In 2010, the Affordable Care Act contributed to a GOP “shellacking” in the midterms, and then-President Barack Obama and Vice President Joe Biden began the second half of their first term with a new GOP House majority and a heavy political albatross around their necks.

As President Biden embarks on an expected run for a second term, the 13-year-old law is now a political asset, with Republicans on the defense and Democrats warning voters of the damage that could come if the once-hated insurance network is undone.

If the Affordable Care Act – commonly known as Obamacare – is repealed, it would be earth-shaking for many millions of Americans, Biden told a Virginia Beach crowd Tuesday.

Protections for patients with pre-existing conditions? Gone, Biden said. Young adults who are getting health care under their parents’ plans? They’d have to look elsewhere. Free cancer screenings? No more. Low-income people who can now get health care coverage for as little as $10 a month? They’d have to pay up – if they could – to the tune of thousands of dollars a year, if the ACA is repealed, he said.

“For millions of Americans, health care remains in the balance,” Biden said, after being introduced by a local woman who said she has health insurance only because of Obamacare.

But make no mistake, Biden cautioned. If “MAGA Republicans try to take away people’s health care by gutting Medicaid and the Affordable Care Act, I will stop them,” the president said, drawing enthusiastic applause from an audience that included health care workers.

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Obamacare is largely blamed – or credited – for the Democrats’ massive losses in the 2010 midterms, as Republicans picked up a stunning 63 seats in the House and six in the Senate. The economy was also a drag on the ruling Democrats, but the sweeping health care law was pivotal in a number of districts.

Some House members received harassing calls and even death threats as they undertook a revamping of the health insurance system lawmakers had tried and failed for decades to achieve.

In November 2010, public opinion on the law was divided, with 42% approving of the law and 40% disapproving of it, according to tracking polls by the Kaiser Family Foundation, a nonpartisan group that studies health care topics. But discontent over the law, which had a difficult early rollout, grew, and by July 2014, 53% of Americans disliked the law, and 37% approved of it, Kaiser found. Republicans picked up 13 House seats that year.

But as Americans have gotten more accustomed to the law and to some of its more popular aspects, such as the ability to keep your kids on your health insurance plan until they turn 26, public opinion has flipped.

As of March 2022, the last month KFF polled on the issue, the pro-ACA crowd was at 55%, with those opposing the law comprising 42% of those polled.

Further, Americans are shifting in their views of how much of a role the federal government should have in ensuring the populace has health care, according to polling by Gallup.

In 2013, 56% of Americans believed the government did not have a responsibility to ensure health care coverage, with 42% believing the government did have that responsibility, Gallup found. But in January, those numbers were virtually reversed, with 57% of the public saying the federal government had a responsibility to provide health care coverage, and 40% disagreeing with that view.

Gallup’s poll did show deep partisan divides, however: 88% of Democrats, for example, believe health care is a federal government responsibility now, compared to 28% of Republicans and 59% of independents who feel that way.

But Biden and other Democrats are banking on the fact that Americans don’t like to have a benefit taken away from them, even if they were leery about the program at first. In January, the White House announced that a record number of people – 16.3 million had signed up for health insurance through federal and state Obamacare exchanges.

For the more than 30 states that use the federal HealthCare.gov exchanges, there has been a combined 50% increase in enrollment since Biden took office in January 2021, the White House said.

Republicans seeking to reduce government spending and undo Obamacare have cast the program as a move toward “socialized medicine.” But they have not been able to kill the program, even when Republicans controlled the White House and both chambers of Congress under former President Donald Trump.



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