The law as signed by the President was not the intended outcome, Ahier adds. To cram it through the Senate, politicians had to tack on politically unpopular pieces – recall the Cornhusker Kickback, under which Nebraska somehow lassoed a permanent exemption from Medicaid expansion while everyone was watching the rodeo. And that’s just the most egregious example.

“It always makes me suspicious when you’re doing health payment reform and the insurance industry says ‘okay, yeah, let’s do this.’” Ahier continues. “Honestly I think that finally swallowing that whole thing like we did may have turned out to be certainly not in healthcare’s best interest.”

That sentiment resonates with Spartanburg Tea Party leader Martin as well, who adds that part of the reason so few truly understand the Affordable Care Act is because the problem it set out to solve was never clearly defined.

[S.C.: Where the Tea Party stronghold reigns over healthcare matters.]

“America did not have a healthcare crisis. We have the best healthcare ever in the world and the only person that could question that is someone pushing reform out of dubious political expediency. Our healthcare system is phenomenal,” Martin said. “What we do have, because of the way our insurance is set up, by routing through the employer, by using HMOs, these third parties to keep patients financially distant from their doctors and not understanding what they’re actually paying for services, we have a health cost crisis. That’s what we have. The way to solve that is a free market.”

Not everyone agrees. OHN’s Lamb argues that, yes, there are problems with health costs but America also has a very apparent and significant healthcare problem.

“I would point to all the chronic conditions as disagreement. If we didn’t have a healthcare problem, we wouldn’t have all the chronic conditions, so we’d be much more preventative in nature, and we wouldn’t have a sick care program,” Lamb says (pictured at right). “We’d be keeping people out of the hospital, out of those types of diseases before they got there.”

Cost not the paramount consideration
The polarizing dialogue will continue through election season and after as Democrats and Republicans fight tooth-and-nail to not only sculpt the future of healthcare but, perhaps as important, dominate the narrative around it.

“The fact that the quite reasonable provisions of the original bill regarding counseling end-of-life care were libeled as ‘death panels’… illustrates the loss of control over the narrative,” Brookings’ Aaron explains. “The job of winning the public will be hard, but, in my view, it is a fight that cannot be shirked and that if waged with vigor, determination, and honesty can be won.”

State legislator Alden Wolfe sees emerging evidence that the American people are starting to better understand healthcare, despite the efforts of politicians.

“I think perhaps Americans are waking up and realizing that there are good things associated with the health reform legislation,” Wolfe says. “It’s not just the cost, but the availability of care that is most meaningful. I think people may be starting to realize that the federal healthcare legislation is doing what it’s supposed to do, and that is making healthcare more available to a wider stratum of society.”

And that is, after all, what the PPACA and the triple aim are designed to accomplish.

But as candidates vying for office from the White House down to local levels continue campaigning on rudimentary mottos that do little to further public understanding of health reform, many Americans are left scratching their heads — some of them spitting-mad at the federal government about goals that are, in many ways, both progressive and conservative at the same time.

For all of our primaries coverage, visit the Elections 2012 page.