Ky. reports 273 new coronavirus cases, by far the largest in a day, but health commissioner says numbers still 'relatively plateaued'

As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Al Cross
Kentucky Health News

As he reported by far the largest number of new coronavirus cases in Kentucky a single day, 273, Gov. Andy Beshear said “That doesn’t mean we are not on the right track. We are. This is just how this virus works.”

The day before, Beshear had reported 206 new cases, which at the time was the second largest, but said he thought a plateau had been reached, on the basis of a three-day rolling average. Saturday, that average was 166; on Sunday, it jumped to 204.

Dr. Steven Stack, state commissioner of public health

Health Commissioner Steven Stack said, “Our numbers are still relatively flat, they’re relatively plateaued, even though today’s the biggest number.” He said Sunday's figure made clear that Kentucky is at least two weeks from relaxing social-distancing rules that limit sharing of the virus. Federal guidelines call for “downward trajectory of documented cases within a 14-day period” or “downward trajectory of positive tests as a percent of total tests within a 14-day period.”

“That is something Dr. Stack will watch and make that call on,” Beshear said.

He and Stack indicated that the greatest obstacle may be getting the materials that are needed to expand testing to people who aren't showing symptoms of the covid-19 disease, another part of the guidelines President Trump issued Friday. Stack said testing, and tracing of contacts of people who test positive, will have to be “much more robust” and last longer “than previous diseases.”

”We may have to, on a typical day, test one-tenth to one-third of 1 percent of the total population, so that would be about 9,000 to about 13,500 tests per day,” Stack said. ”At that rate, in four days the state would exceed the number of tests done so far.”

Previous White House guidelines pointed toward some loosening of restrictions by May 1, but the latest has no dates, and leave testing up to the states.

“I know we all target a May 1 date,” Stack said. “That sorta got put out there. We’re gonna work real hard with all the health-care community and others to try to make sure we can start to do phased steps as soon as are reasonably safe, but remember, we’re gonna have to keep looking for that rate of new cases to determine when we get to the first-stage gate.”

And he warned again that the disease will “come back when we stop doing all of these social-distancing measures. So you are forever gonna have to wash your hands a lot more than you ever did before. Wearing masks is probably going to become a much more normal and typical part of our lives going forward, and doing other steps to have social distancing are gonna be part of our new normal. . . . Obviously we’re gonna work real hard to try to do this in as calibrated a way as we can to minimize disruptions.”

Beshear said the state will "go from encouraging to highly encouraging” that cloth masks be worn in public. “It’s gonna look very different as we go forward," he said. He began his daily briefing by asking for patience: “I know it feels like a long time. It’s been over a month; remember that greatest generation went through years” of sacrifice in World War II.

Beshear has said the first easing is likely to be among health-care providers. Asked why Kentucky is the only state where chiropractors can’t open, he said "I was relying on our public-health experts," and called Stack to the lectern. Stack said, "Chiropractic is a real hands-on experience," and was the health-care field that was "hands down" the target of most complaints about violations of early restrictions. He said all providers will be asked to demonstrate how they will be be efficiently use protective gear and practice social distancing "to keep people from getting infected."

In other covid-19 news Sunday:

• Beshear reported four more deaths, for a total of 148; all four apparently were at long-term-care facilities; he said later that they had four more deaths. That makes a total of 50 at such facilities. The deaths were an 85-year-old woman in Jackson County, a 61-year-old man in Jefferson County, a 94-year-old woman in Hopkins County and a 93-year-old woman in Graves County.
• The Cumberland Valley District Health Department announced that 12 new cases had been found at the Jackson Manor nursing home in Annville, some of whom tested negative earlier. Beshear said people "can test negative before the virus exerts itself," and testing nursing-home patients is "one of our top priorities." He said some people aged 60 to 75 with the virus can have mild or no symptoms, including those at long-term-care facilities.
• Long-term care facilities reported 33 more cases among residents and eight more among staff, for totals of 386 and 172, respectively. 
• Beshear said 129 of Sunday's new cases were in Jefferson County. Other counties reporting more than six new cases were Kenton, 21; Daviess and Muhlenberg, 17 each; Butler, 10; Graves, nine; and Jackson and Warren, eight each.
• Asked if was concerned for his safety after a social-media call to "eliminate him by any means necessary via the Second Amendment," Beshear said he fully trusts the state police, who protect him. "They know what they're doing, and I couldn't be in better hands," he said. Several Republican officeholders who were critical of Beshear last week decried the threat. So did Sen. Steve Meredith, R-Leitchfield, who wrote on Facebook, "Tragically, this is not an isolated incident."
• As he made his daily mention of prioritizing mental health, Beshear said, "I’ve struggled with this; I have. … I know you have; I’ve had trouble calling people that I know that I would normally talk with." He said he joined an online birthday party for the wife of one of his pastors, and "I feel better today because I participated in it."
  
