House Speaker Nancy Pelosi laid into President Trump for his State of the Union address during her weekly press conference on Thursday, accusing him of using Congress as a "backdrop for a reality show" and calling out his "appalling" comments about pre-existing conditions.

Why it matters: The tension between Trump and Pelosi continues to grow in the wake of the president's address Tuesday, which culminated in the speaker ripping up a copy of the speech on national television.

At the National Prayer Breakfast on Thursday, Trump took aim at Pelosi and suggested she used her faith as a false justification for impeachment.

What she's saying: Pelosi called Trump's address a "manifesto of mistruths," particularly with respect to his comments about health care.

"What happened instead was the president using the Congress of the United States as a backdrop for a reality show, presenting a state of mind that had no contact with reality whatsoever."

"It was quite appalling to hear the president say the 150 at least million families in America that are faced with preexisting conditions. A benefit that is afforded to them in the Affordable Care Act that he was protecting that benefit when, in fact, he has done everything to dismantle it."

Between the lines: Trump's claim that he will "always protect patients with pre-existing conditions" was misleading at best, Axios' Caitlin Owen notes.

Republicans' repeal and replace efforts in 2017 wouldn't have preserved the same level of protections the Affordable Care Act provides, nor would any of the plans they've put forward since.

Toward the end of her presser, Pelosi defended her decision to tear up Trump's speech, claiming it had "nothing to do with" him snubbing her handshake at the beginning.