President Barack Obama declared Tuesday that his 5-year-old health care law is firmly established as the “reality” of health care in America, even as he awaits a Supreme Court ruling that could undermine it.

“This is now part of the fabric of how we care for one another,” he said.

Obama defended the health care overhaul during an address to the Catholic Health Association Conference in Washington, just days ahead of an anticipated decision by the Supreme Court that could eliminate health care for millions of people.

Obama poked fun at opponents who have issued “unending Chicken Little warnings” about what would happen if the law passed. None of those predictions have come true, Obama argued.

The aims of the Affordable Care Act (ACA) were to increase health insurance coverage for those under age 65, improve the performance of the health care delivery system, and slow cost growth. Less recognized are the provisions of the law that seek to strengthen the Medicare program.

The ACA addresses gaps in Medicare preventive and prescription drug benefits. It initiates ambitious testing of new payment methods to improve the value of care received by beneficiaries and, indirectly, all Americans. And it substantially extends the solvency of the Medicare Health Insurance Trust Fund by slowing the growth of future Medicare outlays.

President Obama reentered the political battle over healthcare Tuesday, delivering an extended defense of the Affordable Care Act as the Supreme Court prepares to issue its ruling on a case that could strip away health insurance from millions of Americans.

Efforts by insurers to boost premiums are the latest evidence that President Barack Obama’s health care law “just doesn’t work” and must be replaced, the Republican chairman of the House Ways and Means Committee said Wednesday.

Rep. Paul Ryan of Wisconsin launched the GOP’s latest attack against the health care overhaul as Health and Human Services Secretary Sylvia Burwell defended it before his committee. Their conflicting views underscored that Obama’s 5-year-old law remains a partisan flashpoint, likely to reverberate through next year’s presidential and congressional elections.