PRESIDENT OBAMA'S STATEMENT ON AFFORDABLE CARE ACT IMPLIMENTATION

FROM:  THE WHITE HOUSE
Statement by the President on the Affordable Care Act
James S. Brady Press Briefing Room
12:02 P.M. EST

THE PRESIDENT:  Today I want to update the American people on our efforts to implement and improve the Affordable Care Act, and I’ll take a couple of your questions.  But before I do, I just want to say a few words about the tragedy that's unfolded in the Philippines.

Over the past few days, I think all of us have been shaken by the images of the devastation wrought by Typhoon Haiyan.  It’s a heartbreaking reminder of how fragile life is, and among the dead are several Americans.  So our prayers are with the Filipino people, and with Filipino Americans across our country who are anxious about their family and friends back home.

One of our core principles is, when friends are in trouble, America helps.  As I told President Aquino earlier this week, the United States will continue to offer whatever assistance we can.  Our military personnel and USAID team do this better than anybody in the world, and they’ve been already on the ground working tirelessly to deliver food, water, medicine, shelter, and to help with airlift.  Today, the aircraft carrier USS George Washington and other ships arrived to help with search- and-rescue, as well as supplies, medical care and logistical support.  And more help is on the way.

America’s strength, of course, has always been more than just about what our government can do –- it’s also about what our citizens can do.  It’s about the big-heartedness of the American people when they see other folks in trouble.  So today, I would encourage everybody who wants to help, to visit WhiteHouse.gov/typhoon -- that's WhiteHouse.gov/typhoon -- and that will offer you links to organizations that are working on the ground and ways that you can support their efforts.  Our friends in the Philippines will face a long, hard road ahead, but they’ll continue to have a friend and partner in the United States of America.

Now, switching gears, it has now been six weeks since the Affordable Care Act’s new marketplace has opened for business.  I think it's fair to say that the rollout has been rough so far.  And I think everybody understands that I'm not happy about the fact that the rollout has been wrought with a whole range of problems that I've been deeply concerned about.  But today I want to talk about what we know after these first few weeks and what we're doing to implement and improve the law.

Yesterday, the White House announced that in the first month, more than 100,000 Americans successfully enrolled in new insurance plans.  Is that as high a number as we’d like?  Absolutely not.  But it does mean that people want affordable health care.  The problems of the website have prevented too many Americans from completing the enrollment process.  And that’s on us, not on them.  But there is no question that there’s real demand for quality, affordable health insurance.

In the first month, nearly a million people successfully completed an application for themselves or their families.  Those applications represent more than 1.5 million people.  Of those 1.5 million people, 106,000 of them have successfully signed up to get covered.

Another 396,000 have the ability to gain access to Medicaid under the Affordable Care Act.  That’s been less reported on, but it shouldn’t be.  Americans who are having a difficult time, who are poor, many of them working, may have a disability; they're Americans like everybody else, and the fact that they are now able to get insurance is going to be critically important.

Later today, I’ll be in Ohio, where Governor Kasich, a Republican, has expanded Medicaid under the Affordable Care Act.  And as many as 275,000 Ohioans will ultimately be better off because of it.  And if every governor followed suit, another 5.4 million Americans could gain access to health care next year.

So bottom line is, in just one month, despite all the problems that we've seen with the website, more than 500,000 Americans could know the security of health care by January 1st -- many of them for the first time in their lives.  And that’s life-changing and it's significant.

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.

So my message to Congress has been that, let’s see if this short-term, phase-one deal can be completed to our satisfaction where we’re absolutely certain that while we’re talking with the Iranians, they’re not busy advancing their program.  We can buy some additional months in terms of their breakout capacity.  Let’s test how willing they are to actually resolve this diplomatically and peacefully.

We will have lost nothing if, at the end of the day, it turns out that they are not prepared to provide the international community the hard proof and assurances necessary for us to know that they’re not pursuing a nuclear weapon.  And if that turns out to be the case, then not only is our entire sanctions infrastructure still in place, not only are they still losing money from the fact that they can’t sell their oil and get revenue from their oil as easily, even throughout these talks, but other options remain.

