(Bloomberg) — President Barack Obama said 20 million Americans had gained health insurance as a result of the Patient Protection and Affordable Care Act (PPACA), offering a rebuttal to Republican presidential contenders who have vowed to dismantle his signature domestic achievement if they are elected.

Obama traveled to Milwaukee on Thursday to congratulate the city for winning a White House PPACA enrollment contest. The city increased enrollment in private plans sold under the program by 75 percent this year, besting 19 other municipalities.

“The Affordable Care Act, a.k.a. Obamacare, is saving lives and it’s saving money,” Obama said.

See also: Effects of Jan. 1 coverage enrollment extension unclear

The Obama administration hopes that with growing numbers of Americans covered by PPACA programs, Republicans will find repeal of the law to be an increasingly difficult political proposition. That is so far not the case. On Wednesday, Donald Trump, the front-runner for the Republican presidential nomination, proposed a health plan that starts by repealing PPACA and would not guarantee new coverage to people with pre-existing health conditions, a central plank of PPACA.

To Republicans, “the facts I just mentioned don’t matter, because this is an issue of ideology,” Obama said. “Facts, evidence, don’t comport with their conviction that the ACA means an end to the American way, and repeal has been a rallying cry.”

‘Zero times’

Enrollment for plans sold under PPACA closed on Jan. 31, with 12.7 million people signed up for coverage in 2016. That figure exceeded the midpoint of the government’s enrollment projection from October, when it predicted between 11 million and 14.1 million people would sign up.

In Milwaukee, Obama spoke at United Community Center, a 46-year-old social services agency on the city’s south side that says it serves more than 15,000 people a year, primarily Hispanics.

Milwaukee hosted PPACA enrollment events at the city’s libraries, and used flyers, robocalls and phone banks to promote them. The county placed digital signs on buses to direct people to a website and phone number for assistance signing up.

The health law’s insurance exchanges, which sell private coverage often subsidized by the government, are in their third year after surviving two Supreme Court challenges. The U.S. House of Rep.s, under Republican leadership, has voted more than 50 times since 2011 to repeal all or part of the law.

“They’ve told you what they’d replace it with about zero times,” Obama said.

House Speaker Paul Ryan, a Wisconsin Republican, said Feb. 3 that repeal is unrealistic “when a guy with the last name Obama is president.” The day before, the House failed to override Obama’s veto of a Ryan-supported bill to repeal most of the law.

Paying for Quality

Before the speech, Obama had lunch with five people who had written him letters about their difficulties finding or paying for health insurance. One of them was Brent Brown, who wrote that he had opposed Obama in both elections but had a change of heart after realizing his pre-existing health condition — an autoimmune disease — precluded him from buying health insurance in the absence of PPACA.

Brown introduced Obama at the community center as “the man who saved my life,” after telling the audience he had never voted for him and had been a Republican who “cursed his name.”

“To the Republicans who wish to repeal the Affordable Care Act, I plead with you to reconsider,” Brown said. “Swallow your pride, as I am doing right now in front of what I assume are many Democrats, and do what is right.”

See also: States gear up for the PPACA reboot year

The Obama administration also announced today that it reached a goal of tying 30 percent of payments in the traditional Medicare program to quality measures. The U.S. is working to move Medicare, which provides health coverage for the elderly and disabled, away from reimbursing doctors and hospitals based on the quantity of services they provide by paying individually for each visit to the doctor’s office or each procedure performed.

Obama met at the Milwaukee center with its executive director Ricardo Diaz, a Cuban immigrant who was part of Operation Peter Pan to evacuate children from Cuba in the early 1960s, according to the Milwaukee Journal Sentinel. Obama later this month plans to make the first visit to Cuba by a sitting U.S. president since Calvin Coolidge in 1928.

—With assistance from Zachary Tracer.

See also:

5 PPACA exchange broker insights from Kaiser’s new survey

How long does it take to buy an exchange plan?

  

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