Such is the paradox surrounding the first legislative push expected by the new Trump administration.
Since the 2010 passage of the Affordable Care Act, its defunding and eventual repeal have been a top priority for Republicans, who control both chambers of Congress and, beginning with Trump's inauguration Friday, the White House.
In their view, Obamacare has marked a costly drift toward socialized, European-style medical care.
But the law has managed to add more than 20 million people onto the insurance rolls, lowering the percentage of Americans without coverage from 16 percent in 2010 to 8.9 percent last year.
Republicans, in their push to repeal and replace Obamacare, are insisting they will leave no one out in the cold.