"Repeal and delay" won't prevent ObamaCare repeal chaos

The worst-case scenario would be the large-scale withdrawal of insurers from markets and the inversion of risk pyramids, with sicker and sicker patients seeking coverage while they can. Without available insurers or a public option, people without employer coverage or who make too much to qualify for Medicaid might just not have any insurance to buy. If Congress and state governments don’t actively enforce “rate review” and medical-loss ratio rules that give states oversight over large premium increases and mandate that insurance plans spend a certain percentage of premiums on healthcare, insurers could enter markets that don’t have plans and raise premiums for vulnerable people who need insurance most. Alternatively, short-term insurers—which already profit on the mandate despite providing barebones services that don’t qualify as full plans—could continue to fill in the gaps.

Millions of people in the exchanges may have to change insurance or enter the ranks of the uninsured. And though the delay may not immediately affect people with employer coverage or public coverage, downstream challenges for insurers in exchanges could affect the products they offer for those markets. None of this would be good politically for Republicans, who already have to contend with a voter base that actually kind of likes having insurance. Compare that scenario to the political damage that Democrats suffered in the 2016 elections over much less dire and far-reaching problems. Republicans could pin these woes on Obamacare itself, but then their inability to fix those woes despite campaigning on promises to do just that could come back to haunt them.