*(Disclaimer: No, that's not a direct quote from Dr. Molina, but it's a pretty damned spot-on paraphrase).
A couple of weeks ago I noted that a buttload of heavy players in the healthcare field sent a joint letter to Trump, Tom Price and everyone else under the sun making it pretty clear how vital resolving the CSR issue is, and what the consequences would be if Congress and Trump don't make good on them.
Today, Molina Healthcare, which has around 1 million ACA exchange enrollees at the moment (roughly 9% of all effectuated enrollees) lowered the boom even harder (via Bob Herman of Axios):
Molina will exit exchanges if ACA payments aren't made
Politically, the big unknown is whether or not Paul Ryan and Mitch McConnell will get away with trying to pin the blame for this on the Democrats/the law itself. That's why they've been pushing the "Obamacare is already in a death spiral!" claim hard for the past few weeks, even though it quite simply isn't.
...So, if this does end up in a worst-case scenario, Trump's "stop enforcing the mandate altogether!" order here could end up causing that death spiral even if the GOP doesn't technically end up repealing anything legislatively. The carriers would start announcing that they're bailing next year as soon as this spring (remember, the first paperwork for 2018 exchange participation has to be filed in April or May), and McConnell/Ryan would simply say, "See?? We told you it was collapsing all by itself! We didn't touch nuthin'!!"
U.S. health insurers Aetna Inc and Anthem Inc on Friday sought to reassure investors that their Obamacare businesses had not worsened after UnitedHealth Group Inc warned of mounting losses in that sector.
Aetna and Anthem said their individual insurance businesses, which include the plans created by President Barack Obama's national healthcare reform law, had performed in line with projections through October. Both backed their earnings forecasts for 2015.