Obama has been relatively muted on these matters since leaving the White House, choosing to weigh in on some major debates in only the most surface-level of terms. But the Affordable Care Act is his signature domestic achievement and his willingness to chime in with harsh indictments indicates that he, too, thinks it is under existential threat. 

And he’s probably right. A few weeks ago, it wasn’t entirely clear whether the Senate would be able to put together a bill to repeal and replace Obamacare. But an incredibly secretive legislative process culminated on Thursday with the unveiling of legislation that would dramatically scale back Obamacare’s Medicaid expansion, potentially weaken protections for consumers, and likely swell the ranks of the uninsured. 

Obama won’t sway the votes of any legislators on the Hill. But his commentary is likely designed to encourage activism among his supporters. And it’s notable that he framed his critique in a similar vein to what President Donald Trump offered when he deemed the House and Senate health care bills “mean.” 

“I hope our Senators ask themselves ― what will happen to the Americans grappling with opioid addiction who suddenly lose their coverage?” Obama wrote. “What will happen to pregnant mothers, children with disabilities, poor adults and seniors who need long-term care once they can no longer count on Medicaid? What will happen if you have a medical emergency when insurance companies are once again allowed to exclude the benefits you need, send you unlimited bills, or set unaffordable deductibles? What impossible choices will working parents be forced to make if their child’s cancer treatment costs them more than their life savings?”