WASHINGTON — Democrats Pivot Hard to Health Care After Trump Moves to Strike Down Affordable Care Act

The notice to the court, filed late Monday by the Justice Department, could not have come at a more opportune time for Democrats. The finding by Robert S. Mueller III, the special counsel, that there was no evidence of a criminal conspiracy between the Trump campaign and Russia, dashed the hopes of the most partisan Democrats that the House would impeach the president.

Speaker Nancy Pelosi — who celebrated her 79th birthday on Tuesday — had already planned to move to change the conversation with the unveiling of the Democrats’ own health care plan on Tuesday. The Democrats’ bill aims to lower health insurance premiums, strengthen protections for people with pre-existing medical conditions and ban the sale of what Democrats call “junk insurance.”

The Justice Department’s move gave the unveiling an urgency that not even she could have anticipated.

“The Republicans did say during the campaign that they weren’t there to undermine the pre-existing condition benefit, and here they are, right now, saying they’re going to strip the whole Affordable Care Act as the law of the land,” Ms. Pelosi told reporters Tuesday, adding, “This is actually an opportunity for us to speak to the American people with clarity.”

The administration staked out its new position in a lawsuit that was filed by Republican attorneys general in Texas and other states after Congress failed in 2017 to repeal the Affordable Care Act, but later reduced the law’s tax penalty for people who do not have insurance to zero. The suit contended that the absence of the real tax penalty rendered the law’s “individual mandate” — the requirement that most Americans have insurance — unconstitutional.

Without a requirement to purchase insurance, they argued, the law could not then insist that insurance companies cover pre-existing medical conditions and a suite of other “essential health benefits,” such as maternity care and prescription drugs.

A judge in Texas agreed and invalidated the entire law, including its expansion of Medicaid and subsidies to help many low- and middle-income people buy insurance. The Justice Department initially said that only parts of the law, including its protections for pre-existing conditions, should be struck down. But on Monday, it expanded its attack to say the whole law should be invalidated.

The Justice Department’s move caught both parties by surprise, and put Republicans in a very awkward position.

“Not only is this a poor political move, this decision hurts real people who will unfairly lose their health insurance coverage as a result,” said Representative Tom Reed, Republican of New York. “We need to work to find ways to fix our health care system — not blow it up.”

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Representative Kevin McCarthy of California, the House Republican leader, at first said, “I haven’t read through what they — was it last night?” He then added, “I think the president has always been very clear that he wanted to repeal Obamacare, and to put a system in that actually lowers the cost and protects individuals’ pre-existing conditions.”

Other Republicans were more pointed. Senator Susan Collins, Republican of Maine, whose vote helped sink the 2017 repeal effort and who is up for re-election in 2020, pronounced herself “very disappointed,” with the Justice Department’s position.

“I thought it was bad enough when last year they wouldn’t defend parts of the law, including the parts protecting people with pre-existing conditions,” Ms. Collins said. “This goes far beyond that and I think was a huge mistake.”

But Mr. Trump wholeheartedly embraced the new position on Tuesday, both on Twitter and in the Capitol, shortly before joining Senate Republicans at a closed-door luncheon. “The Republican Party will soon become the party of health care,” he told a throng of reporters and photographers, echoing what he had already written on social media.

The president used the closed-door meeting in the Capitol for a rambling, unscripted recitation of his legislative priorities, and repeated his intention to make the subject of health care a major issue over the next two years. That pronouncement elicited a muted response, according to a person in the room.

After the luncheon, Senator Lamar Alexander, Republican of Tennessee and chairman of the Senate health committee, echoed Mr. Trump’s message: “We have to become more the party of health care.”

That is not ground the Democrats will easily cede. After months of distracting talk about the Mueller report and impeachment, they are pushing hard to pivot toward the issues that helped elect them — not just health care, but also bigger pay checks and cleaner government.

On Wednesday, the House will vote on the Paycheck Fairness Act, which would amend a 1963 law to make it easier for women to challenge pay discrimination.

“The focus from the media has been all over Mueller, Russia and so forth,” said Representative Rosa DeLauro of Connecticut, a close ally of Ms. Pelosi. “Day in and day out, literally 24 hours a day. But lest you think that is the only thing that members are focused on, that’s wrong.”

