Donald Trump will decide this week whether he will let Obamacare “implode,” Kellyanne Conway said dramatically on Fox News Sunday. “He’s going to make that decision this week, and that’s a decision that only he can make.” Trump’s possible move towards implosion follows a week in which G.O.P. attempts to explode existing health-care legislation culminated in a series of stinging defeats. After even the so-called “skinny repeal” was met with a resounding thumbs-down by John McCain, and failed to pass Friday, Trump took to Twitter to scold Congress for looking “like fools” and to announce another tactic: sabotage. “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!” His threat was supplemented by Health and Human Services Secretary Tom Price, who suggested on ABC’s This Week that Trump might make more people exempt from the existing requirement to purchase health-care coverage, further destabilizing the insurance market.

The plot to sabotage Obamacare appears to be proceeding along two fronts. First, in its continuing efforts to paint millions of people losing their insurance as some kind of populist coup, the White House is raising pressure on Congress, which is exempt from some aspects of Obamacare. As part of the 2010 law, members of Congress and many staffers were required to obtain their insurance through the individual market exchanges that they had set up, with one loophole: the Office of Management and Budget decided that they would still receive the employer contribution toward their premiums. Now, in an odd interpretation of egalitarianism, the Trump administration is arguing that if lawmakers and their staffs truly had to live under Obamacare, without the employer contribution that would otherwise be part of their compensation, they would understand its flaws and be more willing to repeal it. “This is exactly what so many Americans hate about Washington, D.C.,” Conway said Sunday. “They want people to live under the same rules they do.”

This curious commitment to fairness doesn’t seem to stretch very far. Currently, the government is required to provide payouts to insurance companies in order to ensure that health care remains accessible for lower-income people. Although Trump’s government has paid what the president has dubbed “ransom money” on a month-to-month basis, the White House has refused to commit long-term, knowing that withholding the payments could force the A.C.A. into a death spiral. Indeed, if Trump does rescind the payouts which, he argues, simply props up a failing system, insurers would be forced to raise their costs significantly. Paradoxically, a number of people who make up Trump’s core support base of white, lower-income voters would then be locked out from purchasing health care. As Axios reports, insurance companies have so far been keen to avoid this unpleasant conflict with the White House but, if forced into combat, they could hike up their prices as soon as next month, citing the threats to take away subsidies.

Going to war with America’s insurance companies may be easier said than done. In a twist of irony, just as Trump wants to let Obamacare collapse and let others suffer the fiscal consequences, a pending court decision could force the White House to pay billions of dollars to insurers, who have filed multiple lawsuits claiming the government owes them up to $8 billion from a program put in place to make up for their losses under Obamacare. The Obama administration fought the lawsuits, but discussed the possibility of settlements with companies. The prospect of settlements stopped when Trump came into office, which means that the courts will probably have to settle the disagreement. After last week, the prospect of having to funnel billions of dollars towards Obamacare would intensely aggravate the G.O.P.’s health-care humiliation.