Protestors march in favor of protecting the Affordable Care Act. Photo: Erik McGregor/Pacific Press/LightRocket via Getty Images

The Justice Department now says the courts should strike down the entire Affordable Care Act — not just its protections for pre-existing conditions. The department signaled its new, broader position in a legal filing Monday, part of a lawsuit challenging the law's individual insurance mandate.

Why it matters: A ruling striking down the entire ACA would upend major parts of the health care system. Millions of people would lose their health care coverage, and a host of seemingly unrelated policies — including new experiments in how Medicare pays for care and an entire class of prescription drugs — would also go out the window.

How it works: A federal judge ruled in December that the ACA's individual mandate has become unconstitutional, because of the way Republicans zeroed out the penalty for being uninsured.

  • He said the entire ACA had to fall along with the mandate — the position the Republican attorneys general who brought this lawsuit had advocated.
  • At the time, the Justice Department had agreed that the mandate was unconstitutional, but said only 2 other provisions needed to go — the one requiring insurers to cover people with pre-existing conditions, and the one prohibiting them from charging those customers a higher premium.
  • Now, though, the Justice Department says it agrees with the judge's entire opinion, and won't challenge any part of that ruling as the case heads through the appeals process.

What's next: The case is pending before the 5th Circuit Court of Appeals — the most conservative appeals court in the country. From there it would go to the Supreme Court.

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