Kayleigh McEnany hails Trump's support for pre-existing condition coverage – despite his efforts to end policy

Administration's attempt to dismantle landmark Obama-era law could strip millions from insurance

White House press secretary Kayleigh McEnany discussed her mastectomy and breast cancer scare in remarks at the Republican National Convention, saying the first calls she received at the hospital were from Donald Trump and his daughter Ivanka Trump.

"This president stands with Americans who have pre-existing conditions," she said.

The president has actively sought to dismantle the Affordable Care Act, of which a crucial component prevents health providers from denying coverage to people with pre-existing conditions. He has not offered a replacement, should the US Supreme Court rule against the law, which has insured millions of people.

"As I came out of anaesthesia, one of the first calls I received was from Ivanka Trump," she said. "As I recovered, my phone rang again. It was President Trump, calling to check on me. I was blown away."

She told Americans that she has fought within the administration to protect the future for her nine-month-old daughter.

"When I look into my baby's eyes, I see a new life, a miracle for which I have a solemn responsibility to protect," she said. "That means protecting America's future."

The president's Justice Department has asked the Supreme Court to invalidate the ACA, a signature health policy under Barack Obama that the president's Democrat rival Joe Biden has pledged to expand if elected.

In an interview on 19 July, the president promised a "full and complete" health plan "within two weeks" to replace the ACA, following efforts among Congressional Republicans to "repeal and replace" a measure that has insured more than 20 million Americans and expanded Medicaid coverage eligibility. The president did not produce a plan.

The administration has rolled back several key elements of the law, including eliminating the "individual mandate" that forced a penalty to Americans who did not have insurance. The removal of that part of the law has served as a legal basis to invalidate the law.

Officials have also rolled back policies that allow health providers to deny coverage and care to women and transgender people, part of an administration-wide effort to rewrite sex discrimination policies across housing, education and employment sectors.

Stripping pre-existing coverage from the ACA could impact roughly 54 million Americans, according to the Kaiser Family Foundation.

The challenge to the law is under way during the coronavirus pandemic that has seen millions of Americans lose employer-provided insurance coverage after layoffs and business closures.

An estimated 5.4 million Americans lost their health insurance within the first few months of 2020. More Americans became uninsured between February and May than over any year in history, according to a report from nonpartisan consumer advocacy group Families USA, which compiled state-by-state reports estimating Covid-19's impact among workers under 65.

In that time, at least 22 million Americans lost their jobs or left the workforce.