WASHINGTON (AP) — President Joe Biden and Vice President Kamala Harris will promote their health care agenda on Tuesday in North Carolina, a battleground state that Democrats hope to flip in their favor after falling short to Donald Trump in the last two presidential elections.

Fourteen years after President Barack Obama signed the Affordable Care Act into law, the White House still sees health care as a winning issue during a campaign in which Biden has sometimes found himself on the defensive when it comes to immigration or the economy. Republicans have opposed Biden's signature initiatives to lower medical costs, and they've seized opportunities to restrict abortion rights after the U.S. Supreme Court overturned Roe v. Wade.

"That's the split screen on health care you will see on clear display," said Anita Dunn, a senior adviser. "President Biden, Vice President Harris and Democrats want to expand access, make health care more affordable for everyone and defend reproductive freedom. Republicans want to gut health care, raise prices and rip away those basic reproductive freedoms even more than they have already been endangered."

North Carolina is Biden's final stop in his tour of battleground states after his State of the Union earlier this month, which jump-started a frenzied travel schedule as the Democratic president makes his case for a second term in a likely rematch with Trump, the presumptive Republican nominee.

The state is also a health care success story for the president. The American Rescue Plan, a coronavirus pandemic recovery measure signed by Biden, included financial incentives for states to expand Medicaid coverage for low-income residents. North Carolina Gov. Roy Cooper, a Democrat, was able to use the money, which amounted to $1.8 billion, to persuade Republican lawmakers to go along with his plan. More than 600,000 residents are expected to qualify.

The visit from Biden and Harris comes on the same day that the U.S. Supreme Court heard oral arguments in a case about access to mifepristone, a widely used abortion pill. The justices appeared inclined to preserve access to the medication.

The White House has tried to make mifepristone more available as one of its few opportunities to protect women's ability to end their pregnancies.

"We will continue to fight back against unprecedented attacks on women's freedom to make their own health decisions," press secretary Karine Jean-Pierre said.

After speaking about health care in Raleigh, Biden and Harris will also attend a campaign fundraiser in the city. They've built a significant cash advantage over Trump, with $155 million cash on hand through mid-March. Trump had $37 million.

Biden's approval ratings on health care are among his highest on a range of issues, but he remains underwater there too. According to a February poll from The Associated Press and the NORC Center for Public Affairs Research, 42% of U.S. adults approve of Biden's handling of health care while 55% disapprove.

KFF, a health policy research firm, conducted its own poll in November and found that 59% of U.S. adults trust the Democratic Party to do a better job addressing health care affordability issues. Only 39% said the same about Republicans. There was a similar divide in trust when it came to access to mental health care, prescription drug costs and the future of the Affordable Care Act, Medicare and Medicaid.

"I'm a person who believes that good policy is also good politics, that when people feel like policies are in place that are helping and benefiting them in their communities, then you now have loyal supporters," said Maryland Gov. Wes Moore, a Democrat.

Moore said he sympathized with voters who did not believe that Biden had made a significant impact on issues like healthcare, but he stressed the administration's record on policies like lowering prescription drug prices and capping the cost of insulin.

"Nothing happens by accident, it's because you have leaders who are prioritizing it," he said.

Trump has never detailed his health care proposals despite campaigning since 2016 on a promise to end the Affordable Care Act and replace it with something else.

"The cost of Obamacare is out of control, plus, it's not good Healthcare. I'm seriously looking at alternatives," he wrote in a post on his Truth Social site in November.

However, healthcare has not been a prominent issue in his 2024 campaign as Trump instead focuses on immigration, inflation and the wars in Europe and the Middle East.

Polls show a tight race between Biden and Trump this year, and Democrats hope to create another potential path to victory in North Carolina.

Although Democrats have failed to win a U.S. Senate seat or a presidential race there since 2008, Trump beat Biden in North Carolina by just 1.3 percentage points in 2020. The White House has repeatedly highlighted federal injections of funds for transportation, rural broadband and other initiatives while dispatching top administration officials to the state.

Democrats also want to exploit what they view as weaknesses among Republican candidates for statewide offices. For example, the party's nominees for governor and state schools superintendent, Mark Robinson and Michele Morrow, have a history of inflammatory comments.

"We're seeing a Republican slate at the statewide level that is filled with MAGA extremists that ultimately is going to hurt the Republicans' chances of winning the state again," state Sen. Jay Chaudhuri of Raleigh, the chamber's Democratic whip, said Monday in an interview. "As we get closer to November, I think independents that are critical in winning the state will be able to see how extreme the Republican ticket is from top to bottom."

Democrats hope that unaffiliated voters, the largest category in the state, will cool to Trump in part based on worries that his election along with Robinson and Morrow could make businesses question relocating to a state that is currently riding an economic boom.

"It's clear that Republicans have nominated a slew of candidates that want to throw us right back into the culture wars," said Cooper, the Democratic governor, last week. "And Donald Trump is right on top of that, driving the train on this."

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This story has been corrected to show that Biden's $155 million cash on hand was through mid-March, not the end of the first quarter.

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Associated Press writers Gary Robertson in Raleigh, North Carolina, Jill Colvin in New York and Darlene Superville, Amelia Thomson-DeVeaux and Matt Brown in Washington contributed to this report.