President Donald Trump speaks on May 4 while flanked by House Republicans after they passed health care legislation.
CNN  — 

President Donald Trump issued a warning to fellow Republicans to support coverage of pre-existing conditions with less than 20 days until the midterm elections.

“All Republicans support people with pre-existing conditions, and if they don’t, they will after I speak to them. I am in total support. Also, Democrats will destroy your Medicare, and I will keep it healthy and well!” he tweeted Thursday afternoon after departing the White House for a campaign swing out West.

The tweet is in line with a familiar refrain from Trump’s recent campaign rallies and even dating back to his debates during the Republican primary. However, it’s not consistent with his administration’s actions and policies.

Earlier this month, a Democratic measure aimed at eliminating short-term health care plans that don’t have to cover pre-existing conditions failed in the Senate. Maine Sen. Susan Collins was the sole Republican to vote for the measure. The resolution was aimed at rebuffing a Trump executive order unveiled in August that made it easier to buy these plans.

Short-term health care plans don’t have to adhere to the Affordable Care Act’s regulations that protect people with pre-existing conditions. These plans can deny coverage or charge higher premiums to Americans based on their medical histories. And they don’t have to provide comprehensive coverage. The Trump administration made it easier to buy these plans – allowing people to buy coverage for just under a year, versus the 90-day limit imposed by the Obama administration.

The administration also broadened the availability of plans that small businesses can buy that don’t have to adhere to all of Obamacare’s protections.

Additionally, the administration sought to gut two core provisions of the Affordable Care Act that guarantee protections for those with pre-existing conditions in June.

The White House supported several Obamacare repeal bills, including one in the House of Representatives that advocates argued weakened coverage of pre-existing conditions. Several moderate Republicans in the House of Representatives even cited a lack of protections for people with pre-existing conditions as a reason they voted “no.”

And the White House-endorsed “skinny repeal” of the Affordable Care Act that failed in the Senate after Sen. John McCain’s no vote in July 2017 – something Trump frequently lambasts on the campaign trail – would have waived regulations that would have likely seen higher premiums for those with pre-existing conditions.

Health care has become a rallying cry for Democrats leading up to election day, and many Democrats were quick to pounce on Trump’s tweet.

“Your ACA repeal would’ve left ppl w/ pre-existing conditions to fend for themselves. Your tax bill exploded the deficit so much Mitch is hoping to use it as an excuse to cut Medicare. Your challenges with the truth continue. Bull Trump for short,” Virginia Democrat Rep. Gerry Connolly tweeted.

And Democratic Minority Leader Sen. Chuck Schumer wrote, “Mr. President: Look in the mirror, and you’ll see the person you need to speak with. Pull back your lawsuit fighting to undo protections for pre-existing conditions.”

Massachusetts Rep. Joe Kennedy posted a photo of Trump in the White House Rose Garden after House Republicans passed a bill to repeal and replace Obamacare.

“This is you and all your friends laughing hysterically about gutting preexisting conditions a year ago. You thought we forgot?” he wrote.

CNN’s Tami Luhby, Lauren Fox, Elizabeth Landers and Ted Barrett contributed to this report.