BALTIMORE – As many as 260,000 Maryland residents could see higher premiums or lose their health care coverage altogether because of pre-existing medical conditions, age or gender under a new Trump administration legal strategy, state Democrats warned on Tuesday.

Rep. Elijah Cummings, D-Baltimore, along with other Democratic members of the Maryland congressional delegation and state Attorney General Brian Frosh attacked the Trump administration for refusing to protect Americans guaranteed the right to health insurance under the Affordable Care Act.

The protections, the Democrats argued, are of the utmost importance and won’t be invalidated without a legal fight.

“We’re better than that,” Cummings said. “We’re a better country than that.”

In June, Attorney General Jeff Sessions wrote in a letter to House Speaker Paul Ryan, R-Wisc., that the Justice Department would not defend key provisions of the health care law, a regular target of attacks by President Donald Trump and repeal efforts by congressional Republicans.

Cummings released a report by the Democratic staff of the House Oversight and Government Reform Committee that detailed potential impacts of such a policy on Marylanders. Frosh is among more than a dozen attorneys general challenging Sessions’s decision in federal court.

“Even more troubling, they did not offer any alternative,” Cummings said at a press conference at the University of Maryland Medical Center.

He was flanked by Frosh, Maryland Sens. Ben Cardin and Chris Van Hollen, and Reps. Dutch Ruppersberger of Timonium and John Sarbanes of Towson. All are Democrats.

Trump has largely moved to defund the ACA since taking office, scaling back federal funding from $62.5 million in 2016 to just $10 million this year.

But Health and Human Services Secretary Alex Azar has challenged attacks on Trump’s handling of the health care law.

“The president trying to sabotage the (Affordable Care Act) is proving better at managing it than the president who wrote the law,” Azar said during a Sept. 27 speech in Nashville, The Washington Examiner reported.

Under the new Trump policy, 167,000 Marylanders with pre-existing conditions could lose coverage or face hikes in premiums, the Democrats’ study estimated. Of those, 79,000 have such severe pre-existing conditions that insurance carriers could deny them any coverage.

Up to 160,000 Maryland women could be charged more than men for the same health care coverage, the report said. Such discrimination was barred by the health care law.

In addition, up to 108,000 older Maryland residents could be charged more, according to the report.

Maryland workers in higher-risk occupations also could lose protections: 19,000 construction workers, 9,700 shipping clerks and 4,800 emergency medical technicians.

“Defending the Affordable Care Act will affect the lives of Marylanders and people all over this country,” Cardin said. “It’s critically important that the American people understand what’s at stake when the president does not defend the Affordable Care Act.”

A Kaiser Family Foundation poll released in September showed that 50 percent of adults held a favorable view of the ACA. Forty percent held an unfavorable view. Another Kaiser poll found that 75 percent of people polled said it was “very important” that the ACA’s protections for people with pre-existing conditions ensuring guaranteed coverage remains law.

“When the Trump Administration decided not to defend the law … they’ve given a green light to all those who want to undo that protection through the courts,” Van Hollen said.

Trump, who said during his campaign that he wanted to put somebody on the Supreme Court who would help overturn the ACA, has done just that in nominating Brett Kavanaugh. In 2011, Kavanaugh was the dissenter in a 2-1 federal appeals court ruling on the constitutionality of the ACA’s individual mandate provision.

Cummings said the administration’s hostility to the health care law has caused unease even among government attorneys.

“Their actions are so indefensible,” Cummings said, “that three of four career attorneys representing the government withdrew from the case rather than sign their names on the brief. One attorney even resigned.”

Joel McElvain and two other lawyers withdrew from the case this summer; he later resigned. All three worked on a lawsuit brought by Texas and other Republican-led states that challenges the constitutionality of the ACA and is likely to find its way to the Supreme Court.