Former President Barack Obama expressed anger Wednesday at Republican efforts to repeal the Affordable Care Act. “What is needed today: the engagement of everyone who wants to see a better future for our children," Obama implored during his speech at the Bill and Melinda Gates Foundation’s “Goalkeepers” event in New York. “It can be frustrating,” he continued. “I’ll take an example here in the United States over the past eight years: thousands upon thousands of Americans threw themselves into the collective effort of reforming our health-care system. Those of you who live in countries that already have universal health care are trying to figure out what’s the controversy here. I am too.” He later added: “Now, the legislation that we passed was full of things that still need to be fixed,” Obama said of his signature health-care legislation. “It wasn’t perfect. It was better. And so when I see people trying to undo that hard-won progress, for the 50th or 60th time, with bills that would raise costs, or reduce coverage, or roll back protections for older Americans or people with pre-existing conditions—the cancer survivor, the expecting mom, or the child with autism or asthma for whom coverage once again be almost unattainable—it is aggravating.” Obama has carefully chosen his moments to speak out during the Trump administration, most recently expressing disappointment in his successor’s decision to end the Deferred Action for Childhood Arrivals program.