In this cartoon the artist is trying to say that Obama-Care is like a bird flying out of control
The author is trying to say with the Affordable Care Act it's like rolling the dice, you don't know the outcome.
In the cartoon, President Obama would to put the genie back in the bottle to cover up his lies regarding the ACA
The message of the cartoon is that Obama care has made so many errors, that a football player would be traded for that many fumbles.