• A federal judge denied the request of Maryville Baptist Church in Hillview for an order blocking Beshear from enforcing against churches his order against mass gatherings. "Church members gathered again anyway Sunday. But this time, no state troopers showed up outside to issue notices," reports Andrew Wolfson of the Courier Journal.
• In a long, comprehensive story, The New York Times looks ahead: "There will be no quick return to our previous lives, according to two dozen experts. But there is hope for managing the scourge now and in the long term." But also uncertainty, despite what President Trump might say, Donald McNeil writes: "The administration’s view of the crisis and our future has been rosier than that of its own medical advisers, and of scientists generally. In truth, it is not clear to anyone where this crisis is leading us. . . . The scenario that Mr. Trump has been unrolling at his daily press briefings — that the lockdowns will end soon, that a protective pill is almost at hand, that football stadiums and restaurants will soon be full — is a fantasy, most experts said." Even a vaccine, the Holy Grail of the crisis, may "initially elude scientists."
• "The United States is embarking on a rapid-fire experiment in borrowing without precedent, as the government and corporations take on trillions of dollars of debt to offset the economic damage from the coronavirus pandemic," writes David Lynch of The Washington Post. To support such borrowing, the Federal Reserve has dropped interest rates to zero and added more than $2 trillion of loans to its portfolio in the past six weeks — as much as in the four years following the Great Recession." With government, business and consumer debt already high, economists fret. “We should be very worried,” Princeton University professor Atif Mian told Lynch. “We are talking about a level of debt that would certainly be unprecedented in modern history or in history, period. We are definitely at a tipping point.”

Tax bill would repeal requirement to have health insurance, perhaps boosting efforts to repeal and replace Obamacare

Reporters interviewed Sen. Mitch McConnell between negotiations
on the tax bill. (Associated Press photo by J. Scott Applewhite)

The tax-reform bill the Senate passed early Saturday morning, with Majority Leader Mitch McConnell of Kentucky in the driver's seat, includes a repeal of the requirement that almost all Americans obtain health insurance.

The provision, perhaps the most important part of the 2010 Patient Protection and Affordable Care Act, appears highly likely to remain in the final version of the bill that will emerge from a House-Senate conference committee. That's because it was also in the House bill and would help make up for the budget deficits caused by tax cuts, writes Paige Winfield Cunningham of The Washington Post.

Once the mandate is repealed, Republicans may find it easier to "repeal and replace Obamacare," as they vowed for seven years but have so far failed to do, because "It disposes of a major reason previous GOP measures were projected to result in fewer Americans with coverage," Cunningham notes.

Enactment of the tax bill could also lead to cuts in Medicare. "If lawmakers don’t waive a 2010 rule known as 'paygo,' aimed at keeping government spending in check, that deficit spending would trigger automatic cuts to mandatory spending," limited to 4 percent, Cunningham writes. "Sen. Susan Collins (R-Maine), who generally opposes cuts to entitlement programs," has said that McConnell has promised that Congress will waive 'paygo', "but such a decision is beyond McConnell’s ability to control. Waiving 'paygo' requires 60 votes in the Senate, and it’s not at all clear that Democrats would be willing to help Republicans save themselves from mandatory cuts." Perhaps McConnell believes enough would.

Part of the price McConnell paid for the vote of Collins, who helped kill a repeal-and-replace-Obamacare bill in the summer, was a promise for a vote on legislation to restore the insurance subsidies that President Trump ended recently. That measure, sponsored by Sen. Lamar Alexamder (R-Tenn.) and Patty Murray (D-Wash.), "seems awfully shaky," Cunningham writes. "The Senate is focused right now on the tax overhaul; yesterday House conservatives told The Hill they wouldn't support it (they've labeled it an 'insurer bailout'); and, as conservative policy wonk Chris Jacobs writes over at The Federalist, even if the payments are included in a year-end spending bill, they might not ever get made, due to mandatory sequester cuts."

