WASHINGTON — President Donald Trump still has Barack Obama’s signature legislative accomplishment on his mind, but the political calendar and environment are not on his side.

Pushing a measure to revise — or even replace — the 2010 health care law known as the Affordable Care Act as the nation heads into what will likely be a contentious midterm election year would be among the biggest battles of his turbulent decade-old political career.

After all, neither party will have much incentive to help the other run on a big legislative win.

Trump was asked about health care and the Obama-era law during an interview that aired Sunday night on “60 Minutes.” As he verbally sparred with Norah O’Donnell of CBS News, the president at times seemed intent to revisit his first-term pledge to “repeal and replace” the entire law. But in a subsequent comment, he seemed focused mostly on expired tax credits created by the health care law.

“Obamacare is terrible. It’s bad health care at far too high a price. We should fix that. We should fix it, and we can fix it with the Democrats,” he initially said to O’Donnell.

But in a response to a follow-up question moments later, the president said this: “We can fix [health care]… but I’m not going to do it by extortion. I’m not going to do it by being extorted by the Democrats who have lost their way​.”

The latter comment was cast in the context of — and the president’s own language about — the ongoing government shutdown. He and GOP lawmakers have accused congressional Democrats of trying to use the health care law’s enhanced tax credits as a hostage in the shutdown fight, which Trump contends should be just about extending government funding.

Still, the bulk of Trump’s health care comments during the interview were broader in scope.

“We can make it much less expensive for people and give them much better health care — and I’d be willing to work with the Democrats on it,” he told CBS. “The problem is they want to give money to prisoners, to drug dealers, to all these millions of people that were allowed to come in with an open border from Biden, and nobody can do that. Not one Republican would ever do that.”

(Democrats have denied those allegations and accused Trump and GOP lawmakers of distorting their health care policy goals.)

Beneath the surface of Trump’s remarks was a desire to first reopen the federal government, then have serious conversations with congressional Democrats about the art of the possible on health care, according to a source familiar with the president’s thinking.

The source advised not “precluding anything about what the president’s goals are on health care policy,” the source added.

Notably, a bipartisan group of House lawmakers, composed of two members of each party, on Monday released a framework aimed at avoiding the health care subsidy cliff at year’s end.

One major reason behind Trump’s continued interest in the issue: Majorities of voters in each party support parts of the Obama-era law. That even includes Trump’s “Make America Great Again” base.

A KFF Health Tracking Poll conducted Sept. 23-29 found 78% of surveyed adults favored extending the health subsidies — including 57% who said they are aligned with Trump’s MAGA movement. Among all Republicans polled, 59% supported a tax-credit extension.

Another reason: Trump’s 2024 presidential election victory was heavily aided by independent voters in the seven swing states that he is fond of reminding everyone he swept.

“Overall favorability of the 2010 health care law known as the Affordable Care Act (ACA) continues to be at historically high levels, with about two-thirds (64%) of the public viewing the law positively,” KFF noted in a summary of the late-September poll, adding that 64% of independents hold a favorable view.

Still, as the Republican nominee last year, Trump railed against the Obama-era law on the campaign trail. But, just like during his first term, candidate Trump never released a comprehensive plan to replace it.

‘Get screwed over’

The same goes for Trump 2.0.

The president spent his first 10 months back in office largely focused on other issues, though the source noted he has acted aggressively to try bringing down prescription drug costs.

His second term has included unilateral efforts on culture war matters important to his conservative base, including targeting all things “woke” and “diversity, equity and inclusion.” He and his Justice Department have gone after political and legal foes on a retribution tour. Trump has had a bigger foreign policy focus than many expected, and planning for his White House ballroom has admittedly taken up many hours in recent months.

Those are reasons why some congressional Democrats have accused him of not caring that the loss of the health subsidies would hit millions of American households like a financial gut punch.

“I keep hearing Trump and Republicans say rising health care costs isn’t an urgent problem, but take a look at the price increases on the ACA exchange for the same insurance plans from 2025 to 2026. Millions of Americans are about to get screwed over with higher bills,” Arizona Democratic Sen. Mark Kelly, a Joint Economic Committee member, wrote Sunday on X.

To be sure, Trump’s health care ambitions have several impediments. All are related to the calendar.

Speaker Mike Johnson, R-La., has shown little interest in bringing back a House that has not held votes since Sept. 19. Some Democrats, like veteran Armed Services ranking member Adam Smith of Washington state, have begun charging him with “dissolving” the House.

Congress has been in a standoff over the near-record-long shutdown for over a month, with efforts slowly picking up to find a way out. Those efforts are expected to take several more weeks — at least — eating up valuable legislative days.

Once the government is open, lawmakers will have to pivot to the must-pass defense policy bill and possibly legislation focused on those enhanced tax credits. Amendment votes on both would gobble up more floor time — with lawmakers beginning to itch for a long holiday break.

Earlier this fall, several GOP sources laid out their expectations for Trump’s congressional to-do list — none included health care legislation.

But one of the biggest hurdles: Democrats just don’t trust him on this or really any issue. And they see a lack of empathy, meaning they are unmoved when he claims, as he did to reporters Friday on Air Force One: “But I’m president. I want to help everybody. I want to help Democrats and Republicans.”

Democratic strategist Mike Nellis on Monday wrote on Substack of Trump: “He’s still pretending inflation doesn’t exist. Still waving around a mythical health care plan he’s been promising since 2015.”

“Meanwhile, people are barely hanging on. The job market’s in the gutter. Prices are surging. The economy’s weak. Eighty percent of Americans are struggling,” Nellis added. “And what’s Trump doing? Running scams. Pardoning criminals. Ripping up parts of the White House so he can build a damn ballroom for himself. He’s turned the presidency into a playground for corrupt billionaires. It’s obscene.”

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