Finally, a key purpose of Obamacare is to increase the number of Americans covered by Medicaid, the federal health system for the poor. Obamacare expands Medicaid coverage to those with up to 133 percent of poverty-level income; for the first few years at least, all the extra cost will be paid by the federal government.
More people on welfare, food stamps, Medicaid; that has been the trend under the first Obama administration and most certainly would be the trend -- perhaps an accelerated trend -- under a second Obama term. The economic downturn undoubtedly meant that more people would receive temporary government assistance, but the effect of Obama's policies has been to expand dependence far beyond that.
A few months ago, conservatives laughed when the Obama campaign came up with "The Life of Julia: A look at how President Obama's policies help one woman over her lifetime." Obama told the story of a fictional girl who received Head Start before kindergarten; got an Obama-provided $10,000 tax credit to go to college; got a job as a Web designer; and enjoyed free contraceptives courtesy of Obamacare; got a government loan to start a small business; and ultimately headed into retirement and coverage by Social Security and Medicare.
Conservatives scoffed at the whole thing. "Julia's world ... may be the most self-revealing parody of liberalism ever conceived," wrote columnist Charles Krauthammer, noting that Julia is "swaddled and subsidized throughout her life by an all-giving government" and "the only time she's on her own is at her gravesite." But the Obama campaign is entirely serious about ensuring that Americans spend much of their lives receiving one government benefit or another.
And if the president is re-elected, Obama's expanded nanny state will be here to stay. As the administration well knows, once the government confers benefits on citizens, withdrawing those benefits can be enormously unpopular, a move few politicians will wish to risk.
So in four more years, Barack Obama could make great strides toward the goal of making more and more Americans dependent on government. Yes, issues like debt and deficits are important. But dependency could be the biggest issue of all on the ballot this November.