What's at stake

When I think about what happens if Romney wins, I generally come back to how devastating this could be for the health (and thus happiness and welfare) of millions and millions of Americans.  Sure, it’s personal to a degree.  There’s a good chance that we could exceed the lifetime cap on Alex’s insurance (which ACA abolishes but Romney would re-institute  and at some point, Alex will need to rely on Medicaid for insurance as a disable adult. Fortunately, my family has some means and I’d like to think Alex will always be alright.  But I can’t help thinking about all the other Alex’s out there who don’t have the same advantages.  Are they supposed to just suffer because our country– with all of its obscene wealth– cannot afford to help them?  I get that Republicans like to blame all the people on welfare as just too lazy, their own choices, etc.  I surely don’t agree, but I can at least understand how they have these views.  But how on earth do you justify the cuts to America’s neediest that the Romney/Ryan budget and repealing the ACA surely imply?  Even more, how do you square that with your deep and abiding love of Jesus?  Self delusion.  Damn, I hate hypocrisy.  Even more so, I hate a completely self-serving lack of empathy.  Here’s Ezra on the matter:

The most important fact of the 2012 election is that the Affordable Care Act was passed in 2010; it just hasn’t been fully implemented yet. If President Obama is reelected, the bulk of it will roll out on schedule in 2014.

That health care act is key because, unlike challenger Mitt Romney’s tax reform plan or Obama’s deficit-reduction plan, voters can truly count on it. If Obama is reelected, every American making less than 133 percent of the poverty line will receive Medicaid (sorry, but I don’t buy that even the reddest of states will long refuse a 9-to-1 ratio of federal-to-state Medicaid funding for very long); every American making between 133 percent and 400 percent of the poverty line will get tax credits to help buy private insurance; and there will be an expectation — reinforced by a tax penalty — that Americans who can buy quality health insurance for less than eight percent of their income will do so.

If Obama is reelected, Americans who lose their jobs needn’t fear that their families will lose their health insurance. Discrimination based on preexisting conditions will be a thing of the past, and every state will have a health insurance exchange where insurers compete for business and where regulators can expel shoddy health plans. Medicare will continue itstransition from the fee-for-service model toward a system of value-based payments in which providers are compensated for maintaining healthy patients. Expensive employer-based health plans will be slapped with a hefty tax beginning in 2018.

If Obama is reelected, in other words, we will see the first iteration of a uniquely American universal health-care system. If history is any guide, it will become effectively permanent soon after it is introduced…

Which is all to say that, yes, this election matters more than most. It matters more politically because the party in power will likely see their agenda affirmed by a cyclical recovery. But it matters more to actual people because the Affordable Care Act is poised to reshape American health care in two years. A vote for Obama is a vote for the law to take effect and for 30 million Americans to get health insurance they won’t get otherwise. A vote for Romney is a vote for the law — and its spending and its taxes — to be repealed. There are few elections in which the stakes are so clear.

But oh sure, go ahead and vote Republican to protect the unborn babies and to keep from punishing the poor millionaires for their success.

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