Mr. Bertolini of Aetna predicted: “There will be a repeal first, and I think the repeal will be at a minimum in name.”

It’s nearly impossible for the law to be replaced with the flip of a switch. “Because what’s going to happen in the next year?” he said. “We have people signed up; we have to honor that through 2017. We’ll have to work quickly to have something for 2018.”

Mr. Bertolini said that whatever replacement plan might materialize, the government was not going to just stop insuring the 20 million or so people who are covered under the Affordable Care Act. “You can’t put them out on the street without insurance,” he said. His expectation is that Medicare Advantage will be expanded.

The backpedaling on the “repeal” pledge has already begun: Mr. Trump has said in the past several days that he intends to make sure that health insurers will not be able to turn away people with pre-existing conditions, and that people under the age of 26 will still be able to have coverage under their parents’ plans.

About the latter provision, Mr. Trump said he would “very much try and keep that.” In an interview with Lesley Stahl of “60 Minutes” that aired Sunday night, the president-elect said that the measure “adds cost, but it’s very much something we’re going to try and keep.”

Of course, the biggest question is how Mr. Trump is going to create a new manufacturing class in America. He has suggested that he is going to renegotiate trade agreements, increase tariffs on goods and deport illegal immigrants — both for security reasons, he contends, and because they take jobs from Americans. How those ambitions ultimately play out is anyone’s guess.

One issue that Mr. Trump has seemingly avoided is that of how new technologies are steadily taking American jobs.