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In a survey earlier this year by the Pew Research Center for the People and the Press, 74 percent of registered voters and 72 percent of Catholic voters named health care a top priority in their voting decision. There are few issues in the 2012 presidential campaign on which the major candidates have more clearly differentiated opinions than health care. Much of President Barack Obama’s stand on health care is built on provisions of the 2010 Patient Protection and Affordable Care Act, which the Republican candidate, Mitt Romney, former governor of Massachusetts, has said should be repealed.

“President Obama believes that quality, affordable health insurance you can rely on is a key part of middle-class security,” says the president’s campaign Web site.

Meanwhile the Romney campaign charges that the Affordable Care Act “relies on a dense web of regulations, fees, subsidies, excise taxes, exchanges and rule-setting boards to give the federal government extraordinary control over every corner of the health care system.” The Republican candidate said in mid-September he would replace the health care law with his own plan, which would still allow young adults and those with pre-existing conditions to get coverage.

Rep. Paul Ryan, Republican of Wisconsin, and the Republicans’ vice presidential candidate, has become the point man for his party on the issues surrounding Medicare, Medicaid and the Affordable Care Act. In an address on Sept. 21 at the American Association of Retired People convention in New Orleans, Ryan called repeal of the Affordable Care Act “the first step to a stronger Medicare” and said the law “weakens Medicare for today’s seniors and puts it at risk for the next generation.”

President Obama, addressing the same gathering by satellite on the same day, argued that health reform “actually strengthened Medicare.” He said repeal of the law would mean billions in new profits for insurance companies. “No American should ever spend their golden years at the mercy of insurance companies,” he added.

Obama and the Department of Health and Human Services also have touted the benefits already achieved by the law, including nearly $4.5 billion saved on prescription drugs by closing the “doughnut hole” for 5.5 million seniors and people with disabilities. The A.C.A. has also led to a notable drop in the number of uninsured young adults, who may now be covered under their parents’ health insurance to age 26.

Controversially, contraceptives, including drugs many consider abortifacients, and sterilizations are among the new “preventive services” mandated by the Affordable Care Act. Certain religious employers qualify for what critics charge is a too-narrow exemption based on conscience objections.

Bruce Berg, an associate professor of political science at Fordham University in New York, predicted that both parties will continue to make health care an issue—but without changing very many minds. “Everything that is going to be said about health care with a degree of certitude has already been said,” he said. “There’s a lot we won’t know until three, four, five years down the road,” as other parts of the law are implemented, Berg added. After all the changes mandated in the law have taken effect, he said, “then we can have the real debate.”

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