Joe Biden knocks both President Trump and some of his fellow Democratic White House hopefuls in a television ad that debuted Tuesday in Iowa in which the former vice president suggests they are all a threat to the Affordable Care Act.

Health care has emerged as a fault line in the Democratic primary debate, with Biden calling for building upon President Barack Obama’s signature achievement while other leading candidates, including Sens. Bernie Sanders (Vt.) and Elizabeth Warren (Mass.), advocate for a Medicare-for-all single-payer plan.

In his 60-second spot, Biden highlights the importance to his family of having had health insurance at key moments as well as the passage of the Affordable Care Act in 2010 while he was vice president.

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“The fact of the matter is, health care is personal to me. Obamacare is personal to me,” Biden says, as a picture is shown of Obama with a hand on his back. “When I see the president try to tear it down, and others propose to replace it and start over, that’s personal to me, too. We’ve got to build on what we did, because every American deserves affordable health care.”

Biden does not mention any of his Democratic rivals by name in his ad. Sanders and Warren, the two other leading candidates in recent polling, have made Medicare-for-all central to their campaigns.

Trump has sought repeatedly — through legislation and legal challenges — to repeal the Affordable Care Act since taking office in 2017.

In his ad, Biden recalls the death of his first wife and daughter in a car accident and his swearing in as a U.S. senator next to the hospital beds of his two young sons, as well the cancer diagnosis decades later of his eldest son, Beau Biden.

“I can’t fathom what would have happened if the insurance companies had said, ‘For the last six months of your life you’re on your own,’ ” Biden says in the ad.

Biden’s campaign said the ad is part of a six-figure media effort launched last week in Iowa’s Des Moines, Cedar Rapids, Quad Cities and Sioux City markets. In addition to television ads, the campaign also is buying digital ads on multiple social media platforms.

“Protecting the ACA from Republicans seeking to tear it down, or from others proposing to replace it, is a crucial and personal issue for Vice President Biden and for Americans across the country,” Biden campaign manager Greg Schultz said in a statement.