Former President Barack Obama returned to the White House on Tuesday for the first time since Jan. 20, 2017, to celebrate how his former vice president, now President Joe Biden, has been able to expand benefits under their signature health care law.

Since Biden was inaugurated, Democrats have enjoyed a rare moment where the 2010 health care law is not a political football. The law was hotly contested throughout Obama’s presidency and Republicans spent much of then-President Donald Trump’s administration trying to roll back its protections as insurers left the markets and chaos reigned.

The reunion comes as Democrats are fearing, if not expecting, a repeat of the first midterms of the Obama presidency, which saw Republicans end the unified Democratic government by taking the House. This year, the Senate’s very much in play, as well.

As Obama was exiting the East Room event Tuesday, he was asked about his message to Democrats ahead of this year’s midterms.

“We’ve got a story to tell,” Obama replied. “We’ve just got to tell it.”

Biden has made expanding health insurance coverage a hallmark of the first year-and-a-half of his presidency, and the two presidents looked to the future of health care coverage.

Obama compared the health care law to a “starter home” for universal health care, and complemented Biden’s efforts to increase coverage and make it more affordable for families.

Biden signed an executive order Tuesday directing agencies to lower costs and expand coverage, along with the proposed rule to close a subsidy loophole dubbed the family glitch, two actions to help more Americans access health care. During the most recent HealthCare.gov. enrollment period, 14.5 million Americans signed up for health insurance.

“That ladies and gentlemen, is what happens when you have an administration that’s committed to making a program work,” Obama said of the Biden administration’s efforts to shore up the ACA.

Vice President Kamala Harris called on Congress and states to do more to expand the health care law, such as allowing Medicare to negotiate drug costs, permanently expand insurance subsidies and encourage the twelve states who have not yet done so to expand Medicaid.

Attendees included Democratic members of Congress who had worked on the passage of the law more than a decade ago — and helped turn back repeated efforts by Republicans to repeal the law in the years since 2010.

Obama recalled that both Speaker Nancy Pelosi of California and the late Sen. Harry Reid, D-Nev., wrangled the votes to help turn the bills into law, and acknowledged the Democrats who lost their seats did so thanks, in part, to the early unpopularity of the law. And, he conceded, some of those wounds leading into the 2010 midterms were self-inflicted, including the failed initial launch of HealthCare.gov.

“I intended to get health care passed even if it cost me reelection. Which, for a while, it looked like it might,” Obama said, adding that passing the sweeping overhaul meant “members of Congress took courageous votes, including some who knew that their vote would likely cost them their seat.”

“Republicans tried to repeal what we had done, again and again and again,” Obama noted, giving a shout out to, among others, former Solicitor General Donald B. Verrilli, who successfully defended the law before the Supreme Court.

Obama has made a point to let his former vice president shine during the first couple years of his presidency, but Biden gave his former partner all the credit on Tuesday.

“The Affordable Care Act has been called a lot of things, but Obamacare is the most fitting,” Biden said, leaning on his lectern and almost whispering into the affixed microphones.

Lowering costs for millions

Biden issued a proposed rule to end the family glitch, a move that the White House told reporters is “the most significant administrative action to improve the implementation of the ACA that we’ve taken since the law was first implemented.” The rule, if finalized, could lower health insurance costs for up to 5 million Americans.

Under current law, if an employer offers affordable coverage to an individual, but not an entire family, that family would not qualify for premium subsidies on the health insurance exchanges. Under the proposed rule, that family would qualify for subsidies to help them buy insurance.

The glitch means families in that scenario would be unable to get insurance they can afford. The proposed rule would close the family glitch loophole beginning Jan. 1, 2023.

Lawmakers and advocates have pushed the administration to act on the family glitch for some time. In 2020, the House passed legislation to close the family glitch as part of a broader health care bill, but the legislation never made it to the Senate. Rep. Susan Wild, D-Pa., along with 38 other House members, sent a letter to Biden this March urging him to close the family glitch ahead of this year’s ACA marketplace enrollment period.

Democrats on Capitol Hill and in advocacy groups applauded the move.

“Many workers and their families have been locked out of premium tax credits due to a previous interpretation of ‘affordable’ by the Internal Revenue Service. By fixing this unintended glitch, the Administration is helping lower health care costs for millions of families,” Education and Labor Committee Chairman Robert C. Scott, D-Va., said.

Ohio Democratic Sen. Sherrod Brown introduced a bill in 2019 to fix the family glitch, and on Tuesday he said the proposed rule would bring down costs for hundreds of thousands of Americans.

“I’m glad the Biden-Harris administration is implementing a long overdue fix to the family glitch — no one should ever have to worry about whether they can afford health care coverage for their family,” Brown said in a statement. “Fixing this glitch in the system will bring down health care costs for hundreds of thousands of families, and make sure more people can get the tax credits that help make comprehensive health insurance more affordable.”

But some Republicans and right-leaning groups say a potential IRS rule change on the family glitch could increase premiums for all Americans, due to the increase in subsidies. Currently, over 90 percent of people affected by the family glitch chose to pay for private insurance, even if it costs more than 10 percent of their income, according to the Kaiser Family Foundation.

“The main policy implication of a new and unlawful IRS interpretation would not be to reduce the number of uninsured but to instead replace employer-sponsored coverage with heavily subsidized exchange-based coverage,” Brian Blase, a former Trump administration official at the White House’s National Economic Council, said. He also argued that more employers would not offer affordable family coverage as a result of this rule.

Heather Korbulic, a former Nevada exchange official and policy lead at GetInsured, noted that it could be complicated for families to transition from expensive employer coverage to the exchanges. But most of these families who overpay for employer-sponsored plans are usually in good health, she noted, so it’s unlikely these people will cause premiums to go up dramatically.

“We don’t think that there would be any big impact to the existing risk pool in the individual market. However, there may even be a benefit to the risk pool because we’re welcoming more healthy and younger folks,” Korbulic said.