Obamacare repeal 'not dead', Donald Trump insists, 'unless Republican Senators are total quitters'

Policy to repeal and replace the Affordable Care Act was a key campaign promise

Donald Trump has insisted his healthcare reforms are 'not dead' (REUTERS)

Donald Trump's flagship policy, the repeal and replacement of the Affordable Care Act (ACA), is "not dead" despite defeat in the Senate, the US president has insisted.

Mr Trump used Twitter to suggest his fellow Republicans would be "total quitters" unless they demanded a new vote on the a bill to roll back Obamacare.

A majority of senators, including three Republicans, handed the billionaire another legislative defeat on Friday when they rejected the latest plan to dismantle the ACA.

Mr Trump said on Saturday: "Unless the Republican Senators are total quitters, Repeal and Replace is not dead! Demand another vote before voting on any other bill!"

It came a few hours after he appeared to threaten members of Congress over the same issue.

He wrote earlier on Saturday: "If a new Health Care Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!"

It was an apparent threat to end required payments to insurance companies unless lawmakers repeal and replace the Obama-era health care law, a policy which Mr Trump made a key campaign promise.

The issue has dominated the opening months of Mr Trump's presidency, but it remains out of reach even with Republicans controlling both the White House and Congress.

The subsidies, totalling about $7bn (£5.3bn) a year, help reduce costs for consumers with modest incomes.

The Obama administration used its authority to set direct payments to insurers to help offset these costs. Mr Trump inherited the payment structure, but he also has the power to end them.

The payments are the subject of a lawsuit brought by House Republicans over whether the ACA specifically included a congressional appropriation for the money, as required under the constitution. Mr Trump has only guaranteed the payments through July, which ends Monday.

Mr Trump previously said Obamacare would collapse immediately whenever those payments stop. He has indicated a desire to halt the subsidies but so far has allowed them to continue on a month-to-month basis.

Without the payments, analysts have said, more insurers might drop out of the system, limiting options for consumers and clearing the way for the insurers who stay to charge more for coverage.

Additional reporting by agencies