DOVER — During his presidential campaign, Donald Trump promised the Affordable Care Act would be repealed and replaced with something better.

Now, if the American Health Care Act of 2017 passes and is signed into law, the president will have broken his promise, Sen. Tom Carper believes.

Sen. Carper, 70, a Democrat and senior member of Delaware’s congressional delegation, said Monday the country would take a step back if it replaces the ACA with the AHCA.

“We’ve made in some cases a little bit of progress, in other cases a whole lot of progress,” he said at a news conference at Westside Family Healthcare, with other state officials and several doctors nearby. “With the Affordable Care Act ... I thought we made real progress. We cut in half, in fact, the number of people who didn’t have coverage in the state and actually made a lot of progress in terms of getting value, better value out of health care dollars that we spend.”

Thomas R. Carper

The AHCA bill, which passed the House in May and is now being considered by the Senate, would roll back the 2010 Affordable Care Act, or “Obamacare.” It would, according to the Congressional Budget Office, reduce the cumulative federal deficit by $119 billion over 10 years but would also cause 23 million more people to become uninsured by 2026. The CBO says less healthy people, such as those with pre-existing conditions, might face rising costs or a loss of care.

The Associated Press last week said President Trump told Republican senators in a closed-door meeting the AHCA is “mean, mean, mean.”

The ACA is seen by some as the biggest piece of President Barack Obama’s legacy, and supporters view it as a necessary piece of legislation that expands access to care.

But opponents — including a large majority of Republicans, per a March Gallup poll — argue it helped drive costs up and forced some people off their previous plans.

“The Affordable Care Act (‘Obamacare’) has resulted in skyrocketing health insurance prices, a diminishing choice of providers and in some areas a dwindling to no choice of health insurance plans,” U.S. Rep. Andy Harris, a Republican from Maryland’s Eastern Shore, said in a statement after the AHCA passed the House. “That is why I voted in favor of legislation that will immediately lower premiums and begin to fix our broken health insurance system.”

Senate Republicans are considering their own version of the bill, with no vote scheduled so far.

Democrats have blasted the Republican majority for not holding public hearings on the bill, drawing a contrast between the lead-ups to the vote on the ACA and the planned vote on the GOP bill.

“Our Republican friends in the Senate are basically doing this in secret,” Sen. Carper said Monday.

Sen. Chris Coons, 53, a Democrat and Delaware’s junior member of the Senate, last week told CNN Democrats are willing to work with Republicans to improve the ACA but have received a cold reception.

“They have a shrinking window. They’re going to use a vehicle to do this called reconciliation that allows them to do it by just 51 votes, 50 votes plus the vice president,” he said. “In order to do that, they are pursuing a path that would be Republican-only.

Chris Coons

“They are finding it very hard to get to 50 votes in the Republican caucus in the Senate because some of the far right wants to completely repeal the Affordable Care Act. The things that fund it and the consumer protection provisions and the ways it has helped 24 million Americans get access to health care and improved the quality of the health care that more than 150 million Americans have.

“But then there are folks who are moderate Republicans who want to save or extend the Medicaid expansion that their states have benefitted so much from. They have big internal divisions. Mitch McConnell, the Republican majority leader is pushing hard to get this done before the August recess. We’re hearing rumors they are making progress. But we have very little insight to what the provisions are of the bill.”

About 11,000 more Delawareans have coverage due to a Medicaid expansion undertaken under then Gov. Jack Markell as part of the ACA. If the AHCA is to pass, Delaware would need to either come up with more than $150 million to fund health care for that group or effectively kick people off Medicaid.

“What oftentimes I hear people talk about individuals who are on Medicaid that they think they don’t want to work or they can’t work or they’re living off the system,” Insurance Commissioner Trinidad Navarro said. “And the truth is and the facts are these are children. These are our elderly population, our disabled. This is a population that well needs to be protected.”

Delaware’s Medicaid costs are growing, however, and at $767 million, the money associated with it already makes up nearly 20 percent of the state’s current budget. Both Democrats and Republicans in the First State acknowledge health care costs are a problem for the budget, but they differ as to how to solve the issue.

The AHCA would spend $834 million less on Medicaid over the next 10 years, and state Sen. Colin Bonini, R-Dover, believes it would be a welcome change from the ACA.

“The reality is that public health care is on an unsustainable, regardless of whether it’s Obamacare or Medicaid, an unsustainable trajectory and our country needs to have an adult discussion about how we’ll do this,” he said.