As Andy Slavitt, the former Medicare and Medicaid chief in the Obama administration, put it on Twitter, "Trump just made the 2020 election all about pre-existing conditions". "Someone has a pre-existing illness, they have to be assured - and I can assure them - that when they live in the state of OH and they're an OH citizen, we're not going to let them be in a position where they can no longer buy insurance".
Meanwhile, Democrats have vowed to defend the Affordable Care Act. "But more substantively, we should be finding areas where we can fix healthcare, and not continue this division of [repealing] Obamacare with no hardcore proposal as to what we're going to do about the millions of folks that are potentially adversely impacted".
Now the Justice Department is moving to eradicate the Affordable Care Act altogether, arguing that it has no constitutional authority. The ruling is on hold pending appeal.
But among Republican senators, there's reluctance to embrace Trump's new priority.
During his 2016 campaign, Trump repeatedly promised people with preexisting conditions that they would be covered under his health care plan. Polling has shown that the party's landslide electoral victory in the 2018 midterms was largely attributable to the health care debate following Republicans' repeated (and failed) efforts to repeal the ACA. "On Day One, the first day, as we were sworn in the 116 Congress, the House voted to intervene against Republicans' monstrous health care lawsuit", Pelosi said.
President Trump himself cited the sabotage of the ACA as the clear objective of the AHP Rule, proclaiming that it was a "truly historic step in our efforts to rescue Americans from Obamacare and the Obamacare nightmare" and would "escape some of Obamacare's most burdensome mandates".
"He didn't have to do it now", said House Republican Conference Chair Liz Cheney, R-Wyo., the third-ranking Republican in that chamber.
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Texas-based Judge Reed O'Connor issued his ruling in December following a lawsuit brought by conservative states, but later ordered a stay while an appeal lodged by Democratic attorneys general was being heard.
If the health care law is repealed, 21 million people could be left uninsured and the almost 52 million people living with preexisting conditions would be without future protections.
"Republicans, and particularly this administration, have shown yet again that their protection for the sick, the elderly, the folks in need of health care - which by the way is going to every single American at some point in this country, every single one of us - is essentially hollow", Kennedy said.
They have whittled away at the law, and managed to scrap the penalty imposed on anyone who fails to get insurance.
McEnany said that Democrats' frustration with the Affordable Care Act is "why they're not all doubling down on Obamacare, they're saying we've got to go to government takeover of health care", referring to Medicare for All, which the majority of 2020 Democratic presidential candidates support.
Healthcare was the top issue in last year's mid-term elections, which swept Democrats to power in the House of Representatives.