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Posted: 2018-06-20T18:42:32Z | Updated: 2018-06-20T18:42:32Z

The latest legal assault on the Affordable Care Act is downright laughable, but the consequences would be deadly serious if it succeeded.

President Donald Trump and congressional Republicans failed to repeal the Affordable Care Act last year despite making a real go at it, and conservative activists and state officials failed in two previous attempts to get the Supreme Court to overturn or upend the law. Now theyre trying again to get the judiciary to do their dirty work for them.

The Trump administration is now taking the nearly unprecedented step of refusing to defend the law against a legal challenge from elected GOP officials in 20 states.

Those state officials maintain that the Affordable Care Acts individual mandate is now unconstitutional because Congress repealed the tax penalties owed by those who fail to comply with it. And, further, they say the entire law must fall if the mandate doesnt conform to the Constitution.

The Trump administration merely wants the court to throw out the protections for people with pre-existing conditions. This, by the way, is separate from all the other stuff Trump is doing to damage the Affordable Care Acts insurance markets.

Before reviewing the absurd legal arguments of the U.S. Department of Justice under Attorney General Jeff Sessions , its important to be clear about what would happen if these Republican officials succeed.

At a minimum, a ruling against the Affordable Care Act would eliminate the most popular part of the law President Barack Obama enacted in 2010: the ban on health insurance companies rejecting people or charging them higher premiums because of pre-existing conditions.

A ruling in favor of the state officials or the Trump administration would herald the return of the days when people with any black marks on their medical histories could find themselves uninsurable.

It might seem bizarre for the Trump administration to call for the end to a consumer protection that the vast majority of Americans support in the middle of an election year in which Democrats already are attacking the GOP for harming the insurance markets and driving up costs .

But the Justice Department lawyers thought of that. They asked the federal judge in Texas hearing the case to hold off on wrecking the insurance market until January a couple of months after the midterm elections.

A ruling in favor of the state officials or the Trump administration each of which wants to court to blow up the Affordable Care Act in a different way would herald the return of the days when people with any black marks on their medical histories could find themselves uninsurable.

Applications for health coverage would once again require consumers to detail every time theyve been sick or injured, going back as far as 10 years, so that insurers could decide whether to issue a policy and how much to charge.

In other words, those with the greatest need for health care would again face the biggest obstacles to getting it.

But this wouldnt affect only people with histories of serious or chronic illnesses, such as cancer or diabetes. Women who have experienced postpartum depression or underwent Caesarean sections could be tagged as having pre-existing conditions. A high school sports injury or adolescent acne could even be enough for an insurance company to deny coverage or jack up rates.

This is how it worked before the Affordable Care Act for those who dont get health benefits from a large employer or a government program like Medicare.