I also had visions of a GAO or an Inspector General’s report down the road and press headlines screaming, “Obamacare Riddled with Fraudsters.” At its core, the subsidies for buying insurance and qualifications for Medicaid expansion make the Affordable Care Act a means-tested program like food stamps or Supplemental Security Income (SSI). And we know how those programs have been “demagogued” to death. This, of course, leads to the equity in healthcare question, which has not really been settled by the incremental approach to coverage, the premise of the ACA. Is every American entitled to healthcare and a way to pay for it?

“The coverage gap illustrates the polarizing debate over what role government should play in health care, who is truly needy and how to pay the bills,” Young wrote, and explored the equity question through the comments of 40-year-old Jennifer Rosa. Rosa works full time in a grocery store stocking shelves and carrying out bags of food for customers in Ellingon, MO. Her employer providers no insurance and her income is too high to qualify for Medicaid, although her son does. Like most people in this fix, she doesn’t go to the doctor even when she might need to. She says she’d like to have affordable insurance but is not a fan of the Affordable Care Act. “I don’t like the idea of them forcing this down our throats,” she explained, adding she opposes people who “sit at home and draw a check. I don’t want them to do everything for me, but as a working person, some help would be great. We’re people who work for a living.” Her comment makes the point. America is still schizophrenic about the government giving its citizens a helping hand—even in matters of life and death.

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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.