If, as he has said, President Trump undermines the implementation of the Patient Protection and Affordable Care Act, if he acts contrary to the execution of the law and, in his words, will "...Let it fail", he will be in violation of the Take Care Clause of the Constitution and that will be grounds for Impeachment and possible removal from office.

He is arguably already in violation, as he has taken steps to limit or minimize federal payments to the states.

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