The piece describes America under Obama specifically in regards to healthcare. Based on the residential seal, the American eagle is depicted as double headed in a dual reference to the Russian emblem and the divided nature of the American government: Obama has been accused of being socialist and the two heads have been jeweled in red and blue respectively, referring to the current tensions between democrats and republicans.

The nooses point to the US history of slavery while the breasts within them refer to the removal of all federal funding for abortion impacting the reproductive rights of women across the nation, belying the separation of church and state.