Barack obama selected sp.., p.43
Barack Obama Selected Speeches, page 43
That still leaves about 1 million Americans who successfully made it through the website, and now qualify to buy insurance, but haven’t picked a plan yet. And there’s no question that if the website were working as it’s supposed to, that number would be much higher of people who have actually enrolled. So that’s problem number one—making sure that the website works the way it’s supposed to. It’s gotten a lot better over the last few weeks than it was on the first day, but we’re working 24/7 to get it working for the vast majority of Americans in a smooth, consistent way.
The other problem that has received a lot of attention concerns Americans who have received letters from their insurers that they may be losing the plans they bought in the old individual market, often because they no longer meet the law’s requirements to cover basic benefits like prescription drugs or doctors’ visits.
Now, as I indicated earlier, I completely get how upsetting this can be for a lot of Americans, particularly after assurances they heard from me that if they had a plan that they liked, they could keep it. And to those Americans, I hear you loud and clear. I said that I would do everything we can to fix this problem. And today I’m offering an idea that will help do it.
Already, people who have plans that predate the Affordable Care Act can keep those plans if they haven’t changed. That was already in the law. That’s what’s called a grandfather clause. It was included in the law. Today, we’re going to extend that principle both to people whose plans have changed since the law took effect, and to people who bought plans since the law took effect.
So state insurance commissioners still have the power to decide what plans can and can’t be sold in their states. But the bottom line is, insurers can extend current plans that would otherwise be canceled into 2014, and Americans whose plans have been canceled can choose to re-enroll in the same kind of plan.
We’re also requiring insurers to extend current plans to inform their customers about two things. One, that protections—what protections these renewed plans don’t include. And number two, that the marketplace offers new options with better coverage and tax credits that might help you bring down the cost.
So if you’ve received one of these letters, I’d encourage you to take a look at the marketplace. Even if the website isn’t working as smoothly as it should be for everybody yet, the plan comparison tool that lets you browse costs for new plans near you is working just fine.
Now, this fix won’t solve every problem for every person. But it’s going to help a lot of people. Doing more will require work with Congress. And I’ve said from the beginning, I’m willing to work with Democrats and Republicans to fix problems as they arise. This is an example of what I was talking about. We can always make this law work better.
It is important to understand, though, that the old individual market was not working well. And it’s important that we don’t pretend that somehow that’s a place worth going back to. Too often, it works fine as long as you stay healthy; it doesn’t work well when you’re sick. So year after year, Americans were routinely exposed to financial ruin, or denied coverage due to minor preexisting conditions, or dropped from coverage altogether—even if they paid their premiums on time.
That’s one of the reasons we pursued this reform in the first place. And that’s why I will not accept proposals that are just another brazen attempt to undermine or repeal the overall law and drag us back into a broken system. We will continue to make the case, even to folks who choose to keep their own plans, that they should shop around in the new marketplace because there’s a good chance that they’ll be able to buy better insurance at lower cost.
So we’re going to do everything we can to help the Americans who have received these cancellation notices. But I also want everybody to remember there are still 40 million Americans who don’t have health insurance at all. I’m not going to walk away from 40 million people who have the chance to get health insurance for the first time. And I’m not going to walk away from something that has helped the cost of health care grow at its slowest rate in 50 years.
So we’re at the opening weeks of the project to build a better health care system for everybody—a system that will offer real financial security and peace of mind to millions of Americans. It is a complex process. There are all kinds of challenges. I’m sure there will be additional challenges that come up. And it’s important that we’re honest and straightforward in terms of when we come up with a problem with these reforms and these laws, that we address them. But we’ve got to move forward on this.
It took 100 years for us to even get to the point where we could start talking about and implementing a law to make sure everybody has got health insurance. And my pledge to the American people is, is that we’re going to solve the problems that are there, we’re going to get it right, and the Affordable Care Act is going to work for the American people.
So with that, I’m going to take your questions, and I’m going to start with Julie Pace of AP.
Q: Thank you, Mr. President. The combination of the website problems and the concerns over the policy cancellations has sparked a lot of worry within your own party, and polls also show that you’re taking some hits with the public on both your overall job approval rating and also on factors like trust and honesty. Do you feel as though the flawed health care rollout has led to a breach in the public trust and confidence in government? And if so, how do you plan to resolve that?
THE PRESIDENT: There is no doubt that people are frustrated. We just came out of a shutdown and the possibility that for the first time in over 200 years, we wouldn’t pay our bills. And people breathed a sigh of relief when that finally got done, and the next thing they know is, is that the President’s health care reform can’t get the website to work and that there are these other problems with respect to cancellation notices.
And I understand why folks are frustrated. I would be, too. Because sometimes people look at what’s taking place in Washington and they say, not enough is getting done that helps me with my life. And regardless of what Congress does, ultimately I’m the President of the United States and they expect me to do something about it.
