What Obama might say on the ACA to a Congress controlled by its critics

President Barack Obama is expected to confront the Republican-controlled Congress with the achievements of his signature healthcare reform legislation when he lays out his vision for the final two years of his presidency during Tuesday's State of the Union Address.

Between 8 million and 10 million Americans gained insurance coverage because of the Patient Protection and Affordable Care Act's Medicaid expansion and the subsidies now available through the state and federal exchanges.

And while last year's State of the Union speech was clouded by the botched rollout of HealthCare.gov, the second open-enrollment season, which ends Feb. 15, has proceeded with few technological glitches and steady enrollment. The most recent tally from the CMS indicated that 6.8 million individuals—both new and returning customers—had signed up for 2015 coverage through Jan. 9.

“I'm sure he'll crow about the economy and I'm sure he'll crow about the healthcare law,” said Theda Skocpol, a political science professor at Harvard University who tracks healthcare issues. “He's got a very good story to tell.”

But Thomas Miller, a resident fellow at the conservative American Enterprise Institute, doesn't expect much emphasis on healthcare during the speech. He suggested that reauthorization of the Children's Health Insurance Program, which expires at the end of October and has attracted bipartisan support in the past, could get a nod from the president.

Republicans plan to use their majorities in both the House and Senate to dismantle Obamacare bit by bit. The president has signaled that he will veto any legislation that would significantly hinder implementation of the landmark healthcare law. He's likely to reiterate that line in the sand during Tuesday's speech.

Freshman Sen. Joni Ernst (R-Iowa), who ran an ad during the primary campaign featuring her at a gun range vowing to take aim at Obamacare, will give the GOP response. She is expected to attack the law for its alleged failings, including canceled plans and premium increases, and lay out changes that Republicans hope to make. That's likely to include abolishing the employer mandate and scrapping the medical device tax.

Hanging over the healthcare policy talking points will be the specter of the King v. Burwell lawsuit, which could strike down insurance subsidies in 37 states if the U.S. Supreme Court sides with the plaintiffs. Miller suggested it would be more interesting to hear the healthcare stance of each side after that ruling, which is expected in June.

“Then you'd have a hell of a State of the Union Address,” he said. “That's the state of the union we want to know about.”

Follow Paul Demko on Twitter: @MHpdemko