The Biden campaign reached out to pitch what might be lost if former President Donald Trump and his Republican allies win control of the White House and Congress: the Affordable Care Act — colloquially known as Obamacare — and the health insurance rules it mandates.

President Joe Biden pulled out a couple of ringers in former President Barack Obama and former Speaker of the House Nancy Pelosi with the video message, which also marked the 14th anniversary of the ACA’s passage. The two were instrumental to the passage of the law, which Obama considers his signature achievement in office.

What You Need To Know

  • President Joe Biden tapped former President Barack Obama and former House Speaker Nancy Pelosi in defense of the Affordable Care Act, which former President Donald Trump has pledged to repeal should he win the presidency in 2024

  • The ACA — popularly known as Obamacare — signed up a record 21.3 million Americans in 2024, 5 million more than in 2023; it also polls at 59% favorability, three points shy of its 62% high last year

  • Biden, Obama and Pelosi repeatedly pressed provisions of the law that provide healthcare to young adults on their family's insurance up to age 26, as well as those that ensure coverage despite pre-existing medical conditions

  • Biden also continued his pitch for expanding healthcare provisions in a second term, including expansion of prescription drug price caps, a promise to defend Medicare and Medicaid and a pledge to enshrine abortion care protections into law

"While the Affordable Care Act has been called a lot of things, especially by Republican friends, Obamacare is the most fitting description because of Barack — it wouldn’t happen without him, no matter how many times he was told to give up," Biden said, praising his old boss’s leadership in ensuring the bill’s passage. "We also can’t take anything for granted. Republicans have voted — it’s hard to believe — 50 times to repeal the Affordable Care Act…and now Donald Trump and his MAGA extremists are determined to try again," he added.

Trump, the presumptive Republican nominee for the November presidential election, continually sought to repeal the ACA during his presidency, and has repeated his pledge on the campaign trail — both in 2020, when he said during a debate that he’d like to "terminate" the ACA, and in the run-up to 2024, when he’s said he’s "seriously looking at alternatives" to the law.

Trump, it was noted repeatedly Saturday, was but one vote away from a Senate vote that would have repealed the ACA in 2017 when the late Sen. John McCain famously quashed the effort with a thumbs-down. His "no" vote sealed the repeal’s fate and forever cemented mutual antipathy with Trump. ("John McCain, for some reason, couldn’t get his arm up that day," Trump said in a speech in January. McCain, a Naval pilot shot down over Vietnam in 1967, spent more than five years as a prisoner of war, and suffered injuries that kept him from lifting his arms over his head for the rest of his life.)

Biden, Obama and Pelosi repeatedly pressed two points, with the help of guest speakers Ashleigh Ewald and Dr. Tyra Bryant-Stephens, who respectively offered the perspectives of a young adult and a pediatrician in underserved communities.

Through Ewald, Obama and Pelosi reiterated the ACA clause that allows young adults to stay on their parents’ health care plans until age 26. "While young people are generally pretty healthy, all it takes is one diagnosis or one injury, one accident, to throw off your plans if you don’t have insurance," Obama noted.

Bryant-Stephens shared her appreciation for the law, noting that before the ACA’s implementation, health care companies could deny coverage for children with pre-existing conditions. "I worry about what [a repeal] means for the families that I see and serve in my clinic, and the children who have asthma simply because of the environment they grow up in," Bryant-Stephens said.

Biden wound up the message by pitching his vision for health care, including expanding capping costs on prescription drugs, including insulin, and promising to defend Medicare and Medicaid from cuts. He also pledged, with the support of Democratic control in the House and Senate, to enshrine abortion care protections — once assured by Roe v. Wade — as law.

The Affordable Care Act has significantly grown in popularity since it was enacted in 2010, reaching 59% favorability as of February — down from a high of 62% in March 2023 — according to KFF research. More Americans than ever signed up for health care through the ACA for 2024, as a record 21.3 million people sought out its coverage. That was an increase of more than 5 million sign-ups from 2023, the Centers for Medicare and Medicaid Services said in January.