Cunningham concludes, "Here's the interesting question at play over the next few weeks: Will Congress make two changes to the ACA marketplaces that are contrary to each other? Repealing the mandate undermines the marketplaces by ultimately weakening their risk pools (some healthy people drop coverage without the mandate). Making the subsidy payments (known as cost-sharing reductions) helps lower marketplace premiums, but it's kind of moot if you've already removed the key requirement underpinning the whole ACA."

If Trump signs the individual-mandate repeal into law, health-insurance companies will have to decide whether they want to sell through the Obamacare marketplaces, notes Sarah Kliff of Vox: "Are they comfortable selling in a marketplace where they have to offer all consumers coverage but healthy people can decide not to purchase? Or are they scared off by the prospect of getting swamped with sick customers? . . . By September or October of next year, we'd have a sense of whether there are some places where nobody wants to sell Obamacare. And we'll know if there are places with really high premiums, as insurance plans only their sicker customers to stick around."

Kliff concludes, "If Obamacare does truly seem to be in collapse — insurance plans fleeing the markets, premiums spiking — that might give Republicans the pretext to once again take another shot at Obamacare repeal."

Trump seeks Paul's vote for last-ditch bill to repeal and replace Obamacare, which would cost Kentucky billions in future funds

UPDATE, Sept. 26: Sen. McConnell says the Senate will not vote on the bill.

By Al Cross
Kentucky Health News

Kentucky would be a big financial loser under Senate Republicans' last-ditch plan to repeal and replace the Patient Protection and Affordable Care Act. Sen. Rand Paul says he opposes the bill, but not for that reason; he says that it would "keep Obamacare," which he has vowed to repeal, and that a more limited reform he favors is on the way from President Trump.

It remains to be seen whether Kentucky's senior senator, Majority Leader Mitch McConnell, will bring the Graham-Cassidy bill up for a vote by Saturday, Sept. 30, the deadline to pass it with a simple majority under budget-reconciliation rules. He has said he intends to, but that was before Arizona Sen. John McCain said Friday afternoon that he wouldn't vote for the bill, making its passage unlikely.

Friday morning, Trump had pressured Paul, tweeting “Rand Paul, or whoever votes against Hcare bill, will forever (future political campaigns) be known as ‘the Republican who saved ObamaCare.’”  Paul replied on Twitter, “Calling a bill that KEEPS most of Obamacare ‘repeal’ doesn’t make it true. That’s what the swamp does. I won’t be bribed or bullied.”

The next day, after McCain's announcement, Trump tweeted, “I know Rand Paul and I think he may find a way to get there for the good of the Party!” At a speech in Alabama that night, he said, “I haven't given up on him because I think he may come around.”

On NBC's "Meet the Press" Sunday, Paul said, “I’ve always been a ‘yes’ for repeal,” but said he opposes the bill because it keeps “almost all of the spending, and just re-shuffles it and block grants it to the states. . . . You’re keeping all the money we’ve been spending through Obamacare, most of it, re-shuffling it, taking the money from Democrat states and giving it to Republican states. I think what it sets up is a perpetual food fight over the formula.”

U.S. Senator Rand Paul, R-Ky. (file photo)

Paul had made the money-shuffling argument before, and it sounded weak to editors at National Review. The old-line conservative magazine went after him Wednesday, Sept. 20, implying in an editorial that Paul, a Bowling Green ophthalmologist, secretly doesn't want to change the Obamacare system that has provided free Medicaid for 470,000 Kentuckians and subsidized private insurance for 81,000.

"The senator’s objections to the bill amount to a case for improving it, perhaps in a conference committee after it passes the Senate," the editorial said. "They do not amount to a case for voting it down. The bill goes farther in the right direction than the 'skinny repeal' bill for which Paul voted earlier this summer. That bill abolished only the individual and employer mandates. . . . Graham-Cassidy is still much better than Obamacare. It abolishes the individual and employer mandates, caps per capita spending on Medicaid, blocks federal funds from going to insurance plans that cover abortion, and lets interested states attain freedom from some of Obamacare’s regulations."

The editorial concluded, "There has been widespread speculation that Paul is playing a game on Obamacare: that he does not really wish to see major changes to it and will find libertarian-sounding objections to any Republican bill that has a chance of passage. This speculation may be unfair. But Paul’s arguments for a no vote make so little sense, and are so hard to square with his previous votes, that it is getting harder to dismiss."