But what I’ve said to members of Congress is that if, in fact, we’re serious about trying to resolve this diplomatically -- because no matter how good our military is, military options are always messy, they’re always difficult, always have unintended consequences, and in this situation are never complete in terms of making us certain that they don’t then go out and pursue even more vigorously nuclear weapons in the future -- if we’re serious about pursuing diplomacy, then there’s no need for us to add new sanctions on top of the sanctions that are already very effective and that brought them to the table in the first place.

Now, if it turns out they can’t deliver, they can’t come to the table in a serious way and get this issue resolved, the sanctions can be ramped back up.  And we’ve got that option.

All right.  Roger Runningen.  Roger, it’s his birthday, by the way.  So that’s not the reason you got a question, but I thought it was important to note that.

Q    Thank you, Mr. President.

THE PRESIDENT:  Happy birthday.

Q    Back to health care.  Can you guarantee for the American people that the health care website is going to be fully operational for all people, not just the vast majority, by November 30?  And second, more broadly, this is your signature domestic piece of legislation.  You hear criticism on the Hill that you and your White House team are too insular.  Is that how this mess came to be?

THE PRESIDENT:  Well, I think there is going to be a lot of evaluation of how we got to this point.  And I assure you that I’ve been asking a lot of questions about that.  The truth is that this is, number one, very complicated.  The website itself is doing a lot of stuff.  There aren’t a lot of websites out there that have to help people compare their possible insurance options, verify income to find out what kind of tax credits they might get, communicate with those insurance companies so they can purchase, make sure that all of it’s verified.  So there’s just a bunch of pieces to it that made it challenging.

And you combine that with the fact that the federal government does a lot of things really well.  One of the things it does not do well is information technology procurement.  This is kind of a systematic problem that we have across the board.  And it is not surprising then that there were going to be some problems.

Now, I think we have to ask ourselves some hard questions inside the White House as opposed to why we didn't see more of these problems coming earlier on -- A, so we could set expectations; B, so that we could look for different ways for people to end up applying.

So ultimately, you’re right.  This is something that's really important to me, and it’s really important to millions of Americans who have been waiting for a really long time to try to get health care because they don't have it.  And I am very frustrated, but I’m also somebody who, if I fumbled the ball, I’m going to wait until I get the next play, and then I’m going to try to run as hard as I can and do right by the team.  So ultimately, I’m the head of this team.  We did fumble the ball on it, and what I’m going to do is make sure that we get it fixed.

In terms of what happens on November 30th or December 1st, I think it’s fair to say that the improvement will be marked and noticeable.  The website will work much better on November 30th, December 1st than it worked certainly on October 1st.  That's a pretty low bar.  It will be working a lot better than it is -- it was last week, and it will be working better than it was this week, which means that the majority of people who go to the website will see a website that is working the way it’s supposed to.

I think it is not possible for me to guarantee that 100 percent of the people 100 percent of the time going on this website will have a perfectly seamless, smooth experience.  We’re going to have to continue to improve it even after November 30th, December 1st.  But the majority of people who use it will be able to see it operate the way it was supposed to.

One thing that we’ve discovered, though, that I think is worth noting:  A lot of focus has been on the website and the technology, and that's partly because that's how we initially identified it -- these are glitches.  What we’re discovering is that part of the problem has been technology -- hardware and software -- and that's being upgraded.  But even if we get the hardware and software working exactly the way it’s supposed to with relatively minor glitches, what we’re also discovering is that insurance is complicated to buy.

And another mistake that we made I think was underestimating the difficulties of people purchasing insurance online and shopping for a lot of options with a lot of costs and a lot of different benefits and plans, and somehow expecting that that would be very smooth.  And then they’ve also got to try apply for tax credits on the website.

So what we’re doing even as we’re trying to solve the technical problems is also what can we do to make the application a little bit simpler; what can we do to make it in English as opposed to bureaucratese; are there steps that we can skip while still getting the core information that people need

And part of what we’re realizing is that they are going to be a certain portion of people who are just going to need more help and more handholding in the application process.  And so I guess part of the continuous improvement that I’m looking at is not just a technical issue.  It’s also, can we streamline the application process; what are we doing to give people more assistance in the application process; how do the call centers and the people who are helping folks in-person; how are they trained so that things can go more smoothly.

Because the bottom line ultimately is, I just want people to know what their options are in a clear way.  And buying health insurance is never going to be like buying a song on iTunes.  It’s just a much more complicated transaction.  But I think we can continue to make it better -- all of which is to say that on December 1st, November 30th, it will be a lot better, but there will still be some problems.  Some of those will not be because of technological problems -- although I’m sure that there will still be some glitches that have to be smoothed out.  Some of it’s going to be how are we making this application process more user-friendly for folks.

