Trump went for expediency and not what he thinks is best for the country. He got duped by Paul Ryan. If he went with what he thought was best for the country we would go with his ideas-- for single payer-- and not Ryan's and McConnell's.  What he has done according to many insurance companies is to unintentionally (?) sabotage Obamacare by "leaving it alone" but not adhering to the subsidies and the calculations in the markets which are hurting the insurance companies and creating uncertainty about what he will do. What happens next? Trump's threats to withhold payments to the insurers will force moe of them to leave which threatens insurance for more people. Trump's job is to follow the law until Congress passes a new one.