PHILADELPHIA — Republican lawmakers who held a closed-door meeting Thursday aired sharp concerns about their party’s quick push to repeal the Affordable Care Act, according to a recording of the session obtained by The Washington Post.

The recording reveals a party that appears to be filled with doubts about how to make good on a longstanding promise to get rid of Obamacare without explicit guidance from President Donald Trump or his administration. The thorny issues lawmakers grapple with on the tape – including who may end up losing coverage or paying more under a revamped system – highlight the financial and political challenges that flow from upending the current law.

Senators and House members expressed a range of concerns about the task ahead: how to prepare a replacement plan that can be ready to launch at the time of repeal; how to avoid deep damage to the health insurance market; how to keep premiums affordable for middle-class families; even how to avoid the political consequences of defunding Planned Parenthood, as many Republicans hope to do with the repeal of the ACA.

“We’d better be sure that we’re prepared to live with the market we’ve created” with repeal, said Rep. Tom McClintock, R-Calif. “That’s going to be called Trumpcare. Republicans will own that lock, stock and barrel, and we’ll be judged in the election less than two years away.”

SEN. LAMAR ALEXANDER: NO QUICK FIX

Recordings of closed sessions at the Republican policy retreat in Philadelphia this week were sent late Thursday to The Post and several other news outlets from an anonymous email address. The remarks of all lawmakers quoted in this story were confirmed by their offices or by the lawmakers themselves.

“Our goal, in my opinion, should be not a quick fix. We can do it rapidly – but not a quick fix,” said Sen. Lamar Alexander, R-Tenn. “We want a long-term solution that lowers costs.”

Sen. Rob Portman, R-Ohio, warned his colleagues that the estimated budget savings from repealing Obamacare – which Republicans say could approach a half-trillion dollars – would be needed to fund the cost of setting up a replacement.

Rep. Pete Sessions, R-Tex., worried that one idea floated by Republicans – a refundable tax credit – would not work for middle-class families that cannot afford to prepay their premiums and wait for tax refunds.

Republicans have also discussed the idea of generating revenue for their plan by taking aim at deductions that allow most Americans to get health insurance through their employers without paying extra taxes on it. Sen. Bill Cassidy, R-La., who has drafted his own bill to reform the Affordable Care Act, said in response, “It sounds like we are going to be raising taxes on the middle class in order to pay for these new credits.”

Rep. Kevin Brady, R-Tex., who chairs a key tax-writing subcommittee, countered, “I don’t see it that way,” adding that there is “a tax break on employer-sponsored health care and nowhere else” equal to $3.6 billion over 10 years.

PLANNED PARENTHOOD ‘A POLITICAL MINEFIELD’

Rep. John Faso, R-N.Y., a freshman congressman, warned strongly against using the repeal of the ACA to defund Planned Parenthood. “We are just walking into a gigantic political trap if we go down this path of sticking Planned Parenthood in the health insurance bill,” he said. “If you want to do it somewhere else, I have no problem, but I think we are creating a political minefield for ourselves – House and Senate.”

The concerns of rank-and-file lawmakers appeared to be at odds with key congressional leaders and Andrew Bremberg, a top domestic policy adviser to Trump, who have laid out plans to repeal the ACA using a fast-track legislative process and executive actions from the administration. However, the leaders acknowledged in Thursday’s meeting, as they have before, that Obamacare cannot be fully undone – or replaced – without Democratic cooperation.

That and other aspects of the unfinished Republican plan prompted several wary lawmakers to urge their leaders to move more deliberately – even as the Trump administration appears to be moving ahead with repeal.

On Thursday, the White House ordered federal health officials to immediately halt all advertising and other outreach activities for the critical final days in which Americans can sign up for 2017 health coverage through Affordable Care Act marketplaces. The administration partly retracted that directive on Friday, allowing the Department of Health and Human Services to continue to contact people eligible for ACA coverage by email, text and automated phone calls and reviving use of a HealthCare.gov Twitter account. The new directive also allows airing of some ads if the government would otherwise lose the money.

PAUL RYAN DISMISSES COLLEAGUES’ CONCERNS

House Speaker Paul Ryan, R-Wis., dismissed the concerns aired in the meeting during an interview at a Politico event Friday.

“We have a responsibility to work for the people that put us in office,” he said. “That’s the oath we take: to defend the Constitution, to fight for the people we represent, and this is a fiasco that needs to be fixed.”

Of particular concern to some Republican lawmakers was a plan to use the budget reconciliation process – which requires only a simple majority vote – to repeal the existing law, while still needing a filibuster-proof vote of 60 in the Senate to enact a replacement.

“The fact is, we cannot repeal Obamacare through reconciliation,” McClintock said. “We need to understand exactly: What does that reconciliation market look like? And I haven’t heard the answer yet.”

Several important policy areas appeared unsettled. While the chairmen of key committees sketched out various proposals, they did not have a clear plan for how to keep markets viable while requiring insurers to cover everyone who seeks insurance.

At one point Cassidy, a physician who co-founded a community health clinic in Baton Rouge to serve the uninsured, asked the panelists a “simple question”: Will states have the ability to maintain the expanded Medicaid rolls provided for under the ACA, which now provide coverage for more than 10 million Americans, and can other states do similar expansions?

“These are decisions we haven’t made yet,” said House Energy and Commerce Committee Chairman Greg Walden, R-Ore.

Rep. Tom MacArthur, R-N.J., worried that the plans under consideration by Republicans could eviscerate coverage for the roughly 20 million Americans now covered through state and federal marketplaces and the law’s Medicaid expansion: “We’re telling those people that we’re not going to pull the rug out from under them, and if we do this too fast, we are in fact going to pull the rug out from under them.”

Republicans are also still wrestling with whether Obamacare’s taxes can be immediately repealed, a priority for many conservatives, or whether that revenue will be needed to fund a transition.

And there seems to be little consensus on whether to pursue a major overhaul of Medicaid – converting it from an open-ended entitlement that costs federal and state governments $500 billion a year to a fixed block grant. Trump and his top aides, including counselor Kellyanne Conway, have publicly endorsed that idea. But doing so would mean that some low-income Americans would not be automatically covered by a program that now covers 70 million Americans.