Biden and Harris argue that Democrats will preserve health care and Republicans would take it away

President Joe Biden and Vice President Kamala Harris have been promoting their health care agenda during an appearance in Raleigh, North Carolina

RALEIGH, N.C. (AP) — President Joe Biden and Vice President Kamala Harris on Tuesday promoted their health care agenda in the battleground state of North Carolina, arguing that Democrats like themselves would preserve access to care while Republicans would reverse gains made over the past decade and a half.

Fourteen years after President Barack Obama signed the Affordable Care Act into law, the White House still sees health care as a winning issue during a campaign in which Biden has sometimes found himself on the defensive when it comes to immigration or the economy. Republicans have opposed Biden's signature initiatives to lower medical costs, and they've seized opportunities to restrict abortion rights after the U.S. Supreme Court overturned Roe v. Wade.

“It’s sick. Now they want to quote, his words, terminate the ACA, as my predecessor says," Biden said, referring to Republican former President Donald Trump. "If that were ever to happen, we’d also terminate a lot of lives as well. But we’re not going to let that happen, are we? We’re not going to let that happen.”

North Carolina was Biden's final stop on a tour of battleground states after his State of the Union address this month, which jump-started a frenzied travel schedule as the Democratic president makes his case for a second term in a likely rematch with Trump, the presumptive Republican nominee.

The state is also a health care success story for the president. The American Rescue Plan, a coronavirus pandemic recovery measure signed by Biden, included financial incentives for states to expand Medicaid coverage for low-income residents. North Carolina Gov. Roy Cooper, a Democrat, used the money, which amounted to $1.8 billion, to persuade Republican lawmakers to support his plan. More than 600,000 residents are expected to qualify.

Biden and Harris visited hours after the U.S. Supreme Court heard oral arguments in a case about access to mifepristone, a widely used abortion pill. The justices appeared inclined to preserve access to the medication.

The White House has tried to make mifepristone more available as one of its few opportunities to protect women’s ability to end their pregnancies.

Afterward, Biden and Harris attended a campaign fundraiser in Raleigh that raised $2.3 million, said Cooper. Harris told supporters, “This is the most existential, consequential and important election of our lifetime.” Biden asked, “Does anyone here want to go back to 2020?” and the crowd shouted, ”No."

Biden's approval ratings on health care are among his highest on a range of issues, but he trails there, too, According to a February poll from The Associated Press and the NORC Center for Public Affairs Research, 42% of U.S. adults approve of Biden's handling of health care while 55% disapprove.

KFF, a health policy research firm, found in its own poll in November that 59% of U.S. adults trust the Democratic Party to do a better job addressing health care affordability issues. Only 39% said the same about Republicans. There was a similar divide in trust when it came to access to mental health care, prescription drug costs and the future of the Affordable Care Act, Medicare and Medicaid.

Trump has never detailed his health care proposals despite campaigning since 2016 on a promise to repeal and replace the Affordable Care Act. After Biden landed in North Carolina, Trump denied in a new social media post that he wants to "terminate the ACA," even though he had promised to do just that as recently as last week in Arizona. Trump pledged Tuesday, without providing any details, that he would make the Affordable Care Act better, stronger and less expensive.

However, health care has not been a prominent issue in his 2024 campaign as Trump instead focuses on immigration, inflation and the wars in Europe and the Middle East.

Polls show a tight race between Biden and Trump, and Democrats hope to create another potential path to victory in North Carolina.

Although Democrats have failed to win a U.S. Senate seat or a presidential race there since 2008, Trump beat Biden in North Carolina by just 1.3 percentage points in 2020. The White House has repeatedly highlighted federal injections of funds for transportation, rural broadband and other initiatives while dispatching top administration officials to the state.

Democrats also want to exploit what they view as weaknesses among Republican candidates for statewide offices. For example, the party's nominees for governor and state schools superintendent, Mark Robinson and Michele Morrow, respectively, have a history of inflammatory comments.

“We’re seeing a Republican slate at the statewide level that is filled with MAGA extremists that ultimately is going to hurt the Republicans’ chances of winning the state again,” state Sen. Jay Chaudhuri of Raleigh, the chamber’s Democratic whip, said Monday in an interview, using the acronym for Trump's “Make America Great Again” campaign slogan.

Democrats hope unaffiliated voters, the largest category in North Carolina, will cool to Trump in part based on worries that his election along with Robinson and Morrow could make businesses question relocating to a state that is currently riding an economic boom.

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Associated Press writers Gary Robertson in Raleigh, North Carolina, Jill Colvin in New York and Darlene Superville, Amelia Thomson-DeVeaux and Matt Brown in Washington contributed to this report.

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