With more than 8 million Americans now dependent on medical coverage through Obamacare, the law may finally be cemented into the foundation of U.S. society.

The response easily beat a Congressional Budget Office prediction of 6 million, and the agency says it expects at least 7 million more people will enroll in private plans after the sign-up period for 2015 opens in November.

Between now and then, politicians will try to make the law’s effects on consumers a key issue in the November congressional elections. Foes say the law makes insurance too expensive, opens enrollees to high out-of-pocket costs and limits medical choices. Backers say expanded access to care for all Americans and substantial cost reductions for lower-income people outweigh any disruptions in previous coverage.

“Realistically, it’s not going to be repealed,” said Bill Hoagland, a former top adviser to Republican Bill Frist, the retired Tennessee senator, in a telephone interview. “What I think Republicans need to do is move on and focus on those changes in the law that would improve its acceptability to Republicans, as opposed to continuing to talk about repeal.”

Congressional Republicans continue to insist that their top political goal remains repealing the Patient Protection and Affordable Care Act. Without an alternative policy to expand access to health care, however, that position now entails casting millions of Americans out of insurance coverage.

“This thing is working,” President Barack Obama said in a news conference at the White House yesterday.

Medicaid Expansion

At least six million people gained coverage under Obamacare provisions that have expanded Medicaid in 26 states and allowed adult children to stay on their parents’ plans, Obama said. Next year, the budget office says the number of people covered under the Medicaid expansion will increase to about 11 million.

The administration’s success at enrollment has drawn notice from insurers.

“The size of the overall market is positive,” Gail Boudreaux, an executive vice president at UnitedHeath Group Inc. who leads the company’s commercial health plans, said in a conference call with Wall Street analysts yesterday. “Our bias is to increase our participation in 2015.”