Mr. Trump will need to decide, quickly, whether his goal is to knock over the still-functioning markets, or help prop them up. If he decides to topple them, next year could be very messy.
Insurers are making their decisions right now about whether to enter the markets for next year and about how much to charge their customers. Signals from the administration in the next few weeks about whether he will help or hurt them will almost certainly guide insurers’ choices.
The biggest immediate decision concerns a court dispute between the House and the administration over subsidies to help low-income insurance buyers pay their deductibles and co-payments. The House has argued that the money for those subsidies was not properly authorized. The Obama White House fought the case. It is not clear whether Mr. Trump’s lawyers will do the same. The availability of those subsidies, used by a majority of Obamacare customers, is critical for insurers in the markets.
Without the subsidies, all the insurers will lose some money, and many smaller carriers will face bankruptcy. If Mr. Trump does not fight the court case, the Obamacare markets in most states will unravel quickly, leaving millions without insurance options on his watch. Many of the beneficiaries are Trump voters.
