The passage discusses the debate around the Affordable Care Act (ACA) between Democrats and Republicans. While 7 million have now signed up under the ACA, Republicans still want a full repeal. Democrats argue that repeal is unrealistic and want to modify the law instead. However, Democrats are divided on whether to fully embrace the law or propose changes, and have not agreed on specific changes. Support for the law has increased slightly but remains divided along party lines. The politics of healthcare could shift by the November election depending on if Democrats can motivate supporters as much as Republicans motivate opponents.