Former President Barack Obama on Sept. 20 called repeated Republican efforts to repeal his signature health care law “aggravating” as he urged people not to be discouraged by unsteady progress as they work on pressing global issues.

Former President Barack Obama speaks during the Goalkeepers Conference hosted by the Bill and Melinda Gates Foundation, Wednesday, Sept. 20, 2017, in New York. (AP Photo/Julio Cortez)

Speaking at a summit hosted by billionaires Bill and Melinda Gates to coincide with the United Nations General Assembly, the Democrat said the real problems facing the world “can’t discourage any of us from the belief that individually and collectively, we can make a difference.”

He alluded to some of his own frustrations, including the battle over the Affordable Care Act.

Republican leaders in the U.S. Senate are again pushing to repeal central elements of the law after repeated failures. A vote is possible next week.

“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 … it is aggravating,” Obama said. “It’s certainly frustrating to have to mobilize every couple of months to keep our leaders from inflicting real human suffering on our constituents.”

Opponents of the Obama-era health law to expand coverage for more Americans have assailed it as costly and ineffective. They also say people shouldn’t be forced to buy health insurance.

On climate change, Obama said the federal government isn’t “as engaged in these efforts as I would like.” Republican President Donald Trump has said he will pull the U.S. out of the Paris accord, an agreement the Obama administration worked with other countries to help fashion.

But the response to setbacks, Obama said, has to be “to reject cynicism and reject pessimism and push forward.”

He said, “Rather than be daunted by those challenges, those challenges should inspire us and excite us because it gives us an opportunity to make our mark on the world.”

The summit wasn’t the only event to have a high-profile speaker. The General Assembly brings together leaders from all over the world and has become a prime time for gatherings touching on the world’s concerns.

For years until its final event last year, the most well-known of the corollary events was the Clinton Global Initiative, created by former President Bill Clinton as a way to raise attention and money for causes worldwide.

This year’s offerings include the Bloomberg Global Business Forum, hosted by billionaire and former New York City Mayor Michael Bloomberg. The speakers included Clinton and a raft of business and political leaders.