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Right now Karl Rove is telling his Super Pac Pals  that it will all be different in 2014. Without Obama on the ballot, minority turnout will be low and angry white male voter turnout will be through the roof. He is promising them the Senate and maybe even hinting at Brother Jeb in 2016 to turn it all around for the party he crashed.

But we Democrats know better. In 2014, millions of Americans who have been priced out of the health insurance market---or have had the door slammed firmly in their faces due to “pre-existing conditions” or “age”---will be able to afford health insurance. States that have stubbornly refused to create their own pools will find their citizens offered insurance choices by the federal government.

One of these could be Medicaid, which will be expanded. Medicaid may be a good choice for those on fixed incomes, since it typically has no deductibles, low copayments and good (i.e. 100%) drug coverage. Now that Social Security income will no longer be counted towards determining Medicaid eligibility, lots of disabled people who are being nickeled and dimed---or $100ed and $1000ed--- by their Medicare copayments may get relief. Some states have indicated that they will resist the Medicaid expansion. However, this will mean turning away lots of federal money, at a time when many states are strapped for cash. Medicaid pays for such popular items as nursing homes and prenatal care. Does the Tea Party have the guts to paint itself as the enemy of the elderly and pregnant women? I don’t think so. I expect to see  the red states hold out their hands and say “Gimme!” the way they always do, since what blue states give in increased productivity and taxes, red stakes taketh.

For those making too much to qualify for Medicaid, there will be private insurance plans which will no longer be able to discriminate against those with risk factors for disease or medical conditions. Why the change of heart at United and BlueCross? The private insurance industry is salivating at the thought of collecting premiums from healthy 20 something men who never get sick.  They hope that the tax penalty for those who are uninsured will persuade lots of healthy people to sign up. The Tea Party is hoping that the tax penalty will get the angry white male voting block so riled up that they will turn out in record numbers in 2014. My advice? The IRS should “slow walk” the penalty part of the law. Give folks a two or three year grace period to look around and find the insurance that is right for them. This will force the private insurers to write affordable policies that will attract the cherries they want to pick. This will encourage more folks to become insured. And, it will remove the sting from the law, so that in 2016, Affordable Care will be win/win for the Democrats.

Using its executive powers, the Obama administration and HHS should be able to overcome any GOP roadblock. As a last resort, offer Americans the same insurance that federal employees get. Or, better yet, tackle the health care crisis by announcing open enrollment in Medicare.  An “emergency” is anything the administration says it is. And millions of Americans dying needlessly through lack of health insurance is the biggest ongoing crisis we face---much worse in scale than any hurricane or any terrorist attack. It is moral crisis,  that tests our nation’s vow to stand together. It is an economic crisis which strains hospital emergency rooms, decimates the work force and increases disability.

The GOP claims that Affordable Care is a job killer, but I think we will see the exact opposite. Folks who used to look for jobs with big companies, because they needed the insurance, will now be able to work for small businesses. Or even start up their own small businesses. Small businesses are the big employers in this nation---and they are unlikely to move to China. Strengthen small businesses and you increase jobs.

Healthcare spending is also a job creator. Not quite the job creator that education spending is, but much, much better than military spending and tax cuts and about equal to infrastructure spending.

This election was a huge crap shoot for the Tea Party and its corporate backers. I have no idea how much money Karl Rove wasted, but I hear that $150 million was spent for Romney in the last three weeks alone, so I am guessing a couple of billion went down the toilet. Why are the Koch Brothers of the world so determined to strike down Affordable Care?  Because they get rich by keeping American workers poor, uneducated, sick and desperate. If your choices are Dixie Cup or the poor house, you will, reluctantly, choose Dixie Cup.  But who will slave in a Dixie Cup factory when she or he can get a skilled job with better wages and benefits? No one.

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