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The Trump administration has widened its opposition to the Affordable Care Act. This position comes on the heels of a December 2018 decision by a Texas federal district court striking down the entire law as unconstitutional. Initially, the administration did not support the invalidation of the entire law. Instead, the administration only considered invalid the ACA’s protection for people with pre-existing conditions, but stated that the rest of the law should remain in force. However, in a recent two-sentence letter to the court, the Department of Justice changed its position by stating that the court’s full decision invalidating the entire law should be upheld by the Court of Appeals.
The reason for the shift in the administration's opinion is not clear, but it may be the result of the appointment and confirmation of Attorney General William Barr. At his confirmation, he stated that he was interested in reviewing the litigation surrounding the validity of the law. If the entire law is invalidated, millions of people could lose health insurance coverage that they had access to through the ACA’s Medicare expansion or individual health insurance marketplace.