"Meet the Press" host Chuck Todd told Paul that the editorial implied "that you don’t really want to change the Kentucky system. There’s a lot of people in Kentucky that like the system. But you can’t get caught ever saying that."

Paul replied, "That is a personal insult to my character," calling the magazine "a bunch of neocons who don't like libertarians." Earlier, he said, "I started my political career campaigning against Obamacare," pledging repeatedly to repeal it. "I can't in good conscience vote to keep it . . . Once we do, the Republican name is on health care, and thsi isn't going to work."

National Review blogger Theodore Kupfer wrote Sept. 22 that Paul's money-shuffling argument is "not quite accurate. Three analyses of the bill, from the [liberal-leaning] Center on Budget and Policy Priorities, [consulting firm] Avalere, and the [federal] Centers for Medicare and Medicaid Services, have found that the change in federal health-care funding would be negative for states that expanded Medicaid under the Affordable Care Act. Among those states are Republican strongholds Arizona, Louisiana, Arkansas, Ohio, and Kentucky."

Other analyses predict Kentucky would be one of the big losers, because it was one of the states that expanded Medicaid in 2014 under then-Gov. Steve Beshear. The Kaiser Family Foundation estimates that Kentucky would get 19 percent less money in 2020-26, $5.4 billion, than current law provides. That would be the 10th largest percentage loss among the states. The New York Times produced a chart showing that in funding per person, Kentucky would be the eighth biggest loser among the 50 states and the 35 expansion states.

The charts show the estimated differences in what states would get under the bill compared to what they are projected to get under current law. In its overall chart, the Times colored orange the states represented by senators that voted against at least one version of Obamacare repeal bills in July, as Paul did.

The bill is being revised to attract votes from holdouts, but Paul remains opposed, The Washington Post reports. If Paul remains opposed, the bill seems unlikely to pass, since Republicans need 50 votes and hold 52 Senate seats. The bill has drawn widespread opposition from lobbying groups. "A bipartisan group of governors and several influential interest groups came out against the proposal," the Post noted. The Post's Elise Viebeck writes that the hurry-up process for the bill is "unusually chaotic," and Rep. John Yarmuth, D-Louisville, said the new version uses "phony numbers."

Paul has sent Trump a list "of what it would take to get him from no to yes," Jonathan Swan of Axios reports. "It's hard to see how they'd stop at least half a dozen moderate Republican senators dropping their support" for the bill. The list includes "a significant reassessment of this trillion-dollar spending machine," making Obamacare rules optional for states, and expanding association health plans, something that can't be done under budget-reconciliation rules -- but maybe by Trump alone.

Paul repeated on NBC what he told Kentucky interviewers last week, that the Trump administration will act "in the next couple of weeks" to start implementing his plan for a national-association health plan, in which anyone could enroll. That could create a group with great bargaining power, but the plan would also be exempt from most Obamacare rules, allowing people to buy thinner, cheaper coverage and taking them out of the Obamacare markets, perhaps weakening them.

Kentucky's other senator was asked Sept. 20 why he would support a bill that would cost the state billions in federal funding. McConnell spokesman Robert Steurer cited Gov. Matt Bevin's support of the bill with 14 other Republican governors, and quoted McConnell as saying:

Mitch McConnell (Reuters photo)

“The men and women we represent have suffered a lot under Obamacare. Skyrocketing costs. Plummeting choices. Collapsing markets. Many of us thought our constituents deserved better. That’s why we did as we promised and voted to repeal this failed law so we could replace it with something better. The forces of the status quo went all out to defeat our every effort to improve health care. Thus far, they have succeeded. Thus far, they have yet to offer truly serious solutions of their own. The Graham/Cassidy bill would repeal the pillars of Obamacare and replace that failed law’s failed approach with a new one: allowing states and governors to actually implement better health-care ideas by taking more decision-making power out of Washington. Governors and state legislators of both parties would have both the opportunity and the responsibility to help make quality and affordable healthcare available to their citizens in a way that works for their own particular states. It’s an intriguing idea and one that has a great deal of support.”

Jennifer Haberkorn of Politico writes, "If successful, Graham and Cassidy would accomplish what McConnell couldn’t: Make good on the GOP’s pledge to undo Obamacare and transform Medicaid from an open-ended entitlement into a capped program. Critics say the result would be draconian cuts that would throw millions off of their health coverage and endanger the most vulnerable Americans."

