Obamacare will be the next president's first crisis

Going into the 2016 election, the general prospects for Obamacare under a new president seemed fairly straight forward: If a Republican won, the program as passed would be in jeopardy; if a Democrat won, it would remain intact.

But the quickly mounting failures of the law have made things far more complicated. Now it's looking like either Hillary Clinton or Donald Trump is going to enter the White House facing a crumbling individual insurance market — without sufficient support in Congress to address the problem. This will cause an early face-off between the president and Congress, not unlike the 2011 debt ceiling crisis or 2013 government shutdown.

Here's the basic problem. Obamacare has not signed up enough young and healthy individuals in its insurance exchanges to offset the cost of covering older and sicker enrollees. Insurers have been racking up billions of dollars in losses and have responded through a combination of hiking premiums, reducing the number of doctors and hospitals within their networks, or exiting markets altogether. These market exits have left consumers with fewer choices, and put even more pressure on the remaining insurers who now have to absorb yet more high-risk enrollees.

There's no reason to believe things are going to get better in 2017. Higher premiums, narrow networks and limited choices are likely to make Obamacare coverage an even less attractive product to younger and healthier Americans who don't have as urgent of a need for coverage. Furthermore, several programs within Obamacare meant to help insurers manage risk are set to expire at the end of this year.

As more and more insurers feel the heat from investors and exit markets and premiums grow beyond reach, the new president will face calls to do something to address the urgent crisis. But it's unlikely that the political conditions will make this possible.