President Barack Obama
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Campaigning for president in 2007, then-Sen. Barack Obama said: "Affordable, universal health care for every single American must not be a question of whether, it must be a question of how."

What followed three years later? Scary claims from Republicans of "death panels," "socialized medicine" and "government takeovers" of health care.

And in 2009, health care reform led to the birth of the Tea Party. But Republicans, who scaremongered the issue for years, now mostly avoid the subject unless it's forced into the discussion by a debate moderator. 

A year after Obamacare became law, Kentucky's junior senator, Rand Paul, said at a hearing that if you believe in the universal right to health care, "you believe in slavery." As it would turn out, though, more than 413,000 Kentuckians believed in health care and signed up. Kentucky's health care exchange, administered under Democratic Gov. Steve Beshear, has been one of the country's most successful implementations of Obamacare.  

But even though Kentucky's senior Republican senator, Senate Minority Leader Mitch McConnell, is in a close race with Democrat Alison Lundergan Grimes, she won't even acknowledge that she voted for Obama, much less challenge McConnell on the Affordable Care Act. During a debate this week, it was a moderator who forced McConnell to say, "I'm sure there are some people who are getting insurance who didn't have it before." 

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Even though health care has been a success for Kentucky, Grimes' campaign website doesn't include a tab that says "health care"—the closest she gets to the subject is a pledge to "protect Social Security." 

Can Grimes defeat McConnell by not focusing on a program that more than 413,000 Kentuckians have signed up for? Apparently she's going to try. And she's not the only one, with almost no Democratic congressional candidates on the ballot this November regularly talking up the Affordable Care Act.   

Since last year, Republicans have targeted swing-state Democrats who supported health care. And despite its success, the health care shaming is working. Democrats in Arkansas, Georgia, North Carolina and Louisiana campaign without mentioning it. Even though several Democratic candidates need black voters to turn out on Nov. 4, few have mentioned the president's biggest legislative achievement—one that thousands of African Americans have signed up for, and that polls show large majorities of African Americans support.   

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Meanwhile? Health care reform is working. 

More than 8 million Americans have signed up for health care, to the growing silence of Republican critics who were against it. Even so, Democrats run from the idea of bringing up the Affordable Care Act as a party triumph. 

When enrollment opens again next month, it's estimated that millions more will sign up. With 8 million already enrolled, the number of Americans without health care has dropped to the lowest rate since the 1990s—from 18 percent to 13 percent. African Americans, who are 55 percent more likely than whites to be uninsured, have seen the uninsured rate drop from 18.9 percent to 15.1 percent.

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Even as positive stats roll in, congressional Republicans voted to repeal health care reform 54 times by March of this year. And four years after the ACA was signed into law, Democrats still feel uneasy when it comes up.

With the exception of the president. 

During an Oct. 2 speech at Northwestern University, Obama said that the reduced cost of "health care is now the single biggest factor driving down" the federal budget deficit. He's recently made a series of speeches touting this accomplishment—even though Democrats on the ballot across the country haven't.

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"Thanks to the Affordable Care Act, we've seen a 26 percent decline in the uninsured rate in America. African Americans have seen a 30 percent decline. And, by the way, the cost of health care isn't going up as fast anymore either," Obama told the crowd at the Congressional Black Caucus' annual gala on Sept. 27.

As he travels the country listing his accomplishments, few Democrats have joined him, even though 28 states have taken the Medicaid expansion under the Affordable Care Act. And Republicans have blocked implementation in Alabama, Georgia, North Carolina, Florida, Louisiana, Texas and South Carolina, even though those states have important statewide contests on Election Day.

Lauren Victoria Burke is a Washington, D.C.-based political reporter who writes the Crew of 42 blog. She appears regularly on NewsOne Now with Roland Martin on TV One. Follow her on Twitter.