President Joe Biden is about to spend another day reminding voters that health care is on the ballot in 2024.

And this time hes doing it in a swing state that suddenly has 350,000 more people for whom the health care debate is personal.

In a visit Tuesday to Raleigh, North Carolina , Biden and Vice President Kamala Harris will tout a series of recently enacted Democratic initiatives designed to make health care more affordable, White House officials said. Those new initiatives include programs designed to reduce the price of prescription drugs as well as additional financial assistance for people buying private insurance through the Affordable Care Act, also known as Obamacare.

Biden and Harris wont just talk about the past, the White House officials said. They also plan to lay out a vision for how theyd like to expand on these initiatives by, for example, giving the federal government even more leverage over prescription drug prices. These are the same ideas that Biden mentioned in his State of the Union address earlier this month.

But in what is likely to be the most politically charged part of their speeches, Biden and Harris will contrast their administrations record and vision with the Republicans stand.

That will mean highlighting the GOPs history of trying to repeal the Affordable Care Act and make severe cuts in Medicaid. It will also mean citing a new budget plan from House Republicans that seeks to undo the Affordable Care Acts core elements while rolling back big pieces of the new drug pricing laws.

Former President Donald Trump is, of course, a big part of the GOP history on the Affordable Care Act. He tried to lead repeal efforts in 2017, the first year of his presidency. Now, the partys presumptive nominee for 2024 has indicated he would try to repeal it again if he wins the election.

The Trump and GOP agendas on health care would cause dramatic changes in every state. But the greatest effect would be in states that have expanded their Medicaid programs , with money from the Affordable Care Act, so that most legal residents living below or just above the poverty line are eligible.

Thats what makes the issue especially important for North Carolina.

North Carolina Just Expanded Medicaid

The state expanded its Medicaid program last year, becoming the 40th state to do so . And it was a watershed moment, because it was Republican lawmakers who approved the legislation that Democratic Gov. Roy Cooper, a longtime champion for Medicaid expansion, signed into law.

As of February, nearly 350,000 low-income residents had signed up for expanded Medicaid, according to the states Department of Health and Human Services. Thats more than half the newly eligible population.

All of them now have something to lose if that money from the Affordable Care Act goes away. And thats on top of all the other people , both in North Carolina and the nation as a whole, who could lose access to traditional Medicaid or subsidized private insurance through Obamacare if GOP plans to roll back the law succeed.

Republicans at the national level have long argued that the money going into Medicaid and subsidized private insurance through the Affordable Care Act distorts the natural market for health care while driving up government spending to unsustainable levels. Republicans have also argued that the new income taxes to pay for coverage expansion, which fall on the wealthy, harm the economy.