Trump Signs Executive Order 'Starting That Process' Of Obamacare Repeal; Draws Ire With Puerto Rico Tweets

WASHINGTON (CBSNewYork/CBS News) -- President Donald Trump signed an executive order regarding health care Thursday morning, but people are also talking about tweets he put out hours before concerning pulling aid out of hurricane-ravaged Puerto Rico.

As CBS2's Alice Gainer reported, Trump claims he is starting the process of repealing and replacing Obamacare, since he said Republican lawmakers could not agree on a plan.

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Surrounded by top administration officials, business leaders and U.S. Sen. Rand Paul (R-Kentucky) in the White House Roosevelt Room, Trump praised his executive order as step towards repealing and replacing his predecessor's signature health care law. Trump, stuck with a Republican-led Congress that hasn't passed a bill to undo Obamacare, announced earlier this week that he is resorting to his "pen" instead.

Trump began to walk out of the room without signing the order, until Vice President Mike Pence reminded him.

"We've been hearing about the disaster of Obamacare for so long -- in my case, many years, most of it outside in civilian life," Trump said. "And for a long period of time since I've started running and since I became president of the United States, I just keep hearing 'repeal and replace, repeal and replace.' Well, we're starting that process, and we're starting it in a very positive manner."

Trump said the order will cost the federal government "virtually nothing," and will force insurance companies to start "fighting" to sign people up for care.

"But the competition will be staggering," Trump said. "Insurance companies will be fighting to get every single person signed up, and you will be hopefully negotiating, negotiating, negotiating, and you'll get such low prices for such great care."

Trump did not back down from his goal of repealing Obamacare and fulfilling a signature campaign promise, despite the GOP-led Congress' inability to agree on how to do that. Trump said he will "pressure" Congress to repeal and replace Obamacare, "once and for all."

"Well, this is promoting healthcare choice and competition all across the United States," Trump said. "This is going to be something that millions and millions of people will be signing up for, and they're going to be very happy. This will be great health care."

The president's executive order is intended to make lower-premium plans more widely available. Trump has long talked about his desire to make health insurance plans available across state lines.

His order directs Labor Secretary Alexander Acosta to consider expanding access to association health plans, which could possibly allow American employers to form groups across state lines, according to the White House. The order could also allow employers in the same line of work to join together to offer health care to employees, no matter their state.

"This will allow thousands of small business employers to have the same purchasing power as large employers to get more affordable and generous insurance options for their workers," Trump said.

The president's order, according to the White House, also directs the Labor Department, Treasury Department, and Health and Human Services Department to consider expanding coverage for short-term, limited duration plans that could be made available to people in specific circumstances, like if a person loses his job or misses the open enrollment deadline.

Critics argue that association health plans draw in younger, healthier people because of the cheap price tags, which could result in fewer people buying insurance through the Affordable Care Act markets – meaning higher prices for the elderly and sick.

"It is a sabotage of the Affordable Care Act and quite frankly, is a real disservice to the American people, many of whom voted for him," said House Minority Leader Rep. Nancy Pelosi (D-California).

Gov. Andrew Cuomo on Thursday also issued a statement excoriating Trump's executive order.

"President Trump and ultraconservatives in Congress are continuing their reckless assault on our health care and going after our New York values. The President's Executive Order pulls the rug from under the Affordable Care Act, which helped New York expand access to affordable health care to millions of New Yorkers, and takes aim at essential health benefits and protections for people with pre-existing conditions," Cuomo said in the statement. "And if the federal government were to move forward with the proposal to facilitate the unrestricted purchase of insurance across state lines, it would create a race to the bottom on consumer protections for New Yorkers."

Cuomo called the order "just the latest action that targets New York following Congress's failure to renew the Child Health Insurance Plan and the Health Centers Program, putting our children and the most vulnerable among us at risk to lose access to health care."

The president's executive order is likely to face backlash from medical groups, and could very well face a legal challenge. Some Democratic attorneys general already say they plan to sue, claiming the president does not have the legal authority to allow such an order.

New York Attorney General Eric Schneiderman late Thursday announced his plan to sue.

"Hundreds of thousands of New York families rely on the Affordable Care Act's subsidies for their health care - and again and again, President Trump has threatened to cut off these subsidies to undermine our healthcare system and force Congress to the negotiating table. That's unacceptable," Schneiderman said in a statement. "I will not allow President Trump to once again use New York families as political pawns in his dangerous, partisan campaign to eviscerate the Affordable Care Act at any cost."

Meantime, when it comes to rebuilding Puerto Rico, Trump tweeted that the federal response cannot go on "forever."

His words enraged under lawmakers.

"So to kick fellow citizens when they are down is shameful," said U.S. Rep. Nydia Velázquez (D-New York).

White House Chief of Staff John Kelly defended the president.

"The tweet about FEMA and DOD -- read, military -- is exactly accurate," he said. "They're not going to be there forever."

But he said the U.S. will stand with Puerto Rico until the job is done.

Also Thursday, Kirstjen Nielsen, who previously worked for Kelly, was announced as the nominee for Homeland Security secretary. The Senate must confirm her.

The U.S. House of Representatives on Thursday passed a $36.5 billion disaster aid bill for hurricane-hit states and Puerto Rico. The Senate will vote next week.

On Friday, Trump will deliver a speech at the White House regarding Iran and the 2015 nuclear deal.

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