[Y]es, this election matters more than most. It matters more politically because the party in power will probably see its agenda affirmed by a cyclical recovery. But it matters more to actual people because the Affordable Care Act is poised to reshape American health care in two years. A vote for Obama is a vote for the law to take effect and for 30 million Americans to get health insurance they won’t get otherwise. A vote for Romney is a vote for the law to be repealed. There are few elections in which the stakes are so clear.