Economist Paul Krugman Tuesday calculated the number of Donald Trump voters who voted themselves out of health care by supporting the president-elect, finding that as many as 5.5 million people could lose access to health care thanks to their own vote.

Noting Trump’s choice of Rep. Tom Price (R-GA) to lead the Department of Health and Human Services “probably means the death of Obamacare,” Krugman argues at least 3.5 and 4 million people “just shot themselves in the face.”

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As Krugman notes, 6 million non-Hispanic whites gained insurance between 2013 and 2015; considering 66 percent of white people without a college degree (and therefore likely uninsured before Obamacare) voted for Trump, Krugman reasons at least 3.96 million non-college educated Trump voters will lose their insurance.

Throughout the general election, Trump promised to repeal Obamacare “on day one.” Though the president-elect reneged on a total repeal, noting he’s interested in maintaining popular provisions requiring insurance companies to let children stay on their parents’ plan until 26 and banning insurers’ from denying coverage for pre-existing conditions, his choice of Price to head HHS sends a clear signal that the Trump administration will gut as much of the president’s signature legislation as possible.

In his formal announcement Tuesday, Trump said Price “is exceptionally qualified to shepherd our commitment to repeal and replace Obamacare and bring affordable and accessible health care to every American.” It remains unclear what replacement the administration plans to implement.