Usually noted for his placid demeanor and nods to bipartisanship, Pennsylvania U.S. Sen. Bob Casey fiercely defended Medicaid in a conference call with reporters Tuesday, vowing that he would not work with any lawmakers who want to slash the program.

"I'm a very reasonable person," Casey said, but vowed to use "any means possible" to stop Republican attempts to "sabotage" Medicaid.

"I will oppose them to the ends of the Earth," said Casey, a Democrat.

Casey made his comments in support of a report from the advocacy group Protect Our Care which argues that the Medicaid expansion that occurred under the Affordable Care Act has broadly improved health outcomes and lowered costs. Since the Affordable Care Act was approved in 2010, 36 states and the District of Colombia have signed on to the Medicaid expansion, and, according to Protect Our Care, 12.7 million people have gained coverage.

The report also says that states that expanded Medicaid coverage saw their rates of uninsured residents decrease by 6.7 percent, while states that opted out of the Medicaid expansion saw their rates fall by only 4.3 percent. The report from Protect Our Care also says Medicaid expansion has expanded treatment for opioid use disorder and reduced racial disparities in health care.

"Medicaid expansion has made Americans healthier," said Brad Woodhouse, Protect Our Care's executive director. "It is an unqualified success."

The Trump administration attempted to repeal the Affordable Care in 2017, falling one vote short in the Senate, and has expressed support for a December ruling by a federal judge in Texas that found the law unconstitutional. The administration has also proposed slowing Medicaid spending over the next decade, and, perhaps, making it a block grant program to states. White House Chief of Staff Mick Mulvaney has described Medicaid growth as "unsustainable," and that "abundant evidence suggests that new enrollees are not experiencing health improvements to justify the dramatic increase in cost."

In the conference call, Casey also said Medicaid is one program that unites the commonwealth's sometimes disparate urban and rural communities.

"Medicaid is not a 'them' program," he said. "It's an 'us' program."

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