Donald Trump is the U.S. President-elect, and everyone who writes and cares about health insurance and health care policy in America is eager to learn what he and his Republican colleagues in the House and Senate will do with the Affordable Care Act (aka, Obamacare). Will they repeal it? Replace it? Both? Neither? We can reasonably expect that over the next four years, Trump will sign off on some policy changes to Obamacare and millions may lose their health insurance.

Still, the larger Obamacare repeal and replace questions remain, will Speaker of the House, Paul Ryan, get to institute his Better Way (to Fix Health Care) outline? Or will professional President Obama hater and Senate Majority Leader, Mitch McConnell, get to declare Obamacare a total failure with no need to replace? It's looking increasingly likely that they may both get what they want although not because of any powers of persuasion they have, but because repealing and replacing Obamacare will help some Trump family members and friends.

Before he won the election, Trump said he would repeal and replace Obamacare with "something much better for everybody." He also called Obamacare, "A complete disaster." But after he won the election, he said that there are parts of Obamacare that he likes and wants to keep: allowing children to stay on their parents' health plan up to age 26 and the one about people with preconditions (he meant pre-existing conditions, but he's careless and uninformed). Then last week it was reported that Trump has family and friendship ties to a health insurance start-up, Oscar Insurance, that isn't doing so well.

Josh Kushner is Jared Kushner's (Trump's daughter, Ivanka's husband's baby brother) and a co-founder of the health insurance company start-up, Oscar Insurance. Oscar reportedly raised about $750 million from wealthy investors, including Peter Thiel. Thiel supported Trump’s campaign. Thiel is not the only big name tech investor to support Oscar; other investors include—Hong Kong billionaire, Li Ka-shing’s Horizon Ventures, hedge fund billionaire, Stanley Druckenmiller, Joel Cutler, Velos Partners, BoxGroup, Breyer Capital, CapitalG, Goldman Sachs, Fidelity Investments, Alphabet and more.

A little about Oscar Health Insurance…

Josh Kushner, Mario Schlosser and Sina Kevin Nazem founded Oscar in 2013. Oscar is a health insurance company that sells individual health insurance policies, mostly in New York and New Jersey but expanding to California and Texas. Oscar was one of the many companies looking to make money in the individual health insurance market expanded via Obamacare.

The founders all had their stories of how they found the way traditional health insurance companies did business confusing. And get this, because this is important—initially their business model was to sell some tech products to the big health insurers. When the big guys turned them down because they could lease these tools and pass the cost on to policyholders, they had the brilliant idea of starting their own health insurance company and using the tech toys no one wanted to give them an edge. According to their website, their objective is to be "a new kind of health insurance that is using technology to make insurance simple, intuitive and human. In other words, the kind of healthcare we want for ourselves."

Let me add my own in other words. In other words, these three youngish, wealthy, tech-savvy guys who tried to read and understand their insurance policies and billing statements assumed there were millions of others like them. They thought tech tools for price transparency, telemedicine, medical bill tracking and finding doctors could entice millions of young tech-savvy people to suddenly develop an interest in health insurance. All the while leaving out one of the most important tech features this population needs—a health insurance recommendation tool like the one created by a real health insurance tech start-up, HoneyInsured. Oscar may be one of the worst ideas in health insurance to come along in a very long time.

The target market that Oscar went after, young individuals not covered on their parents' health plan are some of the most clueless and disinterested people (not all of them, of course) in health insurance. Not only that, they are willing to go without health insurance to save a few bucks. They are not wealthy start-up owners. They don't want to engage with their health insurance, no matter how cool the app because health insurance is not cool. And, the big health insurers (Aetna, Anthem, Cigna, UnitedHealthcare, Kaiser, etc.,) already have decent tech and okay customer service.

How Trump Can Help

So what does Oscar do now to stop hemorrhaging its investors' money? For now, reduce their individual market presence and enter the group market where the healthy, engaged people are (only the big insurers already have this market locked up). And this is where Donald Trump can help. He can do away with the exchanges and offer tax subsidies to individuals. He can cap the tax subsidies of group plans, even equalizing them with individual ones. He can privatize Medicare and Medicaid, making it easier for young, hungry start-ups to get a piece of the public health insurance pie. He can do whatever Oscar and its investors need him to do to ensure their success regardless of how it may impact the rest of us. And Paul Ryan and Mitch McConnell had nothing to do with it.

Tags: obamacare, Trump, Oscar Insurance