In 2009, when Barack Obama traveled to Bristol, Virginia, for a town hall to promote the Affordable Care Act, his motorcade passed a small but turbulent protest. I was raised just outside this small Appalachian city, and even then, three years after graduating from high school, I knew it desperately needed health care reform. At the time, according to data compiled by the Urban Institute, almost a fifth of Bristol’s residents under age 65 had no health insurance—one of the highest rates in the state. And yet, when Obama arrived, people greeted him with signs that read SOCIALISM ISN’T COOL and OBAMA: “GOD” DECIDES LIFE AND DEATH NOT YOU OR NATIONAL HEALTHCARE.

Six months into his first term, Obama was facing this kind of opposition not just in Bristol, but nationwide, even in districts he’d won the previous fall. Alarmed by conservative talk radio hosts and the constant harping of an intransigent Republican Party, many Americans believed that the ACA would rip apart the fabric of American life. “No one should be surprised at the coming embrace of euthanasia,” conservative columnist Cal Thomas warned.

Despite the opposition, Democrats were promising that Obamacare would eventually boost their chances in elections, as Americans gradually came to see the benefits of the law: It made sure that preexisting conditions were no longer cause for discrimination, and gave people with diabetes, cancer, and other serious conditions a chance to afford health insurance. “As people learn about the bill, it’s going to be more and more popular,” Senator Chuck Schumer said in March 2010. “By November, those who voted for health care will find it an asset, those who voted against it will find it a liability.”

What Schumer predicted never happened, at least not that year. A few months later, the GOP picked up 63 seats in the House and six in the Senate. A study published the following year estimated that at least 13 House Democrats lost their seats because of their support for the law. With the Tea Party sweeping into office, the ACA threatened to drag Democrats down.

This year, the prevailing attitude toward the ACA has changed. In West Virginia, in a September campaign ad, Senator Joe Manchin, perhaps the most conservative Democrat in the Senate, blasted a paper copy of a lawsuit challenging the ACA with a rifle. In Ohio, Democratic gubernatorial nominee Rich Cordray pledged to protect the state’s ACA Medicaid expansion from Republican interference. And in Wisconsin, Democratic gubernatorial candidate Tony Evers has repeatedly attacked Republican incumbent Scott Walker for joining a multistate lawsuit opposing the ACA. “If you want to protect the millions of Wisconsinites with a preexisting condition, drop Wisconsin from this lawsuit,” Evers said in September.