Massachusetts is the only state in the country where you don't have to worry about losing your health insurance if you lose your job, and it will remain that way if Mitt Romney, the man who signed that Massachusetts bill into law, gets elected president. But if President Obama beats him, every state in the Union will join Massachusetts in 2014.
The number one issue in the election, the issue that will decide who will be living at 1600 Pennsylvania Avenue next January 20th, is jobs. President Obama's reelection prospects will be determined by how many of the small percentage of voters who are up for grabs decide that they might as well give Romney a chance, since their economic prospects are just as shaky now as when President Obama took office. It might help if they could see ObamaCare as a jobs issue, which it clearly is.
Many of the independent voters who will determine the presidential election are confused by the Affordable Care Act, as its passage has offered no relief for a major worry in their lives: if they lose their job, they'll lose their health insurance. Or maybe they've already been forced to take a job without health insurance, or are self-employed or out of work. In that case, they may well be among the 51 million uninsured Americans who are worried that one major illness will wipe out whatever financial security they have left. Other swing voters might like to leave their jobs and start a small business, but they are locked into their current jobs until they reach 65 and qualify for Medicare. All that will change in 2014 if they vote for President Obama -- which they might be more likely to do if they knew that.
Starting in 2014, health insurance will be affordable for the great majority of people who don't get coverage at work. Most will qualify for heavily subsidized private health insurance through the new health insurance marketplaces (exchanges) that will be set up in each state. Many others in low-wage jobs will be eligible for coverage under Medicaid, which will be expanded to cover families up to 133 percent of the poverty level, around $30,600 for a family of four.
ObamaCare is more than a health care bill; it is a major step toward addressing the gaping inequities in our economy, where incomes and wealth for the richest 1 percent keep rising while most Americans are treading water or drowning. Three decades ago, a job came with good health care, along with rising wages and a pension. Now only 56 percent of the workforce gets health care on the job. With the implementation of the Affordable Care Act's coverage expansions in 2014, almost all workers will have access to affordable health coverage, even if they don't get the insurance at work.
President Obama and Mitt Romney are both working hard to appeal to the hard-pressed middle class. For Democrats, ObamaCare should be a core part of this appeal and the most powerful rebuttal to attacks on the legislation. The president and Democratic candidates for Congress around the county can reach swing voters on health care if they make the stakes in the election very clear: a vote for Romney and Republicans in Congress is a vote to leave Massachusetts as the only state in the nation in which you don't have to worry that losing your job will mean losing your health care. A vote for Obama and Democrats will mean that, come 2014, Americans will finally have the security that -- job or not -- they will have health coverage for themselves and their families.
Richard Kirsch is a Senior Fellow at the Roosevelt Institute, a Senior Adviser to USAction, and the author of Fighting for Our Health. He was National Campaign Manager of Health Care for America Now during the legislative battle to pass reform. This post appeared first in Next New Deal, the blog of the Roosevelt Institute.
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