Pruitt turn not only on his anti-regulatory bent but on their concerns that he did not adequately answer the written questions they sent him following his confirmation hearing. From the outset of this confirmation process, Scott Pruitt has consistently misrepresented his environmental record and denied us the information we require to perform our duty to advise and consent, chargedDelaware Sen. Tom Carper, the committee ranking Democrat.

After the committee majoritys action, Carper responded: We cannot advise the full Senate on whether Scott Pruitt will lead the EPA in a manner that will protect the publics heath in the absence of critical information about his record. And we cannot consent to move his nomination forward until the Committee does its job and gets those answers.

Pruitts written responsesalsoreflected a more detailed and specific expression of doubt about the science of climate change, compared with the vaguer statements he made in his confirmation hearing.

I am also aware that warmest year ever claims from NASA and NOAA are based on minimal temperature differences that fall within the margin of error, Pruitt asserted in one response. In actuality, however, NASA expressed a more than95 percent certainty that 2016 was the warmest year on record (dating back to 1880) and NOAA gave a 62 percent certainty.

The League of Conservation Voters reacted scathingly to the committees action Thursday morning.

Its all too fitting that on Groundhog Day wed wake up to the same egregiously irresponsible tactics by Senate Republicans to ram through an EPA nominee who refuses to answer vitally important questions, Tiernan Sittenfield, senior vice president of government affairs, said in a statement shortly after the vote. Everything about Pruitt is antithetical to the vitally important mission of the EPA, and we call on the full Senate to reject his nomination.

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Senate Republicans suspend committee rules to approve Scott Pruitt, Trump's EPA nominee - Washington Post