It’s a never-ending battle to refute the lies President Trump tells about health care. He promises to protect people with preexisting conditions from insurance companies that want to raise their rates, or cut them off entirely. Yet his administration is in court arguing against the constitutionality of the Affordable Care Act (ACA), which restricts the insurance industry from these practices.

He says he’s working hard to lower the cost of prescription drugs, but where’s the legislation? And the budget he sent to Congress earlier this month includes significant cuts to Medicare and Medicaid, programs he promised to protect.

A group dedicated to defending the ACA, commonly known as Obamacare, is staking its claim in the political marketplace on the power of the hard-fought protections in Obamacare—including the expansion of Medicaid into 35 states—to carry the Democrats to victory in 2020.

“A winning election (for the Democrats) is a referendum on Donald Trump and health care,” says Leslie Dach, a former top executive at Walmart who chairs Protect Our Care (POC), a resistance group created after the 2016 election to counter Trump’s threat to kill Obamacare.

“It is the kitchen table issue,” Dach continues, bolstering his case with polls that show 85 percent of the voting public want Obamacare’s protections but not everybody realizes the vast difference between what Trump says on this issue and what he and his party are doing, or trying to do.

“ 85 percent of the voting public want Obamacare’s protections ”

These are bigger lies than the everyday falsehoods we’ve come to expect from Trump. These are lies that go to the core of what the 2020 election will be about.

Trump’s Justice Department is in court working to overturn the Affordable Care Act. Legislation that the House passed to rein in drug costs languishes in Mitch McConnell’s Senate graveyard, where Republicans show no interest in taking on the pharmaceutical industry.

After Trump in his State of the Union speech repeated his pledge to protect people with preexisting conditions, a claim that has been thoroughly analyzed and debunked, Protect Our Care put together a digital video of pundit after pundit decrying the “damnable lie.”

With impeachment behind them, Democratic activists are working to move the political conversation back to health care, the issue that won them back the House in 2018. Dach talks about his job as “evangelizing” the message that he believes will carry the Democrats to victory in November.

Democratic pollster Geoff Garin first identified the power of health care as a voting issue in the fall of 2017, and with the ACA in the crosshairs of Trump and the Republican Congress, POC worked in the states where they needed Republican votes, making sure lawmakers felt the heat at town halls.

It was a hard sell at first convincing Democrats to talk about Obamacare. “They all bore the scars,” says Dach, of a health care plan that was highly unpopular at first and that had cost Democrats their majorities in Congress. The ACA now polls at 59 percent, which makes it a winning issue for Democrats to talk about.

Focusing on health care can work again in 2020 if the Democrats don’t screw it up, Dach says. While he is not endorsing any candidate, he says, “It is political malpractice for Democrats to fight among themselves on this issue. Even among Democrats, the more we stress single payer, the more we give him an issue he can run on. We’re giving away an issue we should be running on. They should be defining their opposition to Trump, he’s on the ballot.”

The POC’s war room in the WeWork building in Southeast D.C. is a far cry from the corporate life Dach had at Walmart. “I took a lot of grief,” he recalls, when he joined the big box store in 2006 after having worked on Capitol Hill and in the Clinton administration. Dach says he made some changes there he was proud of: working with first lady Michelle Obama on getting salt and sugar out of food; promising every honorably discharged veteran a job who wanted one; and imposing a somewhat more restrictive approach to selling guns.

He left Walmart in 2013, and after a brief hiatus, joined the Obama administration, where he staffed HHS Secretary Sylvia Mathews Burwell on the department’s response to the Ebola and Zika viruses, and also to the ongoing rollout of the ACA.

Then it was off to the Hillary Clinton campaign, where he organized “Together for America,” the vehicle for well-known Republicans to support Clinton. Following her loss, he gravitated to other groups concerned about health care and the fate of the ACA. There were a dozen or so health care activists and groups around the table like SEIU (Service Employees International Union) and Families USA, and over time, he says, “we all recognized we needed someone who would come to work every day whose only job was to focus on this one threat” to the ACA.

For the 2020 election, his plan his to continue to explain to the American people what Trump is doing to their health care and support legislation to expand health coverage and lower costs. “It’s an everyday fight with the president” that will be highlighted with a bus tour into 10 or 12 states next month, timed to the 10th anniversary of Obamacare, which is March 23.

“We don’t know who the nominee is going to be,” says Dach. “We’re trying to convince the candidates to talk more about Donald Trump. We think it’s a huge missed opportunity to be having a debate on a public option versus Medicare for All when what the voters care about is the cost of prescription drugs and the cost of premiums. That’s what they should be talking about.”

If Bernie Sanders is the nominee, how would an organization dedicated to protecting Obamacare adjust its mission? Keeping the focus on Trump and his “relentless war on health care” would get a whole lot harder with Sanders holding the line on a policy that divides Democrats and hands Trump the edge on an issue that could decide the election. But Dach thinks it can be finessed. “We’re not trying to draw the line with the ACA,” he says. “If Sanders is the nominee, as an alternative to Trump, there’s a lot we would agree on.”