When they were in the majority, House Republicans voted dozens of times to repeal the Affordable Care Act, also known as Obamacare, only to see their legislation die in the Senate. On one occasion, Mr. Trump summoned House Republicans to the White House for a grand ceremony only to see that momentum quickly fade away.
Mr. Trump often laments the failure by blaming Senator John McCain, Republican of Arizona, who voted against one repeal effort in the summer of 2017. Even if Mr. McCain had voted for the bill, however, full repeal of the Affordable Care Act would not have been assured.
That version would have eliminated the individual and employers’ mandate, but left intact the health care law’s Medicaid expansion and insurance regulations. And it would still have required passage in the House or forced lawmakers from both chambers to negotiate their differences.
When Mr. Trump pushed the idea of voting to repeal the law again recently, he was quickly dissuaded by Senator Mitch McConnell, Republican of Kentucky and the majority leader, who argued that comprehensive health care legislation would go nowhere in Congress. The president then insisted it was never his intention to vote on a bill before the 2020 election.
Even as Mr. Trump has delayed producing a plan, he has continued to criticize the existing health care law, repeatedly claiming that it had become unaffordable because of average deductibles exceeding $7,000 or $8,000. This was an exaggeration.
Deductibles vary greatly by the type of plan and the enrollee. While deductibles for some plans can top $7,000, they average $4,375 for silver-tier plans, the most common choice for consumers. And those who receive cost-sharing reductions have lower deductibles still. Also left unsaid was his own administration’s role in causing higher deductibles, as the federal government sets caps on out-of-pocket costs and has increased the limit this year.
Midway through his third year in office, many remain skeptical that Mr. Trump will produce the plan he is now promising to unveil in a month or two.
“He can’t deliver the impossible,” said Len M. Nichols, the director of the Center for Health Policy Research and Ethics at George Mason University, “so he avoids specifics and postpones actually reckoning with a serious legislative proposal of his own.”