U.S. President Donald Trump said on Wednesday that the Obamacare healthcare system is in a ¡°death spiral¡± and must be reformed soon, a day after insurer Anthem Inc. announced it would withdraw from the Ohio health care insurance exchange next year.

Trump has struggled to get a health care package passed by the U.S. Congress even though his Republican Party controls both the House of Representatives and the Senate. A House plan was approved on May 4, and the Senate is trying to pass a version this summer.

Trump, visiting Cincinnati, Ohio, to tout his infrastructure plan, met with several people who dislike former President Barack Obama¡¯s signature health care law, formally known as the Affordable Care Act, and afterward called on Congress to act.

¡°Obamacare is in a total death spiral and the problems will only get worse if Congress fails to act,¡± he said.

Trump spoke a day after Anthem announced it would not participate in the Obamacare insurance exchanges next year in Ohio, a potentially crippling blow to the health care system.

Trump said opposition from Democrats needed to be overcome in order to gain passage of a new law.

¡°It¡¯s only obstruction from the Democrats. The Democrats are destroying health care,¡± he said. ¡°It¡¯s only going to be Republicans or bust. The Democrats are really in our way.¡±