The Trump administration on Monday adopted a more extreme position on a lawsuit challenging the Affordable Care Act: Instead of asking the federal courts to throw out just one part of the law, as it had done previously, now the administration wants the courts to throw out the entire thing.

Protections for people with pre-existing conditions, tax credits for lower- and middle-class insurance buyers, expanded state Medicaid programs for the poor ― all of these things would be gone, and millions of people would lose health insurance if the administration gets its way.

And the effects would not stop there. The health care law includes all kinds of other, lesser-known provisions, touching everything from the way Medicare pays hospitals to the calorie counts on food menus.

“The notion that you could gut the entire ACA and not wreak havoc on the lives of millions of people is insane,” Nicholas Bagley, a University of Michigan law professor and expert on the health care law, wrote in a quick reaction article at “The Incidental Economist” website. “The Act is now part of the plumbing of the health-care system.”

It was less than two months ago that President Donald Trump, during the State of the Union address, declared that one of his priorities was “to protect patients with pre-existing conditions.” It was a vow he has made repeatedly, going back to the 2016 campaign ― and yet it is one he has also broken repeatedly.

Trump spent most of 2017 trying to pass legislation that would repeal Obamacare, as the ACA is known. When that failed, his administration focused on using its regulatory authority to undermine the law.

And in the summer of 2018, the administration decided to back this latest lawsuit against the Affordable Care Act. That was a highly unusual move, because by tradition the executive branch defends federal statutes in court — even those the president might oppose.

To be clear, the lawsuit still has a long ways to go before prevailing.

Although it got a favorable ruling from a federal district judge in Texas, it is currently before the U.S. 5th Circuit Court of Appeals. If it gets past the 5th Circuit, it would almost certainly go before the U.S. Supreme Court, which has already turned away two major challenges to the 2010 health care law. And those cases were widely viewed as more serious than this one.

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