Barack Obama waded into the debate on healthcare Tuesday, sharply criticizing Republicans’ last-ditch attempts to repeal his signature legislative achievement.

“When I see those people trying to undo that hard-won progress, for the 50th or 60th time, with a bill that will raise costs, reduce coverage, and roll back protections for older Americans and people with pre-existing conditions … it’s aggravating,” Obama said Wednesday during a keynote speech at Goalkeepers, an event hosted by the Bill and Melinda Gates Foundation. He noted that there is no “demonstrable economic, actuarial, or even human rationale for pushing such a bill.”

“The legislation that we passed was full of things that needed to be fixed,” Obama said. “It was not perfect; it was better.”

The former President has spoken about the healthcare debate before, working it into his speech when he received the Profile in Courage award at the John F. Kennedy presidential library earlier this year and releasing a public statement after Senate Republicans released a version of repeal legislation in June. His remarks Wednesday come as another version of repeal, written by Sens. Lindsey Graham and Bill Cassidy, is gaining support among Republicans.

Republicans are pushing against a Sept. 30 deadline to garner 50 votes in favor of the legislation. After the 30th, they will need 60 votes to pass reform, an impossible task given Democrats’ universal opposition.

Aside from the bit on healthcare, Obama’s remarks were largely apolitical, and mainly focused on the impact private citizens like the Gates’ can have in effecting global change. This type of commitment, he said, defines his optimism about the future, despite what he called “a steady stream of bad news and cynicism we’re fed on television and Twitter.”

However, he did insinuate that, with the Trump Administration intent on undoing many of his achievements, such as withdrawing from the Paris climate deal, it is incumbent on citizens to keep fighting, highlighting climate change in addition to healthcare.

“Even if the federal government isn’t engaged on this effort right now, it’s because of efforts like Bill’s, and a whole host of entrepreneurs, and universities, and cities, and states, that America and the world will ultimately meet this challenge separate from what government is doing and that gives me hope,” he said.

Aside from his comments about healthcare, former President has kept a relatively low profile since leaving office eight months ago. He spoke up after Trump announced earlier this month that he was rescinding the Deferred Action for Childhood Arrival program, which he had implemented under executive action in 2012. On Tuesday evening, he tweeted his support for the victims of the earthquake in Mexico.

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Write to Alana Abramson at Alana.Abramson@time.com.