The order declares it is the policy of the United States for people with preexisting health conditions to be protected, avoiding the thorny details of how to ensure such protections without either leaving the ACA, or Obamacare, in place or crafting new comprehensive legislation…

“The historic action I’m taking today includes the first-ever executive order to affirm it is the official policy of the United States government to protect patients with preexisting conditions,” Trump said, despite the fact such protections are already enshrined in law. “We’re making that official. We’re putting it down in a stamp, because our opponents, the Democrats, like to constantly talk about it.”

The speech and executive order stood as a tacit admission that Trump had failed to keep his 2016 promise to replace his predecessor’s signature achievement with a conservative alternative. For a president who campaigned in 2016 pledging to “repeal and replace” the ACA, Trump’s 2020 signature health-care speech instead expressed a willingness to keep the law largely in place. Unable to repeal the law, Trump appeared open to simply rebranding it.