Even the most vulnerable Democrats won't risk repealing Obamacare without a replacement

President Barack Obama huddled with congressional Democrats Wednesday, telling his party that if Republicans want to repeal the Affordable Care Act without a viable replacement in mind, Democrats shouldn't "rescue" the GOP from the resulting fallout.

Democrats appear to be heeding that call, with even the most vulnerable among the bunch — those facing re-election in 2018, in states President-elect Donald Trump carried by large margins in 2016 — saying they will work with Republicans on fixing the existing law but will not vote to repeal if there's no alternative attached. 

"We remain committed to improving the ACA, and we urge you to work with us now — to increase affordability for families, protect communities, help small businesses and continue important protections for the most vulnerable," a group of moderate Senate Democrats wrote in a letter to GOP leaders Thursday. "But by pushing an immediate repeal through a partisan reconciliation process, we won't have the opportunity to work together and build on common ground. By moving forward with no plan in place for the future of our health care system, those who support repeal assume the responsibility of mitigating the unnecessary and avoidable chaos this will create."

The fact Democrats are refusing to repeal the law without a viable replacement is a sign party leaders know the political perils of creating chaos in the health care system. Should millions lose coverage as a result of appealing the ACA, Democrats look poised to let Republicans shoulder the blame. 

Sen. Bob Casey, who faces re-election in 2018 in Pennsylvania — which Trump won by a narrow margin in the 2016 presidential election — said he wants to work with members from both sides of the aisle on ACA fixes, but won't repeal the law without a plan to replace it.

"It's time for Republicans to show us their plan to cover 20 million Americans and provide consumer protections for the millions that have insurance," Casey said in a statement. "If Republicans insist on causing chaos and jacking up premiums for the middle class by repealing the ACA without a replacement plan, then it will be incumbent upon them to put forth a real plan to fix the mess they will have created."

Indiana Sen. Joe Donnelly, who's up for re-election in 2018, echoed those sentiments in a YouTube message to his constituents posted on Wednesday.

"I've long said that the health care law is not perfect, and I've offered many ways we can improve it. I've been willing to work with anyone, Republican or Democrat, to improve the health care system in our country," Donnelly said. "But what I won't do is support any effort that would create chaos in the insurance marketplace, increasing premiums and taking away insurance from 20 million Americans."

Even Sen. Joe Manchin, one of the Senate's most conservative Democrats who refused to attend Obama's Capitol Hill meeting Wednesday, said he won't vote to repeal the law if no replacement is teed up.

"It's not perfect, we got a lot of repairing to do, but to say you're going to throw the baby out with the bathwater and repeal the whole thing," Manchin said Wednesday on MSNBC's Morning Joe.

"I'm willing to look at replacing, repairing, doing anything that we can to make it better, but put something on the table," added Manchin, who faces re-election in 2018 in West Virginia, Trump's second-strongest state in November behind Wyoming, according to New York Times election results. "I just can't believe the Republicans would go down this path and just throw it out and say, 'Trust us. In two or three years, we'll fix it.' Joe, I've been here for six years, we haven't fixed very many things, and anyone has trust or belief that we will fix it, they're living in fantasy land."

In 2010, Obamacare passed through Congress without a single Republican vote. And that has given Republicans the ammunition to blame every negative aspect of the law on their counterparts across the aisle. 

However if the GOP now repeals the bill without Democratic votes, they could be singularly blamed for the chaos that could ensue.

"A lot of the politics depends on the status of the program and/or the replacement and how people feel about it," said Nathan Gonzales, a non-partisan political handicapper. 

Even some Republicans are warning against a repeal without a replacement, including Sen. Rand Paul.

"If Congress fails to vote on a replacement at the same time as repeal, the repealers risk assuming the blame for the continued unraveling of Obamacare," Paul, an ophthalmologist by trade, wrote in an op-ed posted on Rare. 

"My fear is that if you leave part of Obamacare in place (the dictate that insurance companies must sell insurance to individuals with pre-existing conditions) then you will see an acceleration of adverse selection and ultimately mass bankruptcy of the healthcare insurance industry," Paul added.