VIENNA, Va. -- President Barack Obama has portrayed the health care reform that bears his name as a means of extending something vital, health insurance, to tens of millions of people who don't have any. Republican challenger Mitt Romney has cast Obamacare as something else, part of a dangerous wave of government interference in free enterprise.
On Tuesday morning in Virginia, a battleground state crucial to both candidates, conversations with voters suggested that Romney's critique had gained significant traction with some in the affluent suburb of Vienna, potentially threatening Obama's prospects in a state he won in 2008.
"The health care issue for me was really just a manifestation of government growth," said José Cardenas, 52, who had just cast his ballot for Romney. "The idea that we're handing one-sixth of the economy over to government control is disconcerting."
Cardenas, who has health insurance through his employer, didn't decide to vote for Romney just because he doesn't like the president's health reform. "I can't say that I came because of Obamacare," said Cardenas, standing outside James Madison High School, less than 20 miles from Washington, D.C. But Obamacare embodies for him the divide in American politics over the proper role of government.
Voters who spoke to The Huffington Post here in Fairfax County, America's second-richest county, saw the health care issue through the lens of their broader views about politics and the interaction of the free market with government. While pro-Romney Virginians like Cardenas complained of over-regulation, Obama supporters described the reforms as key to ensuring more Americans have access to affordable health care.
Obama and Romney campaigned hard in this swing state, and polls heading into Election Day showed Virginia's 13 electoral votes were still up for grabs. In 2008, Virginia favored Obama over Sen. John McCain (R-Ariz.) by 53 percent to 46 percent. Obama won 60 percent of the vote in Fairfax County that year.
The future of the U.S. health care system is on the ballot Tuesday. Two years ago, Obama signed the Affordable Care Act, sweeping legislation to extend health insurance coverage to an estimated 30 million uninsured Americans and to enforce stricter regulations on health insurance, including requirements that health plans offer benefits to anyone regardless of pre-existing conditions and an individual mandate that most individuals obtain coverage. Romney has vowed to repeal that law and favors less federal oversight of the health insurance industry.
Cardenas voted for Romney this year because he believes Obama's approach to solving the nation's problems favors the government over the market. "To the extent that policy gets involved in attempting to regulate a service like this, the more you're disrupting the natural flow of things," he said. Whenever he hears about proposals like Obamacare, "I immediately grab for my wallet," he said.
Diane Lim Rogers, who declined to say whether she had voted for Obama or Romney, works on federal fiscal policy issues and doesn't think either candidate put forth a credible plan to deal with rising spending on Medicare and Medicaid.
Lim Rogers is pleased that Obama's law should reduce the federal budget deficit, aims to contain government health care spending and would expand health insurance coverage to additional people. She wants more, though.
"Politicians are loath to bring up difficult choices," she said. "There's going to have to be some reduction in someone's benefits in the future."
For Henry and Ingrid Bishop, the health care debate is more personal. Their 40-year-old son doesn't get health benefits at work and can't afford to buy his own so the retired couple has been paying for his health insurance for the past few years.
Health care was a "big part" of why they both voted to reelect Obama, said Ingrid Bishop, 77. "I think everyone should have health insurance."
A native of Germany, she is frustrated that health care costs so much in the United States and that so many people go without coverage. While visiting her 100-year-old father in Germany, she broke her arm and had to pay just 200 euros -- about $250 -- for all her treatments, she said.
Both the Bishops are covered by Medicare, but they aren't worried that Obama's health reform, which will reduce Medicare payments to health care providers by $716 billion over a decade, will affect their benefits, said Henry Bishop, 81. And if the law winds up increasing their costs, then so be it, he said.
"I don't think this is going to change it that much. It may cost us a little bit more, but that's the price of getting everybody covered," said Henry Bishop, a retired government employee. "When you got to a restaurant and you have wait staff serving you, you want them to be healthy."
Ingrid Bishop wasn't swayed by Romney's declarations that Medicare cuts would harm senior citizens and doesn't like the plan authored by Rep. Paul Ryan, Romney's running mate, to convert Medicare into a "premium support" voucher system for future retirees. "I'm not a fan of Congressman Ryan. He's too far from the mainstream," she said.
Another voter's experience with her elderly father pushed her in the opposite direction. It was part of why she voted for Romney, said Pia Pell, 55, who was handing out Republican sample ballots outside the high school's entrance.
Pell's 92-year-old father, who served in the military during World War II, receives his medical care from the Department of Veterans Affairs, she said. The VA bureaucracy can be difficult to navigate, and she feels as though her father doesn't have control over his own care. Pell's fear is that the president's health reform will make the private market more like this government program.
"We're very concerned about Obamacare," said Pell, who has health insurance through her husband's job. "There is no recourse when the government takes over," she added.
Although Obama's law will extend health care coverage through the private insurance market, Pell believes it's a step in the direction of creating a single-payer system that the federal government would run for everyone.
A breast cancer survivor, Pell said she worries that greater government regulation of health insurance will lead to medical treatments being denied to people because they're too old or too sick. She also isn't comfortable with government-led public health initiatives touted by New York City Mayor Michael Bloomberg and first lady Michelle Obama, she said.
"Once they're controlling the health care, they're going to think that they have license to control more and more of our health choices," Pell said.
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