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Republicans warned for years that Obamacare would blow up the nation's individual insurance market. Instead, their own rush to repeal the health care law may be what triggers that death spiral. GOP lawmakers say they plan to repeal the Affordable Care Act as soon as President-elect Donald Trump takes office, including a transition period of a year or two before it takes effect. That way, they satisfy their base while giving notice to 20 million Obamacare customers that they must find other coverage options. (Cancryn and Demko, 11/21)

In the summer of 2013, as state and federal officials readied new insurance marketplaces created through the Affordable Care Act, millions of Americans started getting disquieting notices from their insurers. Health plans were being canceled because they didn’t comply with the law, often called Obamacare. Some 4 million people were ultimately told they would lose their plans. The ensuing outrage sparked a political firestorm, seriously eroded public confidence in Obamacare and forced an embarrassed President Obama to change federal regulations so people could keep their coverage. Yet that tumultuous episode could be dwarfed by what President-elect Donald Trump’s administration and its congressional allies unleash beginning next year. They plan to not only repeal the law but are contemplating changes that are significantly more far-reaching and could disrupt insurance coverage for many more Americans than did the original law. (Levey, 11/21)

Shortly after Donald Trump's unexpected victory in the presidential election, leaders of the six-hospital Mission Health system decided to put large capital investments on hold. They wanted to preserve financial flexibility in case the new Republican administration pushed through “very harmful changes and reductions in payment,” said Dr. Ronald Paulus, CEO of the Asheville, N.C.-based system. Meanwhile, Mission Health chose to continue investing in population health initiatives, its new health insurance company and its Medicare Advantage program. Paulus said those decisions flowed out of the huge uncertainty caused by Trump's and congressional Republicans' promise to rapidly repeal and replace the Affordable Care Act. (Meyer, 11/19)

Six years into building its business around the Affordable Care Act, the nation’s $3 trillion health care industry may be losing that political playbook. Industry leaders, like many voters, were stunned by the election of Donald Trump and unprepared for Republicans’ plans to “repeal and replace” Obamacare. In addition, Trump’s vague and sometimes conflicting statements on health policy have left industry officials guessing as to the details of any substitute for the federal health law. (Rovner and Terhune, 11/21)

President-elect Donald Trump will prioritize repealing President Barack Obama's landmark health care law right "out of the gate” once he takes office, Vice President-elect Mike Pence said Sunday. (Temple-West, 11/20)

Repeal of the 2010 health care law is a top priority as soon as Donald Trump takes office in January, Vice President-elect Mike Pence said in a Sunday television interview. “Decisions have been made, that, by the president-elect, that he wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare with the kind of free-market solutions that he campaigned on,” Pence said on “Fox News Sunday.” (Mejdrich, 11/20)

The House Speaker wants Obamacare dead. The House Budget Chairman — a leading candidate for HHS secretary — wants Medicare reform. But all the focus on Republicans' health strategies is ignoring the biggest elephant in the room: Donald Trump, a president-elect who's spent more than a year bucking congressional Republicans — and may not share their priorities, two leading conservative thinkers tell POLITICO's "Pulse Check" podcast. (Diamond, 11/18)

The GOP wasn’t just focused on repealing Obamacare this week. A group of congressional Republicans also want to make sure the Obama administration doesn’t distribute additional funding to insurers as part of the Affordable Care Act’s “risk corridor” program. ... Republicans raised concerns that the Obama administration could get around restrictions on using other funds for the program by simply settling with the insurers that have sued, effectively keeping the program in operation. So this new bill would prohibit the administration from using the “Judgement Fund” to pay out any settlements. (McIntire, 11/18)

With Republicans taking full control in Washington, GOP governors in Wisconsin and across the nation will seek a bedrock shift in how the federal government helps states pay for health care for the needy, highway projects and worker training. Wisconsin Gov. Scott Walker, the newly elected head of the Republican Governors Association, said his group is seeking to move federal aid to states to a looser model that would come with greater flexibility and fewer rules but also the likelihood of much less money, especially over the years to come. (Stein, 11/20)

The post-election confusion over the fate of Obamacare has only complicated the already difficult choices faced by middle class consumers who are worried they can't afford their health insurance options this fall. Premiums and deductibles soared in many parts of the country after the departure of several large insurers from the Affordable Care Act exchanges for 2017. That's led many to fret about how to either afford insurance or how to get by without it. (O'Donnell, 11/20)