Health care premiums are projected to skyrocket this year, after the Trump administration and the Republican Congress wreaked havoc on insurance markets by meddling with the Affordable Care Act. Those changes have devastated families’ budgets, and voters now seem ready to return the favor this fall, citing health care as a top issue heading into the midterm elections.

In a way, this is a restoring of political order. For a generation, the promise of health care reform helped Democrats, including me, win elections. Our decision to deliver on that promise with the ACA became a political liability during the last decade. In the 2010 midterm election, I—and dozens of my Democratic colleagues in Congress—were swept out of office in the wake of our support for Obamacare, which Republicans have seized on as an issue ever since.

But the past few years have produced a sea change, as people across the country enjoy the benefits of the ACA. Democrats running this year should focus not only on rebutting Republican attacks on the ACA, but on bolder health care reforms. The past year reminds voters of a simple fact—one party is fighting to secure affordable care for every American, and the other party is working to tear that care down.

The actions by this Republican Congress are costing American families hundreds of dollars a year in higher premiums, as a result of both new laws they’ve enacted and actions across the board to sabotage the Affordable Care Act. These costs are not abstract or partisan. They are felt painfully at kitchen tables across red and blue America. As voters learn more about who caused these cost spikes, they are threatening to hold accountable the 217 Republicans in the House and 49 Republicans in the Senate who have repeatedly voted to repeal the ACA.

Democrats running this year should focus not only on rebutting Republican attacks on the ACA , but on bolder health care reforms.

That’s a stunning change from 2010, when Republicans wielded the ACA against members like me and used it to take control of the House. As a first-term congressman, I voted in favor of the law because I knew it would save lives and bend the cost curve that was crushing families and federal budgets alike. From children who could continue receiving critically needed treatment without fear of lifetime caps to working people who could afford insurance for the first time, I knew that this law would ensure millions of Americans would gain access to quality, affordable health care. Rarely has a week gone by since then without a parent telling me the story of how the law saved their child or their home, or without a small-business owner telling me this was the only way they were able to keep covering their workers—and their families whom they consider kin.

When Republicans took control of Congress, they immediately looked to reverse the progress we had made—voting nearly 60 times since 2010 to undermine the ACA. One year ago, House Republicans nearly succeeded in repealing the ACA, voting along party lines to strip 23 million Americans of their care. And in their most talked-about legislative accomplishment, the tax bill they passed in December moved to end the individual mandate, pulling the rug out from the millions of Americans who depend on health care.

Could 2018 be 2010 in reverse, with health care flipping control of Congress this time to the Democrats? Health care voters seem mobilized. Recent nationwide polling shows that the American people continue to view health care as one of the most important issues in this election—one that sways them to vote for progressive candidates who will defend our access to affordable health care.

In many ways, voters have already answered this question in beta tests across the country. In my own state of Virginia last year, voters fired an unprecedented number of Republican delegates in the state legislature, even though Republican leaders had rigged district lines to make these leaders untouchable. In fact, health care crushed all other issues by 20 points as a priority for voters, and every successful Democratic challenger ran to protect against Republican efforts to block full implementation of the ACA, including the expansion of Medicaid. It speaks volumes that the Virginia House of Delegates has now voted to pass Medicaid expansion while the Republican-led Senate—which has not had to face voters recently—continues to rush off a political cliff. Democrats can capitalize on the issue again this year, when at least four vulnerable Republican congressmen who supported these price spikes—including the one who replaced me—are on the ballot.

In special elections from Alabama to Pennsylvania, Democrats have already won seats in the Senate and the House, and have retaken control of governors’ mansions, by campaigning to protect our care. Even in incredibly conservative districts—in places like Arizona’s 8th Congressional District—most voters have said that we should keep and improve the ACA. In fact, the pendulum is not shifting back to neutral but swinging instead to substantial increases in care, with rising support for Medicare for all or even a public option.

While all of this may seem like voters flip-flopping on the politicians, their message has been consistent— our families need access to affordable care that is not one pink slip away from being taken away. Opposition to the ACA was based largely on fears that the new policy would cost people their care—fears stoked by ludicrous criticisms and tragically poor communication by those of us who supported it. Refusing to enact a public option, and a painfully slow phase-in period, also didn’t help. But even through the misinformation and missteps, voters have consistently shown that they will vote on this issue, and they will vote out those who threaten their care. That message may once again define midterm elections and empower a new congressional majority to ensure that every American has access to affordable care.