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Affordable Care Act supporters support a 2015 Supreme Court ruling upholding the law's subsidies. Photo: Mark Wilson/Getty Images

Most of the discussion of the Trump administration's decision not to defend the Affordable Care Act — and to urge the courts to throw out its protections for people with pre-existing medical conditions — has focused on what happens to the individual insurance market. But the political impact may be even greater.

Why it matters: Protections for people with pre-existing conditions are hugely popular, and the administration may have handed Democrats their strongest health care weapon yet — because now they can make the case that the administration has gone to court to take away protections for people with pre-existing medical conditions.

The case is also likely to drag on, so it could be the political gift that keeps on giving through 2020, even if it is eventually thrown out.

The back story: The lawsuit that the Trump administration has embraced is the latest assault on the ACA’s marketplaces, and appears to be motivated both by continuing anti-ACA sentiment and a belief that the ACA’s consumer protections drive up rates. No alternative to protect people with pre-existing conditions is offered.

The impact:

  • A lot of people would be affected. Our analysis at the Kaiser Family Foundation found that 52 million non-elderly adults had pre-existing conditions that would have made them uninsurable prior to passage of the ACA. Even more people had health conditions that would lead to premium surcharges based on their health.
  • And they know it. Our March tracking poll found majority support across the board for prohibiting insurers from charging sick people more: 84% of Democrats support that part of the ACA, but so do 68% of independents and 59% of Republicans.
  • 64% of Republicans still favor repeal of the ACA, but they do not favor repeal of protections for people with pre-existing conditions.   

What to watch: The denial of protections under the lawsuit would apply only to people in the individual market, because people in the group market are protected under other federal laws. But it may not play that way in the real world. Everyone with a pre-existing condition would likely be scared, just as most Americans were worried that their rates were increasing when rates spiked in the relatively small non-group market.

Polls show that the public largely holds the Trump administration and Republicans in Congress responsible for problems with the ACA, and Democrats are accusing Republicans of ACA "sabotage." Republicans claim the problems are with the ACA itself, and they'd still like to repeal it — or change the subject to their repeal of the unpopular individual mandate penalty.

This lawsuit ending protections for people with pre-existing conditions changes the equation. It's an action the administration and Republican states will have taken directly themselves that would end these popular protections.

The bottom line: Democrats will try to force Republican candidates to take a position on the lawsuit. The question is how far Democrats will hit this this slow curve ball. 

Go deeper

McCarthy jokes about hitting Pelosi with gavel if he becomes Speaker, in new audio

Kevin McCarthy. Photo: Win McNamee/Getty Images

House Minority Leader Kevin McCarthy (R-Calif.) can be heard saying "it would be hard not to hit" House Speaker Nancy Pelosi with the speaker's gavel if Republicans retake the House in 2022 and he becomes speaker, according to new audio posted to Twitter by a Main Street Nashville reporter.

Driving the news: McCarthy made the comments during a fundraising event in Tennessee, as he was handed an oversized gavel by members of the Tennessee congressional delegation, reports CNN.

Updated 2 hours ago - World

U.S. and U.K. blame Iran for drone strike on oil tanker

Britain's Foreign Secretary Dominic Raab. Photo: Sameer Al-DOUMY / AFP

Secretary of State Antony Blinken and British Foreign Secretary Dominic Raab said on Sunday that the United States and United Kingdom, respectively, now believe Iran was likely responsible for last week's drone strike on an oil tanker in the Arabian sea.

Why it matters: The United States and Britain now join Israel in accusing Tehran of being behind the July 29 attack off the coast of Oman. Iran has denied involvement.

9 hours ago - Sports

Suni Lee wins bronze medal in uneven bars

Photo: Laurence Griffiths/Getty Images

U.S. gymnast Sunisa "Suni" Lee won her 3rd Olympic medal on Sunday, taking home bronze in the individual uneven bars event.

Driving the news: Also on Sunday, U.S. gymnast MyKayla Skinner won the silver medal in the vault on Sunday after stepping in for Simone Biles, who withdrew from the event to prioritize her mental health and well-being.