The Kentucky Republican opposed several bills that other Republicans supported to repeal and replace portions of Obamacare, partly leading to the failure of the most-recently considered healthcare legislation known as Graham-Cassidy. Even so, he worked with the Trump administration for months to make suggestions about executive actions that could be taken to allow people to buy cheaper health insurance plans with fewer Obamacare mandates. He stressed throughout the process that the changes would have little impact on government spending. Paul appeared beside Trump when he signed the order and made opening remarks. When Trump reached the lectern, he called Paul's support "a very positive thing."