That includes the market's cost-sharing subsidies as well as other government payments for sicker-than-usual customers, and finalizing a rule the Trump administration proposed that addresses issues insurers say drive up costs.
The Trump administration could do some of that itself if it wants to, such as using its regulatory authority to adjust the formula for how it compensates insurers for the sickest people, Elizabeth Carpenter at health care consultancy and research firm Avalere Health said.
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But it is unknown if the administration will try to work within the law's existing framework or take actions to undermine it and blame the Democrats for its failure.
"If they fail to act and they don't act in an appropriate way, that will further destabilize the marketplace," Dr. Mario Molina, CEO of Molina Healthcare, said. Molina's enrollment ballooned to 1 million exchange enrollees this year and the company is weighing if it will submit plans for next year.
The administration could also decide to not enforce the individual mandate, which requires that everyone purchase health insurance or pay a fine. It already took steps to erode that provision last month, when it backed off implementing tougher oversight that was due to go into effect for 2016 taxes.
Experts said the individual mandate still cost less than purchasing insurance, but as it increases each year more young and healthy people would have incentive to join the health care market, helping to offset the cost of sicker patients.
The nonpartisan Congressional Budget Office estimated that 14 million more people would be uninsured under the Republican bill next year, with most of the increase coming from the repeal of the penalty associated with the individual mandate.
It's unclear what the Republicans will do. Trump said this bill had been shelved but that Republicans would end up with a "great" health care bill in the future. But for now that they are moving onto tax reform.
Until they do that, they will have to work within the 2010 Affordable Care Act. They can also undercut the health care law through regulatory authority at the Department of Health and Human Services.
(Reporting by Caroline Humer and Yasmeen Abutaleb; Editing by Lisa Shumaker)
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