So in terms of how I intend to approach it, I’m just going to keep on working as hard as I can around the priorities that the American people care about. And I think it’s legitimate for them to expect me to have to win back some credibility on this health care law in particular, and on a whole range of these issues in general.
And that’s on me. I mean, we fumbled the rollout on this health care law. There are a whole bunch of things about it that are working really well which people didn’t notice because they weren’t controversial—so making sure kids could stay on their parents’ plans until they were—through the age of 25, and making sure that seniors got more discounts on their prescription drugs. There were a whole bunch of stuff that we did well over the first three years.
But we always knew that these marketplaces, creating a place where people can shop and through competition get a better deal for the health insurance that their families need, we always knew that that was going to be complicated and everybody was going to be paying a lot of attention to it. And we should have done a better job getting that right on day one—not on day 28 or on day 40.
I am confident that by the time we look back on this next year, that people are going to say this is working well, and it’s helping a lot of people. But my intention in terms of winning back the confidence of the American people is just to work as hard as I can; identify the problems that we’ve got, make sure that we’re fixing them. Whether it’s a website, whether it is making sure that folks who got these cancellation notices get help, we’re just going to keep on chipping away at this until the job is done.
Major Garrett.
Q: Thank you, Mr. President. You said while the law was being debated, “if you like your plan, you can keep it.” You said after the law was implemented or signed, “if you like your plan, you can keep it.” Americans believed you, sir, when you said that to them over and over. Do you not believe, sir, the American people deserve a deeper, more transparent accountability from you as to why you said that over and over when your own statistic published in the Federal Register alerted your policy staff—and I presume you—to the fact that millions of Americans would, in fact, probably fall into the very gap you’re trying to administratively fix now?
That’s one question. Second question. (Laughter.) You were informed, or several people in this building were informed two weeks before the launch of the website that it was failing the most basic tests internally, and yet a decision was made to launch the website on October 1st. Did you, sir, make that test? And if so, did you regret that?
THE PRESIDENT: Okay, on the website, I was not informed directly that the website would not be working the way it was supposed to. Had I been informed, I wouldn’t be going out saying, boy, this is going to be great.
I’m accused of a lot of things, but I don’t think I’m stupid enough to go around saying, this is going to be like shopping on Amazon or Travelocity a week before the website opens if I thought that it wasn’t going to work. So clearly, we and I did not have enough awareness about the problems in the website. Even a week into it, the thinking was that these were some glitches that would be fixed with patches, as opposed to some broader systemic problems that took much longer to fix and we’re still working on them.
So that doesn’t excuse the fact that they just don’t work. But I think it’s fair to say that, no, Garrett—Major, we would not have rolled out something knowing very well that it wasn’t going to work the way it was supposed, given all the scrutiny that we knew was going to be on the website.
With respect to the pledge I made that if you like your plan, you can keep it, I think—and I’ve said in interviews—that there is no doubt that the way I put that forward unequivocally ended up not being accurate. It was not because of my intention not to deliver on that commitment and that promise. We put a grandfather clause into the law, but it was insufficient.
Keep in mind that the individual market accounts for 5 percent of the population. So when I said you can keep your health care, I’m looking at folks who’ve got employer-based health care; I’m looking at folks who’ve got Medicare and Medicaid—and that accounts for the vast majority of Americans. And then for people who don’t have any health insurance at all, obviously that didn’t apply. My commitment to them was, you’re going to be able to get affordable health care for the first time.
You have an individual market that accounts for about 5 percent of the population. And our working assumption was—my working assumption was that the majority of those folks would find better policies at lower costs or the same costs in the marketplaces, and that the universe of folks who potentially would not find a better deal in the marketplaces, the grandfather clause would work sufficiently for them. And it didn’t. And again, that’s on us. Which is why we’re—that’s on me. And that’s why I’m trying to fix it.
And as I said earlier, I guess last week, and I will repeat, that’s something I deeply regret because it’s scary getting a cancellation notice.
Now, it is important to understand that out of that population, typically there is constant churn in that market. This market is not very stable and reliable for people. So people have a lot of complaints when they’re in that marketplace. As long as you’re healthy, things seem to be going pretty good. And so a lot of people think, I’ve got pretty good insurance—until they get sick—and then suddenly they look at the fine print, and they’ve got a $50,000 out-of-pocket expense that they can’t pay.
We know that on average over the last decade, each year, premiums in that individual market would go up an average of 15 percent a year. I know that because when we were talking about health care reform, one of the complaints was: I bought health care in the individual market and I just got a notice from the insurer, they dropped me after I had an illness; or my premium skyrocketed by 20 or 30 percent, why aren’t we doing something about this?
So part of what our goal has been is to make sure that that individual market is stable and fair, and has the kind of consumer protections that make sure that people don’t get a rude surprise when they really need health insurance. But if you just got a cancellation notice, and so far you’re thinking, my prices are pretty good, you haven’t been sick, and it fits your budget, and now you get this notice—you’re going to be worried about it. And if the insurer is saying the reason you’re getting this notice is because of the Affordable Care Act, then you’re going to be understandably aggravated about it.
