President Donald Trump has threatened to withhold key Obamacare subsidies for health insurers in order to force Democrats to negotiate a new deal.
Insurers say if the reimbursements to help cover out-of-pocket medical expenses for the poor are cut, it could send Obamacare into a death spiral.
But Mr Trump said the move might force Democrats to the negotiating table.
His comments come three weeks after Republicans failed to secure a bill to overhaul the US healthcare system.
"I don't want people to get hurt," he told the Wall Street Journal in an interview on Wednesday.
"What I think should happen and will happen is the Democrats will start calling me and negotiating."
Mr Trump vowed to repeal and replace the Affordable Care Act, former President Barack Obama's signature healthcare law, during the presidential election.
But he failed to do so during his first months in officer after a bill to overhaul the system was rejected by the Republican-controlled Congress due to a lack of support.
Mr Trump could cancel cost-sharing reductions (CSRs), which reimburse insurers for giving deep discounts to low-income Obamacare policyholders, by dropping the federal government's appeal in a contested legal battle with House Republicans.
Republican lawmakers sued the Obama administration over CSRs, arguing it was unconstitutionally spending money that Congress had not formally appropriated.
House Republicans won the legal challenge in April 2016 and the Obama administration appealed the decision. The lawsuit is ongoing.
If Mr Trump drops the appeal and cuts the payments, it would cause health insurers to hike premiums or leave the Obamacare market altogether.
Top Democratic Senator Charles Schumer responded to the president's remarks on Wednesday, saying he was "threatening to hold hostage healthcare for millions of Americans".
"This cynical strategy will fail," he added.
But Mr Trump also told the newspaper he would consider continuing the payments so he would not be blamed for the market chaos.
"The longer I'm behind this desk and you have Obamacare, the more I would own it."