Mulvaney Guarantees No One will Lose Coverage if ACA Declared Illegal… But That Doesn’t Make Sense

White House chief of staff Mick Mulvaney said people would not lose health coverage if the ACA was struck down in a lawsuit supported by the Trump administration. However, that doesn’t make sense.

He can’t guarantee no one will lose coverage, in fact, it is almost certain that people will lose coverage unless the ACA is effectively re-written and re-passed to ensure at least the same protections and benefits of the ACA or better.

Here is the logic.

I can’t know for sure, but I think Mulvaney is implying that because the final version of the repeal and replace plan that couldn’t pass the Senate back when repeal and replace was attempted protected pre-existing conditions, that “therefore pre-existing conditions will be protected.” So let’s put aside the fact that the version prior to that final version did not fully protect pre-existing conditions, and just assume this is what he meant and that all future plans will.

Even assuming that, we still have a problem.

The problem with this is that Congress has to pass a replace plan if the ACA is struck down in the ongoing court case supported by the Trump administration. Replacement legislation isn’t up to Trump or chief of staff Mulvaney, it is up to Congress. Thus, the executive cannot promise anything.

The reality is, if the ACA is struck down in the courts, pre-existing conditions protections will be struck down as well… as will every protection, expansion, bit of cost assistance, and everything else contained in the ACA that relies on it existing to be enforced. From there Congress will then have to agree on a new healthcare plan that offers the same protections or better.

If Congress can’t agree, then Americans lose everything, including pre-existing conditions protections, cost assistance, and potentially even expanded Medicaid (since that relies on funding from the ACA).

If Americans lose all of that, then many will lose coverage.

Meanwhile, if Congress can’t match the current system or do better, than at least some are likely to lose coverage.

So therefore, what Mulvaney said does not match up with what is actually the case.

The above is literally how the system works. So we can say “the debate about pre-existing conditions is over”… but the reality is, it is not over if the ACA is repealed, because the debate about how it will be replaced must be had and that debate must then lead to new legislation agreed on by Congress that is enacted in time to ensure everyone keeps their coverage.

For more reading, see: White House chief of staff Mick Mulvaney guarantees no one will lose coverage if Obamacare struck down.

OPINION: If winning this court battle and getting rid of the ACA only to replace it with a similar plan is the goal… then what is the point? Is the point just to undo something Obama did? If the goal is only a few slight tweaks, then why not do this through the executive and legislative like it has been done? The biggest gripe people had, the mandate, is already gone? Why go after the parts people like only to have to re-pass those parts again in a hurry? This whole thing doesn’t add up in my opinion.

Author: Thomas DeMichele

Thomas DeMichele is the head writer and founder of,, and other websites. He has been in the health insurance and healthcare information field since 2012. is a...

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