McConnell is taking a political risk with Graham-Cassidy, after failing to get a repeal bill through the Senate in early August and strongly backing appointed Sen. Luther Strange in an Alabama primary against defrocked judge Roy Moore, who has made McConnell's leadership an issue. Moore is favored to win the Sept. 26 runoff primary.

"McConnell may figure he has nothing left to lose," write Burgess Everett and John Bresnahan of Politico. "He’s already taken a huge political hit for failing to repeal Obamacare. And Republicans say privately that if McConnell didn't take one final stab, he'd be lashed by Trump for giving up. . . . McConnell clearly sees an upside in showing Trump and the GOP base that Republicans haven't abandoned repeal. After weeks of declining to endorse the latest health-care bill, McConnell has embraced Graham and Cassidy’s bill as the Sept. 30 deadline approaches, endorsing it on the floor and playing up the bill on social media."

Massie joins Paul in voting against bill to start Obamacare repeal; McConnell won't say what he has in mind for Medicaid expansion

Kentucky Health News

One Kentucky congressman was among the nine House Republicans who voted against a budget resolution that is the new Congress's first step toward repealing the Patient Protection and Affordable Care Act.

Massie (Breitbart.com photo)

Rep. Thomas Massie of Vanceburg "said he voted against the budget resolution because of the estimated $9.7 trillion it would add to the national debt," Lindsey McPherson reports for The Hill. "He said his fiscal conservative colleagues who voted 'yes' because they only saw the budget as a vehicle to get to Obamacare repeal will regret it."

"We got a Category 5 hurricane coming when you have to reduce to practice the differences between Donald Trump’s agenda and [House Speaker] Paul Ryan’s agenda," he said. "I think there are going to be some very confusing votes in here.”

The resolution passed 227-198, with all Democrats opposed. The Republicans against it were "a mixed bag," The Hill reports: "four members of the moderate Tuesday Group --  Charlie Dent and Brian Fitzpatrick of Pennsylvania, John Katko of New York and Tom MacArthur of New Jersey, and two members of the hard-right House Freedom Caucus, Justin Amash of Michigan and Raul Labrador of Idaho." The others were Massie, North Carolina Rep. Walter B. Jones and California Rep. Tom McClintock, "all of whom are conservatives but not members of the Freedom Caucus."

When the session opened with the vote for speaker, Massie was the only member who voted for Amash, who is chair of their libertarian-oriented Liberty Caucus. Amash called the resolution "the worst budget we've had since I've been in Congress. . . .  We can put together a good budget and also repeal Obamacare."

The resolution is not binding but provides a vehicle for Senate Majority Leader Mitch McConnell to prevent a Democratic filibuster against repealing parts of the health-reform law that relate to spending and taxes. It takes 60 votes to stop a filibuster and Republicans have 52 senators.

Massie, Amash and Paul (Photo via imgdex.com)

Sen. Rand Paul, R-Ky., was the only Republican senator to vote against the resolution, citing concerns similar to Massie's and saying it would add $9.7 trillion to the national debt over the next decade. He unsuccessfully pressed the House Freedom Caucus to stand against it.

After that meeting, Massie challenged Republican leaders' argument that the resolution is merely a vehicle to repeal Obamacare: “If they want to tell us these are pretend numbers, then why do your pretend numbers not even balance?”

Massie told Bridget Bowman of Roll Call that the episode showed why he opposes Ryan and other leaders. “We’re given a lose-lose proposition,” he said. “You either vote to keep Obamacare or you vote to add $10 trillion to the budget when in fact it would be so easy to have a conservative budget that repeals Obamacare.”

Mike DeBonis of The Washington Post writes, "It will now only get harder for Republicans," DeBonis writes. "They must assemble a viable replacement for a law that has expanded health insurance coverage to roughly 20 million Americans and eliminated unpopular insurance industry practices, such as lifetime coverage caps and widespread refusal to cover already-sick individuals. Republican leaders have instead focused on the Affordable Care Act’s flaws — rising premiums for plans sold in state marketplaces, high deductibles and burdensome taxes. GOP lawmakers are set to gather in Philadelphia later this month to hash out a more complete alternative."

Several senators from states that expanded the Medicaid program with federal money through the reform law want to see its replacement before voting on the repeal. Kentucky is one of the states that has benefited most from the law, adding more than 400,000 people to Medicaid and cutting by more than half the percentage of Kentuckians without health insurance.

