President Joe Biden on Monday will ratchet up his attacks on Republicans and former President Donald Trump on a familiar issue: health care.

       On a visit to New Hampshire, a state with one of the country’s oldest populations, Biden plans to outline a health care agenda that he’ll say contrasts sharply with Republicans, who have pledged to repeal the Affordable Care Act and eliminate caps on out-of-pocket drug costs.

       Biden’s aides believe health care is a potent, if sometimes overlooked, issue for voters as the general election gets underway. Democrats have successfully messaged on the issue in the past several election cycles, and the relative popularity of the law known as Obamacare has made for a natural opportunity to have Biden appear alongside his former boss, Barack Obama, in campaign videos.

       Yet polls show many Americans remain unaware of the steps Biden has taken since becoming president to bring the cost of health care down.

       And even as the president plans to call on Congress on Monday to pass new laws that would expand a cap on out-of-pocket drug costs, allow Medicare to negotiate the prices of more drugs, and extend Obamacare premium subsidies, there is little chance the GOP-controlled House will take them up before November.

       That makes Monday’s stop in New Hampshire an opportunity to draw a sharp contrast with Trump and his fellow Republicans. Biden won the Granite State by a 7-point margin in 2020, though polls show a tighter contest this year.

       It’s Biden’s first trip to the state since its primary contest in January, which he won despite his name not appearing on the ballot.

       In a state where a fifth of the population is over 65, lowering health care costs and expanding access to care hold outsize significance. Biden is expected to continue a line of attack he began during his State of the Union address last week.

       In his speech, Biden called the 14-year-old Obamacare “still a very big deal” — a nod to his profanity-laced description of the law the day it was signed. And he vowed to bar Republican attempts to repeal it.

       “I’m not going to let that happen. We stopped you 50 times before, and we’ll stop you again,” Biden said.

       Late last year, Trump said Republicans should “never give up” on trying to repeal the landmark Obama-era health reform law, adding that he was “seriously looking at alternatives.”

       The Biden campaign quickly seized on those comments and has accused Trump of harboring a “vendetta” against the law because of his personal animus toward Obama, Biden’s predecessor.

       For Democrats, being able to campaign in defense of the Affordable Care Act is a dramatic reversal of fortune from a decade ago. GOP presidential and congressional candidates successfully ran against the legislation for years after its passage. Yet as more Americans sign up for coverage through the law’s exchanges, it has become even more embedded into the nation’s health care system.

       Fifty-nine percent of Americans said they had a favorable view of the law as of February, according to the most recent polling from KFF, formerly the Kaiser Family Foundation.

       Another KFF poll from December found that Democratic voters were more than twice as likely as their GOP peers to say that the future of the health reform law is a “very important” issue for the 2024 presidential candidates to discuss. Overall, 49% of voters said the issue is “very important,” but breaking it down by party, 70% of Democratic voters felt that way, while only 32% of Republican voters did.

       For Biden, the past three years have seen steady efforts at trying to bring down the cost of drugs. One of the president’s most frequently touted accomplishments is capping the out-of-pocket cost of insulin at $35 a month for Medicare enrollees. He has vowed to expand the cap for all Americans if reelected.

       In his State of the Union, the president went after not only Republicans for resisting his drug pricing efforts but also pharmaceutical companies, calling out “Big Pharma” three times in his speech. It was an effort at publicizing the 2022 measure that empowered Medicare to negotiate drug prices for the first time. Polls show the publicity is needed.

       Most Americans are not aware of the prescription drug provisions in the 2022 Inflation Reduction Act, even though Biden has repeatedly heralded these measures as evidence of his work to lower drug prices, one of Americans’ biggest complaints.

       Only 32% of adults in KFF’s poll from December said they were aware there’s a federal law that requires the federal government to negotiate the price of some expensive drugs for Medicare enrollees, though that was up from 25% in July.

       The administration and drugmakers are negotiating the prices for 10 costly drugs, including those that treat heart disease, certain cancers and diabetes, among other conditions. The negotiated prices will be announced by September 1 and take effect in 2026. The drugmakers and industry groups have filed lawsuits in federal courts across the US in hopes of stopping the effort, contending that the program is unconstitutional.

       And, despite Biden calling attention to the benefit, only about a quarter of those surveyed by KFF were aware there is a federal law that caps the cost of insulin for Medicare enrollees, which took effect in 2023.

       Another provision of the Inflation Reduction Act places an annual cap on the out-of-pocket costs in Medicare Part D drug plans. Enrollees will spend no more than about $3,300 for brand name drugs this year. A $2,000 annual cap on out-of-pocket drug spending will kick in in 2025.

       Fewer than a quarter of adults knew about the federal law that limits out-of-pocket drug costs for Medicare beneficiaries, according to KFF’s poll.