Popular vote loser Donald Trump reacted to the stunning loss of the Republican party's seven-year raison d'etre as you would expect him to, on Twitter, with a threat and a promise.
The promise you can forget. We won't all get together, ever, when Paul Ryan's primary goal is making the maximum people suffer in return for tax cuts to the wealthy. Democrats will never be complicit in that. And they don't need to. Republicans have now proven themselves perfectly capable of scoring historic defeats all by their lonesomes.
But the threat of Obamacare "exploding" (I suspect he means imploding, but Trump), that has to be taken seriously. There's a lot that the administration and Republicans can do to undermine the law because it has so many moving parts. Let's start with the pending lawsuit House Republicans brought against the Obama administration over cost-sharing subsidies, payments to insurance companies from the federal government that reduce the deductibles and co-pays for more than half of enrollees on the Obamacare exchanges. Congress sued, saying that the payments had not been specifically appropriated and were illegal, and a district court judge agreed. That decision, though, has been stayed and there's an appeal still pending from the Obama administration—Trump and Health and Human Services Secretary Tom Price haven't decided yet whether to drop the appeal and asked for a three-month extension of the stay a month ago. If the Trump administration decides to drop the appeal, they can cause a lot of disruption really fast. But there's a power lobby pushing them to allow the subsidies to continue: America's Health Insurance Plans, the primary industry group. "Every American deserves access to affordable coverage and high-quality care—and cost-sharing reductions help millions of Americans get the care and coverage they need," it said in a statement. "They are a critical part of ensuring short-term stability of the market."
Apart from that, there are "a spectrum of options, ranging from actively undermining the ACA marketplaces to administrative actions that start to reshape the insurance market in a more conservative mold," Larry Levitt, a senior vice president at the Kaiser Family Foundation tells the Wall Street Journal. They could essentially end the individual mandate by not enforcing it. They could withdraw regulations and directives that insurers cover things like contraceptive. They've already encouraged states to add work requirements to Medicaid and signaled that that was just the beginning of the hoops they're going to allow states to force people to jump through to get on the program.
They can also shut down outreach to both future Obamacare customers and to insurance companies considering participating in the exchanges. They can keep enrollments down by, for example, not advertising open enrollment periods, by shortening those windows of opportunity, by not investing in keeping Healthcare.gov running smoothly, and who knows, outright sabotage of it.
Trump would do all of this on the assumption that people wouldn't recognize that it was him doing the destruction. He still thinks he can blame the Democrats and President Obama (remember his insane conspiracy theory—expressed in practically every statement about Trumpcare in the past two weeks—that Obama booby-trapped the law to explode in 2017?). That's where last week's spectacular fail comes in handy for Democrats. Republicans went so far over the top in this cartoon villain-ish law, made it so terrible that even Republicans hated it, that they laid their intent bare. When they further try to destroy Obamacare, everyone is going to know where to put the blame. Republicans now own this.