McConnell, in a news release after the Senate vote, mentioned various problems with private insurance under Obamacare but said nothing about Medicaid. Asked what he plans to do with the Medicaid expansion, his spokesman, Robert Steurer, replied via email, "Sen. McConnell will have lots more to say about this issue in the coming weeks."

Paul, citing deficit, is among small but potentially pivotal group of GOP senators who want Obamacare replaced when repealed

This story was updated Monday, Jan. 9.

Kentuckian Rand Paul is among a small but growing and potentially pivotal group of Republican senators who say the Patient Protection and Affordable Care Act should be replaced at the same time it is repealed. And now President-elect Donald Trump appears to be with them.

“He called after seeing an interview that I had done [talking about] that we should vote on Obamacare replacement at the same time,” Paul said told Burgess Everett of Politico on Monday. “He said he was in complete agreement with that.”

"With Trump going out of his way to bless the Kentucky senator’s approach, Paul’s week-long campaign to hold a vote on replacing Obamacare alongside a simultaneous repeal measure has seemingly upended the GOP’s long-sought plans for a cathartic and immediate vote to gut the health care law, Everett reports. "As news broke that Trump backed Paul's play, several other Senate Republicans were also beginning calls for a new strategy — threatening the trajectory of the party’s rush to repeal the law."

Paul says repealing parts of the law in a budget resolution, the only way around the Senate's 60-vote requirement for most major votes, would add too much to the federal budget deficit and the national debt.

"He’s putting together an initial proposal containing the GOP’s best ideas and will ship them this afternoon to Trump’s administration after getting buy-in from the president-elect," Everett reports. "He’s putting together an initial proposal containing the GOP’s best ideas and will ship them this afternoon to Trump’s administration after getting buy-in from the president-elect."

Paul was the only Republican to join Democrats on a procedural vote Wednesday that allowed the Senate to consider the resolution, but "at least five other Senate Republicans have signaled they are uneasy over repealing the law without having settled on its replacement," Kristina Peterson and Stephanie Armour of The Wall Street Journal. "GOP leaders have said they plan to develop replacement legislation this year, which would go into effect after a transition period of two to three years."

Senate Majority Leader Mitch McConnell of Kentucky, who discussed Obamacare with Trump Monday in New York, can afford only two dissenters in his 52-member Republican caucus, because 50 votes are needed to pass a budget resolution, with a tie-breaking vote from Mike Pence after he becomes vice president and president of the Senate. Until Jan. 20, 51 votes are needed.

Aware of that, "Sens. Ted Cruz of Texas, Mike Lee of Utah and Marco Rubio of Florida wrote Tuesday in a joint letter to GOP Senate leaders that while they understood the budget was “primarily a mechanism to advance [the health law’s] repeal,” the Senate should still abstain from any budget devices that they oppose," the Journal reported.

Paul said on MSNBC's "Morning Joe," “Everybody is hot and heavy to vote on this budget because they want to repeal Obamacare. But the budget they’re going to introduce will add $8.8 trillion to the debt over the next 10 years. So I told them look, I’m not going to vote for a budget that never balances.”

Paul later said he would support a stand-alone repeal measure, and Arkansas Sen. Tom Cotton expressed views similar to Paul's. But on the moderate side of the Republican caucus, Sen. Susan Collins of Maine "wants Republicans to both repeal and replace the law at the same time," at least with what she calls "a detailed framework," and both Tennessee senators have taken similar stands.

The latest was Bob Corker, who said Friday that it "would be best for our country to go ahead and replace it with something that works and repeal at the same time." He called immediate repeal "a flawed concept."

Corker "noted that President-elect Donald Trump voiced support during the campaign for moving the two together and told '60 Minutes' in November that he backed repealing and replacing ObamaCare simultaneously," Jordain Carney reports for The Hill. Corker said, "I think the president-elect's position is the right position."

Paul tweeted Friday that he had just spoken with Trump, "and he fully supports my plan to replace Obamacare the same day we repeal it." But Trump adviser Kellyanne Conway said on CNN's "State of the Union" said only that "He is committed to replacing Obamacare with something that actually is affordable and accessible and allows you to buy health insurance over state lines and allows people to have health savings accounts."

Asked about Paul and Obamacare Sunday on CBS's "Face the Nation," McConnell said he hadn't seen a replacement plan from Paul but said Congress would pass one "rapidly." he declined to be more specific.