Now, for a big portion of those people, the truth is they might have gotten a notice saying, we’re jacking up your rates by 30 percent. They might have said, from here on out, we’re not going to cover X, Y and Z illnesses, we’re changing the—because these were all 12-month policies. The insurance companies were under no obligation to renew the exact same policies that you had before.
But, look, one of the things I understood when we decided to reform that health insurance market, part of the reason why it hasn’t been done before and it’s very difficult to do, is that anything that’s going on that’s tough in the health care market, if you initiated a reform, can be attributed to your law. And so what we want to do is to be able to say to these folks, you know what, the Affordable Care Act is not going to be the reason why insurers have to cancel your plan.
Now, what folks may find is the insurance companies may still come back and say, we want to charge you 20 percent more than we did last year; or we’re not going to cover prescription drugs now. But that’s in the nature of the market that existed earlier.
Q: Did you decide, sir, that the simple declaration was something the American people could handle, but this nuanced answer you just gave now was something that you couldn’t handle and you didn’t trust the American people with a fuller truth?
THE PRESIDENT: No. I think, as I said earlier, Major, my expectation was that for 98 percent of the American people, either it genuinely wouldn’t change at all, or they’d be pleasantly surprised with the options in the marketplace, and that the grandfather clause would cover the rest.
That proved not to be the case. And that’s on me. And the American people—those who got cancellation notices do deserve and have received an apology from me. But they don’t want just words. What they want is whether we can make sure that they are in a better place, and that we meet that commitment.
And, by the way, I think it’s very important for me to note that there are a whole bunch of folks up in Congress and others who made this statement, and they were entirely sincere about it. And the fact that you’ve got this percentage of people who have had this impact—I want them to know that their senator or congressman, they were making representations based on what I told them and what this White House and our administrative staff told them. And so it’s not on them. It’s on us. But it is something that we intend to fix.
Steve Collinson.
Q: Do you have reason to believe that Iran would walk away from nuclear talks if Congress draws up new sanctions? And would a diplomatic breakdown at this stage leave you no option but military action? And how do you respond to your critics on the Hill who say that it was only tough sanctions that got Iran to the table, but only tougher sanctions will make it capitulate?
THE PRESIDENT: Well, let me make a couple of points. Number one, I’ve said before and I will repeat: We do not want Iran having nuclear weapons. And it would be not only dangerous to us and our allies, but it would be destabilizing to the entire region, and could trigger a nuclear arms race that would make life much more dangerous for all of us. So our policy is Iran cannot have nuclear weapons. And I’m leaving all options on the table to make sure that we meet that goal.
Point number two: The reason we’ve got such vigorous sanctions is because I and my administration put in place, when I came into office, the international structure to have the most effective sanctions ever. And so I think it’s fair to say that I know a little bit about sanctions, since we’ve set them up, and made sure that we mobilize the entire international community so that there weren’t a lot of loopholes and they really had bite.
And the intention in setting up those sanctions always was to bring the Iranians to the table so that we could resolve this issue peacefully, because that is my preference. That’s my preference because any armed conflict has cost to it, but it’s also my preference because the best way to assure that a country does not have nuclear weapons is that they are making a decision not to have nuclear weapons, and we’re in a position to verify that they don’t have nuclear weapons.
So as a consequence of the sanctions that we put in place—and I appreciate all the help, bipartisan help, that we received from Congress in making that happen—Iran’s economy has been crippled. They had a -5 percent growth rate last year. Their currency plummeted. They’re having significant problems in just the day-to-day economy on the ground in Iran. And President Rouhani made a decision that he was prepared to come and have a conversation with the international community about what they could do to solve this problem with us.
We’ve now had a series of conversations, and it has never been realistic that we would resolve the entire problem all at once. What we have done is seen the possibility of an agreement in which Iran would halt advances on its program; that it would dilute some of the highly enriched uranium that makes it easier for them to potentially produce a weapon; that they are subjecting themselves to much more vigorous inspections so that we know exactly what they’re doing at all their various facilities; and that that would then provide time and space for us to test, over a certain period of months, whether or not they are prepared to actually resolve this issue to the satisfaction of the international community—making us confident that, in fact, they’re not pursuing a nuclear weapons program.
In return, the basic structure of what’s been talked about, although not completed, is that we would provide very modest relief at the margins of the sanctions that we’ve set up. But importantly, we would leave in place the core sanctions that are most effective and have most impact on the Iranian economy, specifically oil sanctions and sanctions with respect to banks and financing. And what that gives us is the opportunity to test how serious are they, but it also gives us an assurance that if it turns out six months from now that they’re not serious, we can crank—we can dial those sanctions right back up.
