President Trump announced Thursday that he would seek to guarantee health care coverage for Americans with preexisting conditions, a protection that is already part of the Affordable Care Act his administration is seeking to repeal.

“The historic action I’m taking today includes the first-ever executive order to affirm it is the official policy of the United States government to protect patients with preexisting conditions,” Trump said at an event in Charlotte, N.C., where he signed an executive order that he claimed would improve health care in the U.S.

Under the ACA, which was passed under former President Barack Obama, Americans with preexisting health conditions cannot be denied health coverage by insurers. Trump’s new executive order, meanwhile, amounts to a pledge and comes after he has repeatedly attempted to gut current health care law.

On a call earlier in the day, White House officials said that Trump’s “protections” for preexisting conditions would not actually be law should the ACA be repealed, but were a “defined statement of U.S. policy.” The White House also announced that Trump would be giving Congress a Jan. 1 deadline to pass legislation on surprise medical billing and encouraging more health care choice.

Without protections for preexisting conditions provided by Obamacare, the Kaiser Family Foundation estimated in 2016 that up to 52 million people could be denied coverage. Millions more would lose insurance if the Medicaid expansion that was adopted by dozens of states and Washington, D.C., is killed. A full repeal with no immediate replacement plan could also hurt the fight against opioid addiction and HIV.

For years, Trump has promised he would unveil a health care plan that would cost less than the ACA, or Obamacare, while providing better coverage. A Fox News poll released earlier this summer found that a record high of 56 percent of U.S. voters had a favorable view of Obamacare, which was up 4 percent from the prior year.

In June, the Trump administration filed a brief to the Supreme Court urging it to overturn the ACA in a case backed by 20 Republican-led states. The brief included a section arguing that the ACA’s protections for those with preexisting conditions must be overturned as well, contradicting Trump’s repeated statements that he and Republicans supported maintaining them.

“If we win, we will have a better and less expensive plan that will always protect individuals with preexisting conditions,” Trump claimed Thursday, failing to mention that his administration has not produced a replacement plan for the millions who rely on the ACA for care, much less a bill to be debated in Congress.

Health care was a top issue for Democrats in 2018, when they retook the House in the midterm elections. According to a Washington Post report, GOP House Leader Kevin McCarthy blamed the party’s failures in the 2018 midterms on their attempts to roll back preexisting conditions. The issue is expected to be a key focus again in the wake of the death of Justice Ruth Bader Ginsburg. Democrats have already stated that if Trump is allowed to replace Ginsburg with a sixth Republican-appointed justice on the nine-person panel, then the ACA and the health care of millions are in danger. On Sunday, Biden said voters “know their health care hangs in the balance in the middle of the worst health crisis in living memory.”

More than 202,000 Americans have died from the coronavirus and millions have lost their health insurance due to unemployment.

Republicans made a sustained effort to replace the ACA with a new plan during the first two years of Trump’s term, when they had control of both chambers of Congress in addition to the White House. The Congressional Budget Office found in March 2017 that the American Health Care Act (AHCA), the Republicans’ replacement proposal, would knock 14 million people off insurance in one year and 24 million more by 2026, while the AARP estimated it would raise health care costs for older Americans by thousands of dollars.



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