The general Republican strategy of “repealing and replacing” Obamacare has had remarkable staying power even as uninsured rates have plummeted, perhaps reflecting public ambivalence about the law. Obama’s speech took jabs at would-be repealers using a timely quip about replacing Samsung smartphones with rotary phones, but his overall sentiment seemed to be that the endurance of calls to repeal Obamacare is tied as much to him as it is to the actual policy. His speech appeared to concern his legacy: Will politicians be able to make the necessary fixes to the ACA once he leaves office?

President Obama is optimistic on that front, but it is unclear if future fights over health policy will become any less bitter after he leaves office. As the American conservative movement splinters with the rise of Trump, and the Republican Party sees factionalism grow within its ranks, perhaps the most consistent, unifying policy thread among all camps is an ardent refusal to play ball with Obamacare. That refusal was obviously animated by obstructionism and has not been supplemented with many workable replacement policies, but it has been a key issue for Republican voters in three straight elections.

The law still faces a significant public unfavorability rating and rising dissatisfaction about costs, even as the approval rating of the president himself is the highest that it’s been in years. Given that Clinton has positioned herself both as an ideological progenitor and a reformer of Obamacare—and also given her own deep unpopularity—it is unclear whether, if she takes office and rebrands the bill “Hillarycare,” the bitter fight will magically subside. After all, health policy has often been contentious. Nevertheless, Obama is confident that the Affordable Care Act will endure.