Something still needs to be done for 230,000 people on exchange plans in Tennessee, Senator Lamar Alexander, a Republican from the state, said Friday after the ACA replacement was pulled before a scheduled House floor vote.

“Unless Congress and the President act soon, these Tennesseans -- some of the most vulnerable citizens in our state -- are likely to have zero choices of insurance in 2018,” he said.

Insurers, by and large, are still losing money after three years of selling coverage in the program, according to an analysis from Bloomberg Intelligence. That’s pushed some of the big players -- Aetna Inc., UnitedHealth Group Inc. and Humana Inc. -- to pull back. Higher premiums may give insurers better results this year, according to an analysis from S&P Global Ratings. That is, so long as the administration’s actions don’t undermine the market.

Why Take Risk?

That’s where the difficulties emerge. Trump, on Friday and again over the weekend, said Obamacare was collapsing. “It’s imploding and soon will explode and it’s not going to be pretty,” he said.

Price and Congressional Republicans have made similar statements. That could undermine the desire of insurers to sell in the market. If regulators aren’t willing to make it work, why should they take a risk?

“Market participants need faith in their regulator. When their regulator says market is ‘exploding,’ it has an influence,” Andy Slavitt, the former head of the Centers for Medicare and Medicaid Services under President Barack Obama, said Monday on Twitter. “Can you imagine investing or offering stock as a company in the stock exchange if the head of SEC called it a ‘disaster?”’

This article was provided by Bloomberg News.

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