WASHINGTON (AP) — President Donald Trump warned Monday that the nation’s health care system was in danger of imploding and said Congress must make fundamental changes to the sweeping health law passed by his predecessor.

Trump said at a White House meeting with dozens of governors that he hoped to overhaul the American tax system but that was a “tiny little ant” compared to what he would need to do to remake the so-called Obamacare law.

The president’s first major meeting with governors comes as Congress prepares to move forward on a repeal and replacement of the health care law, one of Trump’s main campaign promises. Governors have raised concerns that the changes could undermine their efforts to expand Medicaid in their states and leave them stuck with a bigger share of the health care tab.

“It’s an unbelievably complex subject. Nobody knew that health care could be so complicated,” Trump told the governors.

Trump met later Monday morning with health insurance executives, some of whom are worried that the uncertainty over the health care law’s future is spilling into the marketplace.

The president and the Republican-led Congress have made the overhaul of the health care law one of their top priorities at the start of Trump’s administration.

The Affordable Care Act has subsidized private health insurance available in all 50 states while an optional Medicaid expansion has been accepted by 31 states and the District of Columbia. The two components cover more than 20 million people.

A report by the consulting firms Avalere Health and McKinsey & Company presented to the governors during a weekend of meetings with the National Governors Association concluded that the changes under consideration by the GOP-led House would reduce significantly federal funding for Medicaid and subsidize private insurance, creating funding gaps for states and threatening a loss of coverage for many participants.

Without offering specific details about what he wants in a replacement package, Trump said the current health insurance market is “going to absolutely implode” and called on the executives to work with the government on a way forward.

“We must work together to save Americans from Obamacare,” Trump said.

A group of Republican governors said after the meeting that Trump would provide details of his repeal and replace plan in his address to Congress on Tuesday night. They declined to offer specifics in deference to the president.

The GOP governors said Obama’s health overhaul had focused on access to health care, but had failed to contain costs.

“This is a time for reform, to broaden the issue from beyond coverage to how do we do better quality, better cost-containment for long-term and ultimately it’s about compassion,” said Michigan Gov. Rick Snyder. “We’re talking about real people here.”

The insurers said after their meeting that Trump and Health Secretary Tom Price pledged to stabilize the insurance markets and bring down costs in the industry.
“President Trump and Vice President Pence were very clear that they will work toward a clear transition,” said Dan Hilferty, CEO of Independence Blue Cross.

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