President-elect Donald Trump has promised to repeal and replace Obamacare with "something terrific." His pick to lead HHS has called for radical overhauls of Medicare and Medicaid, and the Republican-controlled Congress has the votes to get it done, or not.
For better or worse, the next 12 months could be the most unsettled period for the healthcare sector in decades. Or, not much could happen.
The only thing that's certain is uncertainty.
We could see the complete unravelling of the Affordable Care Act, or not. President-elect Donald Trump vowed throughout his campaign to repeal and replace it with "something terrific" on his first day in office.
Now that the election is over, however, there are mumblings that the repeal could go forward, on a delayed track, while the "replace" component could take years to craft, and most certainly won't occur before the mid-term elections in two years.
In large part, that's because the ACA is mind-bogglingly complex, entrenched and expansive, and Republicans have so far provided only a vague outline of a potential replacement, and they don't want to do anything to anger voters.
It's not clear what any of this will mean for the approximately 20 million people that HHS says have gained health insurance in some form through the ACA, or how trimming the ranks of the insured would affect hospital operations.
The presumption is that it would not be a good thing for hospital bottom lines.
John Commins is a senior editor at HealthLeaders.