Donald Trump has said that he will continue trying to revoke all of the Affordable Care Act, even as some in his administration, including attorney general William Barr, have privately argued that parts of the law should be preserved amid a pandemic.

“We want to terminate health care under Obamacare,” Mr Trump told reporters on Wednesday, the last day for his administration to change its position in a Supreme Court case challenging the law. “Obamacare, we run it really well … But running it great, it’s still lousy health care.”

While the president has said he will preserve some of the Affordable Care Act’s (ACA) most popular provisions, including guaranteed coverage for pre-existing medical conditions, he has not offered a plan to do so, and his administration’s legal position seeks to end all parts of the law, including those provisions.

Democrats, who view the fight over Obamacare as a winning election issue for them, denounced the president’s decision.

House speaker Nancy Pelosi said: “The president’s insistence on doubling down on his senseless and cruel argument in court to destroy the ACA and every last one of its benefits and protections is unconscionable, particularly in the middle of a pandemic.”

Mr Trump’s declaration caps months of debate within his administration about the best course of action, in which the stakes have become greater now that America’s health-care system is struggling to deal with the spread of Covid-19.

On Monday, Mr Barr attended a meeting of senior officials in which he argued that the administration should temper its opposition to Obamacare, leaving some parts of the law intact, according to people familiar with the discussion who spoke on the condition of anonymity because the conversation was private.

The case before the court was brought by a group of Republican states, and as part of that case, the Trump administration is seeking to invalidate the entire Affordable Care Act, which passed in 2010 and became one of president Barack Obama’s most significant legislative victories.

Mr Barr and others in the administration have argued that killing Obamacare completely could be politically damaging to Republicans in an election year, particularly at a time when there is a national health crisis. In two previous case, the Supreme Court upheld the law, but if the high court were to strike it down, millions of people could find themselves without affordable health care.

The high court plans to hear arguments in the case this year, and a decision may not come until 2021, well after the November election.

The latest ACA suit was organised by Republican attorneys general in Texas and other Republican-led states. When the Trump administration declined to defend the law, a coalition of Democratic-led states entered.

The case began after the Republican-led Congress in 2017, unable to secure the votes to abolish the law, reduced to zero the penalty for a person not buying health insurance. Lawyers for the state of Texas argued that in doing so, Congress had removed the essential tax element that the Supreme Court had previously ruled made the program constitutional.

A district judge in Texas agreed and said the entire law must fall. Eventually the Trump administration agreed with that assessment.

The Washington Post