This year is likely to be a “period of uncertainty and flux” for health insurers due to the political debate on repealing the Affordable Care Act (ACA), according to Deloitte’s 2017 health insurance industry outlook.

“Political change and disruption, market disruption prompted by political change is likely to be the number one issue not just on January 1, obviously before the January 20 inauguration Day and probably too early in the year to have anything approaching an understanding of what sort of statutory and regulatory change from Washington DC will come to health plans,” said Deloitte’s U.S. health plan practice leader Greg Scott.

Beyond the ACA concerns, Scott expects affordability to dominate discussions between providers and insurers. While healthcare spending continues to grow, consumers are being asked to shoulder more of the costs, which is a trend insurers shouldn’t ignore, according to Scott.

“The share of the burden of American healthcare, the costs of American healthcare, that has shifted over recent years to the consumers, is really amazing,” he said.

For more on how the shift to value-based care and consumer priorities will affect the insurance industry in the next year, read the full interview below: