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Trump's pre-existing conditions promise clashes with ACA lawsuit

President Trump said in an exclusive interview with "Axios on HBO" that he'll reinstate protections for pre-existing conditions if a lawsuit — which his administration supports — guts the Affordable Care Act. But Republicans have never come up with a replacement plan that would offer the same level of protection as the ACA.

The intrigue: Trump also said Attorney General Jeff Sessions didn't give him a heads-up before urging a court to throw out the ACA's provisions on pre-existing conditions. But Sessions has said Trump signed off on the move.

The big picture: The Justice Department is arguing that the courts should strike down the Affordable Care Act’s individual mandate and toss out its protections for people with pre-existing conditions in the process.

  • If that position ultimately prevails, millions of people could lose their coverage or see their costs skyrocket.
  • Republican attorneys general want the court to strike down the entire law, which would have the same effect.

“It wouldn’t matter” if those ACA provisions are struck down, Trump said, “because pre-existing conditions, on anything we do, will be put into it.”

  • “I support terminating Obamacare, but if we terminate it, we will reinstitute pre-existing conditions in whatever we do,” he said.

Trump has said this throughout the midterm campaign season. But in the eight years since the ACA passed, Republicans have never proposed an alternative that would offer the same level of protection.

  • Their proposals have either been underfunded or have left gaps that would still expose some people to higher costs and denied coverage.

Where it stands: Judge Reed O’Connor, a George W. Bush appointee, is expected to rule any day now, and oral arguments seemed to go poorly for the ACA’s allies.

  • DOJ’s position in the case has already caused plenty of headaches for Republican candidates in the midterms.

Axios asked Trump whether Sessions had told him that this was coming.

  • “No, he didn’t, actually,” Trump said.
  • But Sessions has said he took this politically explosive position “with the approval of the President of the United States.”
  • The Justice Department referred questions about the discrepancy to the White House.
  • “Litigation decisions are typically handled through the White House Counsel’s office on behalf of the President,” White House Press Secretary Sarah Sanders said when asked about the conflicting answers. “The issue presented in this case is a technical constitutional issue and does not represent the Administration’s general position on pre-existing conditions.”

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