After failing to repeal Obamacare outright through congressional legislation, Trump issued an executive order that would deregulate parts of the insurance industry and strip back some restrictions on the coverage insurers can offer.

Trump said the measure would “increase competition, increase choice” and impact millions.

“This will cost the United States government virtually nothing, and people will have great, great health care. And when I say people, I mean by the millions and millions,” he said at a White House signing ceremony.

“Seven years ago, congressional Democrats broke the American health care system by forcing the Obamacare nightmare onto the American people,” Trump added.

But Democrats said Trump’s move amounted to “sabotaging the system” by creating a race to the bottom, including lifting restrictions that prevented insurance companies from barring coverage to people with pre-existing conditions.

“If the system deteriorates, make no mistake about it, the blame will fall squarely on the president’s back,” Senate Minority Leader Chuck Schumer said.

While Obamacare brought millions more Americans health care coverage, Republicans argue it represents government meddling in the market. They have also blamed the seven-year-old law for a spike in premiums for millions who purchase insurance through the individual marketplaces.

Several congressional efforts to repeal and replace the Affordable Care Act failed this year, with the latest collapse coming after three Republican Senators announced their opposition.

One of them was Senator Rand Paul. But Kentucky Republican was all in on Trump’s executive order because it included reforms similar to those he had proposed.

“President Trump is doing what I believe is the biggest free market reform of health care in a generation,” Paul said at the signing ceremony.

The order notably will allow people to purchase health care plans across state lines, a move championed by conservatives as a market-based fix that would increase competition and drive down prices.

Health experts are not in agreement on what selling insurance plans across state lines might do to the market.

But the Alliance of Community Health Plans, a health policy group, warned that the move could hamper efforts to stabilize Obamacare insurance markets.

“Instead, it would draw younger and healthier people away from the exchanges and drive additional plans out of the market,” causing premiums to continue to increase and threatening coverage for millions of working families, ACHP said in a statement. DM