At the end of a day when incoming and outgoing presidents tussled over the fate of U.S. health care, it was the words of Vice President-elect Mike Pence that seemed to matter most to anxious investors.

Pence, in a visit to Congress, sought to ease concerns that a repeal of Obamacare would be done so abruptly that it leaves millions of Americans without insurance and throws health-care companies into chaos across the country. He told reporters that he was talking with Republican leaders to coordinate “both a legislative and executive action agenda to ensure that an orderly and smooth transition to market-based health care system is achieved.”

Earlier in the day, the mood was more strained. President-elect Donald Trump, calling Obamacare “a disaster” on Twitter Wednesday, urged Republicans not to take the blame for the law as they start a process to change it. Meanwhile, President Barack Obama urged Democrats on Capitol Hill to resist efforts to repeal his signature domestic policy achievement.

“It will be important that we are careful in how we do that,” Pence said at a news conference with House Speaker Paul Ryan.

Enormous challenges remain, including debate within the GOP over how quickly to proceed with their plans. Yet the remarks sent hospital stocks rising on Wednesday, as Community Health Systems Inc., HCA Holdings Inc. and Tenet Healthcare Corp. all had their best day of trading since November.

Obama meeting

At the same time, Obama -- in his final weeks in office -- met with Democrats on Capitol Hill to discuss how to defend the Affordable Care Act from being upended by the unified Republican presidency and Congress. The Republican plan would “make America sick again,” Minority Leader Chuck Schumer said at a news conference afterward. The administration announced on Wednesday that 8.8 million people have so far signed up for coverage this year under the law, more than at the same time last year.

Representative Louise Slaughter, a New York Democrat, scoffed at the GOP’s repeal strategy, saying, “You wouldn’t think of tearing down a house before you have a new one.” Asked whether she intends to work with Republicans on a replacement, she said no.

New York’s Schumer told reporters that Democrats’ position is that Republicans must first put forth a replacement plan. Then Democrats will respond and decide their next step.

“I think we have unanimity in our caucuses on that position,” he said.

Pence told Republicans during their private meeting that Trump, on his first day in office, plans to take action on Obamacare through executive orders aimed at making sure the insurance marketplace isn’t disrupted by a repeal, according to Representative Chris Collins of New York, one of Trump’s earliest House GOP backers.

Republicans hope to have a replacement plan on paper in six months, Collins said.

GOP split

There are GOP divisions on what steps to take first. Some want to see a full health care program before voting to repeal the law, and others want to repeal it first and work on replacement after.

Maine Republican Senator Susan Collins, a moderate, told reporters she would like to see a “detailed framework for what replacement is going to include as we are moving toward repeal.” She said she would look at a replacement policy before giving her vote to repeal efforts.

“I want to make sure that we don’t have a gap that leaves people who have coverage without coverage” after repeal, Collins said.

A leading House conservative, Representative Jim Jordan of Ohio, said he wants repeal done quickly. “I don’t want that to turn into some 2, 3, 4-year phase-in,” he said.

Instant Insights /

Promise of orderly Obamacare repeal sends hospital stocks rising

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