There will be no death spiral, just more taxes and the redistribution of wealth to keep it going. Obamacare is too big to fail. It will be just like SS and Medicare, which have an unfunded liability of over $60 trillion over the next 75 years.
No economy can bear pressure as is being applied to our's indefinitely.
Things that can’t go on forever, don’t, at some point.
It won’t be pretty.