At a closed-door meeting of House Democrats Tuesday morning, Ms. Pelosi praised Ms. DeLauro’s pay equity legislation and urged her fellow Democrats to “stay focused” on issues that matter to most people, not Washington partisans.

At his regular weekly news conference, Representative Hakeem Jeffries of New York, the Democratic Caucus chairman, studiously avoided the Mueller inquiry as he talked up the “For the People” agenda that they notionally campaigned on. “Nowhere in the For the People agenda does it talk about Russia,” he said. “Nowhere in the For the People agenda does it talk about collusion; nowhere in the For the People agenda does it talk about obstruction of justice.”

Instead, Mr. Jeffries attacked Republicans for “launching an assault on health care in the United States of America.”

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In the nine years since it was signed by President Barack Obama, the Affordable Care Act has become deeply ingrained in the nation’s health care system. It revamped the way Medicare pays doctors, hospitals and other health care providers. It unleashed innovation in the delivery of health care. Since its passage, the health insurance industry has invented a new business model selling coverage to anyone who applies, regardless of any pre-existing conditions.

The law also includes dozens of other less known provisions. Chain restaurants are now required to print nutrition labeling and calorie counts on standard menu items. Certain employers must now provide “reasonable break time” and a private space for nursing mothers to pump breast milk. The law also improved prescription drug coverage for Medicare beneficiaries, and created a new pathway for the approval of less expensive versions of advanced “biologic” medicines made from living cells.

Lawyers and other experts say that uprooting the law could have “dire consequences for millions of people,” in the words of Abbe R. Gluck, a law professor at Yale who has closely followed the litigation. It would also raise legal and practical questions.

“The Justice Department’s position is mind-boggling,” said Timothy S. Jost, an emeritus professor of health law at Washington and Lee University. “The Affordable Care Act affects the whole health care system, including Medicare, Medicaid, the Food and Drug Administration, the Indian Health Service and much more. The administration is asking the appeals court to invalidate the entire law without really knowing exactly what that would mean. It’s reckless.”

But Ken Paxton, the attorney general of Texas who led the group of Republican state officials who challenged the Affordable Care Act, said he welcomed the Trump administration’s latest expression of support for a lawsuit that had already prompted a district court judge in Texas to strike down the health law. That judge’s ruling in December has been on hold as the matter winds its way through the court system.

“We have always been confident that the district court’s extremely well-reasoned opinion was correct on the law, just as we have also always been confident that this administration takes its obligation to uphold the Constitution seriously,” Marc Rylander, a spokesman for Mr. Paxton, said Tuesday. “We applaud the Department of Justice’s faithful execution of that duty.”

In addition to inciting a furor on Capitol Hill, the administration’s new position is also certain to take center stage as an issue in the 2020 elections. Democrats have been saying that Mr. Trump still wants to abolish the law, and they can now point to the Justice Department’s filing as proof.

The Democrats’ offensive on health care is more than an effort to draw a contrast with Republicans. But in unveiling their bill on Tuesday, Democratic leaders were also trying to smooth over internal divisions between liberals pushing the single-payer government insurance plan known as “Medicare for all” and centrists, who are calling for a more incremental approach.

The House Democrats’ health care plan,, put together by Ms. Pelosi and several House committee chairmen, builds on the Affordable Care Act, which the speaker was instrumental in passing.

It would overturn a rule Mr. Trump issued in August that greatly expanded the market for sales of short-term insurance plans that do not have to cover prescription drugs, maternity care, drug abuse treatment or pre-existing conditions. And it would increase the two main types of financial assistance the law provides: tax credits to help low- and middle-income people pay premiums, and cost-sharing reductions to lower deductibles, co-payments and other out-of-pocket costs.

At Tuesday’s news conference, Democrats were eager to remind reporters that Mr. Trump said in the 2018 campaign that “Republicans will always protect patients with pre-existing conditions.”

“We will remind the American people time and time again of that broken promise,” said Representative James E. Clyburn of South Carolina, the No. 3 House Democrat.