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Senate Republican leaders, after meeting with Vice President-elect Mike Pence, said on Tuesday that they would move immediately next month to start repealing the Affordable Care Act, despite qualms among some of their members. ... Republicans have not fleshed out a plan to replace the 2010 health care law, President Obama’s signature legislative achievement. But on Tuesday they laid out their principles for a replacement plan and said they would try to minimize disruption for the 20 million people who have gained coverage under the law. (Pear, 12/6)

After meeting with Vice President-elect Mike Pence on Tuesday to hash out plans to repeal Obamacare, top Senate Republicans are no closer to resolving an issue that’s splintering the GOP heading into the start of Donald Trump’s presidency: how long to give themselves to replace the law. Pence communicated that the incoming administration is prepared to work closely with Congress on the issue, senators said, but did not dictate how long the transition period should last. That decision will affect millions of Americans’ health care and send insurance companies scrambling to adjust. (Everett and Haberkorn, 12/7)

Senate Majority Leader Mitch McConnell (R-Ky.) says legislation repealing the Affordable Care Act will be the first order of business in the new Congress. McConnell announced the agenda Tuesday, after meeting with Vice President-elect Mike Pence and Senate GOP colleagues over lunch."When we come back Jan. 3 we'll be moving to the ObamaCare replacement resolution, the ObamaCare repeal resolution will be the first item up in the New Year," McConnell said, referring to repeal legislation that is expected to pass with a simple majority vote under special budgetary rules. (Bolton, 12/6)

Repealing Obamacare will be the first order of business in the U.S. Senate in January, Senate Majority Leader Mitch McConnell, a Republican, said on Tuesday. Republicans will replace President Barack Obama's signature health insurance program that provides coverage to millions of Americans "step by step," said Senator John Thune, another member of the Republican leadership. (Cornwell, 12/6)

[Rep. Mark] Meadows served notice that the emerging congressional GOP plan for tackling the 2010 health care law is a non-starter with the Freedom Caucus. The group has more than enough voting strength to stop anything the House GOP high command hopes to pass along party lines .... The emerging GOP plan for the health care law is to enact a repeal in time for Trump’s signature soon after taking office, but with language phasing out many aspects of the complicated statute over three years .... Meadows says the deadline for replacement should be the end of the 115th Congress, but preferably before the open insurance enrollment next fall. Any timetable allowing deliberations beyond 2018, he says, would subject the GOP Congress in the next campaign to worthy criticism about breaking a central 2016 campaign promise. (Hawkings, 12/7)

Incoming Senate Democratic leader Chuck Schumer taunted Republicans Tuesday over their plans to replace Obamacare, insisting they have no solution and vowing that his party won’t go along with their attempts to unravel the law. "Bring it on," the New York Democrat said. "They don’t know what to do. They’re like the dog that caught the bus." Republicans say they intend to advance plans to undo President Barack Obama’s signature legislative achievement early next year. But they lack consensus on what to replace it with and how to go about it, even as they’re asking Democrats to work with them. (Kapur, 12/6)

In CMS regional offices around the country, health insurance workers are nervously preparing for a hiring freeze. At Medicare’s new innovation center in Baltimore, more than 300 staffers are trying to figure out if Republicans will eliminate their office. And at HHS headquarters in Washington, dozens of political appointees are still trying to determine whether Donald Trump’s surprising victory will upend their years of work expanding health insurance to millions. (Diamond, 12/6)

Before the Trump administration takes office and the promised repeal of the Affordable Care Act begins, dozens of health care groups this week wrote to leaders of the next Congress and administration and urged them to keep moving away from fee-for-service health care and towards payment models that encourage value. “At this critical time of the industry’s transformation, bipartisan support is critical to help consumers and businesses fully realize the goal of a sustainable, person-centered health care system that promotes choice, quality, and affordability,” the letter, first shared with Morning Consult, says. “This is not the time for policymakers to waiver or reverse course, which would send a negative message to the industry and chill ongoing transformation efforts.” (McIntire, 12/7)

The 2010 Obamacare law carefully prescribes ground rules for insurers participating in the subsidized health insurance program, including a prohibition against taking into account a person’s pre-existing medical conditions before determining whether to accept an applicant. The insurers can only consider an applicant’s age and location in setting premium prices, and they are obliged to offer every applicant a basic menu of coverage and benefits. Trump’s idea – echoed by House Speaker Paul Ryan (R-WI) and House Budget Chair Tom Price (R-GA), who has been nominated to be the next secretary of Health and Human Services -- is that by cutting through detailed regulations tied to state insurance regulations, insurance companies will be able to offer national plans with lower premiums and reduced administrative costs. (Pianin, 12/6)