The downsides are huge, though: higher federal spending, new taxes on life-saving medical devices, a vast grant of discretionary authority to the executive branch, and subsidies designed in a way that punishes lower-middle-class people.
It didn't have to be that way. We could and should have increased coverage with a much less government-centered law.
We could have changed tax and regulatory policies to foster a national market in individually purchased insurance, while creating well-funded risk pools to cover people with pre-existing conditions. That would have cost much less and ceded less power to bureaucrats.
Obama says the law cuts "wasteful" Medicare spending. All it does is pursue strategies - tighter price controls, government-funded research on effective practices, pilot programs - that have failed for decades.
And that's the best thing Obama has done on entitlements - indeed, the only thing he has even proposed while in office.
He has been trashing promising ideas such as improving Medicare's efficiency by letting insurers compete for beneficiaries' dollars. Many Democrats have supported that approach.
Paul Ryan's proposal for addressing the country's debt challenge has its flaws. But to attack it while advancing no alternative is to abdicate leadership.
These aren't the only reasons to oppose Obama's re-election. There is also his pattern of rewriting laws to suit his preferences when Congress doesn't oblige him - something he has done on immigration, welfare and health care.
Then there are his positions on abortion and the courts, which many people abhor.
His conviction that his mere presence in the Oval Office would alter the conduct of other countries to America's benefit now seems like vanity rather than a sound foreign policy.
It's remarkable to watch a president run for re-election without discussing his plans or the elements of his record.
The stimulus and the health care bill are two of Obama's most consequential policies, and Americans could be paying for them for a very long time.
They are only footnotes to Obama's campaign.
They ought to be his political epitaph.
Ponnuru, a senior editor at National Review, is a Bloomberg View columnist.