The consolidation of Republican power in Washington was supposed to create huge dividends for every kind of interest group by eliminating legislative gridlock and brinkmanship and giving a single party power to set policy. By the same telling, this was supposed to be a particular boon for business owners (and, downstream, for workers), who would welcome a climate of lower taxes, laxer regulation, and greater certainty with new investment, and thus more jobs.

The concept of “certainty” was one Republicans in Congress wielded as a brickbat against President Obama for eight years only to abandon it when President Donald Trump, through a mix of incompetence and malevolence, turned uncertainty into a weapon.

In the realms of health, immigration, and foreign policy, Trump has managed to leave stakeholders on all sides of issues—consumers, providers, civilians, enforcers, diplomats, and entire countries—completely befuddled in ways that threaten to cause great harm. The question is whether people around Trump can convince him that the policy environment he has created needs to change, or, more ominously, whether he has convinced himself that chaos gives him the upper hand.

Trump is certainly capable of such delusion. Since Congress failed to pass Trumpcare, the president has threatened to use policy levers at his disposal to disintegrate the individual insurance markets, on the presumption that it will force Democrats in Congress to vote for a more systematic dismantling of the Affordable Care Act.

In reality, it would create a long and indefinite suffering for which, polling suggests, the public would hold him and Republicans accountable. We will find out soon whether Trump is serious or bluffing (or whether he simply needs someone to spend 10 minutes explaining reality to him). What’s notable about the whole mess is that the very Republicans in Congress who fancied themselves avatars of business certainty could strip Trump of his power to weaponize chaos in Obamacare, but have so far declined.