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Obama: Affordable Care Act 'woven into the fabric of America'

The Supreme Court will decide this month whether millions of Americans can keep their health insurance with federal subsidies under the Affordable Care Act.

President Obama pressed to preserve his landmark health care law Tuesday ahead of a Supreme Court decision later this month that could imperil insurance access for millions of people, calling the reform too critical and "woven into the fabric of America" for the U.S. to let unravel. 

Forcefully defending the Affordable Care Act (ACA) during remarks before the Catholic Health Association Assembly, Obama went after the partisan attacks designed to gut a key pillar of the reform law.

“We’re not going backward,” Obama said. "There’s something, I have to say, just deeply cynical about the ceaseless, endless, partisan attempts to rollback progress."

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The stakes facing the health care law are critical. The Supreme Court will announce its decision later this month on whether millions of Americans can keep their health insurance with federal subsidies under the ACA, also known as Obamacare.

The issue before the court in King vs. Burwell boils down to the reading of the law: The challengers contend that subsidies under the health law are only available in marketplaces "established by the state" and not the federal government. The Obama administration, for its part, argues such a straightforward reading of the law is incorrect and ignores what Congress intended when it passed the legislation.

The decision could affect more than 6 million Americans in as many as 34 states that have not set up their own health care exchanges. Without the federal subsidies, it is expected that many people would no longer be able to afford health insurance, likely forcing many to give up their coverage.

The Affordable Care Act is the cornerstone, if not the single-most significant piece, of Obama's legacy in the White House. Republican-led opposition has remained steadfast and impassioned since the legislation was first signed into law in 2010.

“After a century of talk, after decades of trying, after a year of sustained debate, we finally made health care reform a reality here in America,” Obama said to a round of applause.

“And despite the constant doom and gloom predictions, the unending chicken-little warnings that somehow making health insurance fair and easier to buy would lead to the end of freedom, the end to the American way of life, lo and behold, it did not happen.”

The president spoke of the outpouring of stories he heard from everyday Americans who were outstretched by billowing medical bills and the 16 million people who now have health insurance thanks to reform.

“Every one of these stories tugged at me in a personal way,” Obama said, adding a personal note about rushing his young daughter to the hospital because of a meningitis scare. “I never felt so scared or helpless in all my life.”

The White House rolled out additional efforts to promote the health care law's achievements ahead of Obama's Tuesday address, including a multimedia blitz full of explainers and testimonials from Americans who have benefited from the affordable coverage made available under the law.

Speaking at a press conference Monday at a summit of world leaders in Germany, Obama acknowledged that it would be "hard to fix" the ACA if the Supreme Court rules against the administration.

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Without the federal subsidies, it is expected that healthier patients would drop out, leaving only the least healthy patients who need insurance the most on the federal exchanges. The imbalance could cause premiums to skyrocket and undercut the entire health care law. The states that have yet to set up their own exchanges could do so to help those Americans who would lose insurance -- but any move would be just as political for Republican leaders who staunchly oppose the law.

Any ruling will undoubtedly have political ramifications ahead of the 2016 presidential race, opening the possibility that the GOP-led efforts to dismantle Obamacare could see some blowback. A signal that Republicans are already preparing for a possible Supreme Court decision against the administration, GOP Sen. John Thune of South Dakota on Monday tried to spin the blame onto the president.

According to a recent poll conducted by The Washington Post and ABC News, while the health care law as a whole is unpopular, the federal subsidies currently at issue in the courts garners significant support -- particularly in battleground states. The poll finds that 55% of Americans believe the Supreme Court should not gut the federal subsidies, compared to 38% who says it should.