For health care advocates, congressional Republicans’ difficulties in passing regressive health care legislation have brought some comfort, but the threats haven’t gone away. Not only are many GOP lawmakers committed to returning to the issue, but systemic sabotage from Donald Trump remains a real possibility.

Indeed, as we’ve discussed many times, the president has made repeated threats to cut off cost-sharing reductions (or CSRs) – a component of the Affordable Care Act that helps cover working families’ out-of-pocket costs – which Trump has effectively turned into a political weapon. The mere threat has already pushed consumers’ costs higher.

But what if the president followed through on the threat and decide to use this weapon? NBC News’ Benjy Sarlin noted the latest findings from the Congressional Budget Office.

Health care premiums will spike, insurers will exit the market, and deficits will increase if President Donald Trump follows through on his threats to cut off government payments to insurance companies, according to a new Congressional Budget Office report. The cost of a “silver” insurance plan under Obamacare would be 20 percent higher in 2018 and 25 percent higher by 2020 compared to current law, according to the report. About five percent of the population would not be able to buy insurance through Obamacare at all next year, the CBO predicted, because companies would withdraw plans in response to the “substantial uncertainty” created by the move.

The full CBO report, which was prepared at the request of congressional Democratic leaders, is online here, and the executive summary is online here.

The picture painted by the non-partisan budget office isn’t pretty. Indeed, it’s difficult to find a policy that would force consumers to pay more and increase the overall costs of the program, but if Trump scrapped CSR payments, that’s exactly what would happen. As it turns out, sabotaging the American health care system this way is expensive: the CBO found that the deficit would increase by $194 billion over the next decade.

All of which leads to the next question: why in the world would Trump do this?

The president, who’s so confused by the basics of health care policy that he thinks CSR payments constitute a “bailout,” has said more than once that he’s tempted to scrap the CSRs and do systemic damage in order to force Democrats to strike a deal with Republicans on a new reform package.

This is a spectacularly bad plan. For one thing, Dems would never go along with such a scheme. For another, hurting American families on purpose in the hopes of creating conditions for negotiations is bonkers.

And as a simple matter of political sanity, there’s no upside for Trump if he’s caught sabotaging the nation’s health care system. He wouldn’t be able to blame “Obamacare” for failing, since under his plan, the failures would be the direct result of Trump’s own actions.

Yes, in time, the CBO concluded that the markets would adjust, but that would take a while. In the meantime, consumers would see premium increases that would be imposed as a result of Donald Trump and partisan spite.

Up until recently, there were independent estimates about the effects of ending CSRs. Now, there’s a detailed CBO analysis. If Trump follows through on his threat, and Americans suffer as a consequence, the president won’t be able to say he wasn’t warned.