'It’s not complex once you understand the basic concept of the “three-legged stool” of regulations, mandates and subsidies. But it has more failure points than Medicare or Social Security: people aren’t automatically signed up for coverage, so it's CRUCIAL that the officials running the system make it work, reaching out to potential beneficiaries to ensure that they know what’s available, while reminding currently healthy Americans that they are still legally required to sign up for coverage. The Times reported on 3 ways the Trump administration is sabotaging the A.C.A. . First, the administration is weakening enforcement of the requirement that healthy people buy coverage. Second, it’s letting states impose onerous rules like work requirements on people seeking Medicaid. Third, it has backed off on advertising and outreach designed to let people know about options for coverage.'