And one good example of this, by the way, just to use an analogy -- when we came into office, we heard a lot of complaints about the financial aid forms that families have to fill out to get federal financial aid.  And I actually remember applying for some of that stuff and remember how difficult and confusing it was.  And Arne Duncan over at Education worked with a team to see what we could do to simplify it, and it made a big difference.

And that's part of the process that we’ve got to go through.  And in fact, if we can get some focus groups and we sit down with actual users and see how well is this working, what would improve it, what part of it didn't you understand --  that all I think is part of what we’re going to be working on in the weeks ahead.

Q    What about the insularity criticism that you hear on the Hill?

THE PRESIDENT:  I’ve got to say I meet with an awful lot of folks, and I talk to an awful lot of folks every day.  And I have lunches with CEOs and IT venture capitalists and labor leaders and pretty much folks from all walks of life on a whole bunch of topics.  And if you looked at my schedule on any given day, we’re interacting with a whole lot of people.

And I think it’s fair to say that we have a pretty good track record of working with folks on technology and IT from our campaign where, both in 2008 and 2012, we did a pretty darn good job on that.  So it’s not -- the idea that somehow we didn't have access or were interested in people’s ideas, I think isn’t accurate.  What is true is that, as I said before, our IT systems, how we purchase technology in the federal government is cumbersome, complicated, and outdated.

And so this isn’t a situation where on my campaign I could simply say, who are the best folks out there; let’s get them around a table, let’s figure out what we’re doing, and we’re just going to continue to improve it and refine it and work on our goals.  If you're doing it at the federal government level, you're going through 40 pages of specs and this and that and the other, and there are all kinds of laws involved, and it makes it more difficult.  It's part of the reason why, chronically, federal IT programs are over budget, behind schedule.

And one of the -- when I do some Monday morning quarterbacking on myself, one of the things that I do recognize is -- since I know that the federal government has not been good at this stuff in the past -- two years ago, as we were thinking about this, we might have done more to make sure that we were breaking the mold on how we were going to be setting this up.  But that doesn't help us now.  We've got to move forward.

Jeff Mason.

Q    Thank you, Mr. President.  Today's fix that you just announced leaves it up to state insurance commissioners and insurance companies to ultimately decide whether to allow old policies to be renewed for a year.  How confident are you that they will do that?  And secondly, how concerned are you that this flawed rollout may hurt Democrats' chances in next year's midterm elections, and your ability to advance other priorities such as immigration reform?

THE PRESIDENT:  On the first question, traditionally, state insurance commissioners make decisions about what plans can be or cannot be sold, how they interact with insurers.  What we're essentially saying is the Affordable Care Act is not going to be the factor in what happens with folks in the individual market.  And my guess is right away you're going to see a number of state insurance commissioners exercise it.

Part of the challenge is the individual markets are different in different states.  There are some states that have individual insurance markets that already have almost all the consumer protections that the Affordable Care Act does.  They match up pretty good.  It's not some big jump for folks to move into the marketplace.  In others, they're pretty low standards, so you can sell pretty substandard plans in those markets.  And that's where people might see a bigger jump in their premiums.

So I think there's going to be some state-by-state evaluation on how this is handled.  But the key point is, is that it allows us to be able to say to the folks who received these notices:  Look, I, the President of the United States and the insurance –- that the insurance model, the Affordable Care Act, is not going to be getting in the way of you shopping in the individual market that you used to have.  As I said, there are still going to be some folks who over time, I think, are going to find that the marketplaces are better.

One way I described this to -- I met with a group of senators when this issue first came up -- and it's not a perfect analogy -- but we made a decision as a society that every car has to have a seatbelt or airbags.  And so you pass a regulation.  And there are some additional costs, particularly at the start of increasing the safety and protections, but we make a decision as a society that the costs are outweighed by the benefits of all the lives that are saved.  So what we're saying now is if you're buying a new car, you got to have a seatbelt.

Well, the problem with the grandfather clause that we put in place is it's almost like we said to folks, you got to buy a new car, even if you can't afford it right now.  And sooner or later, folks are going to start trading in their old cars.  But we don't need -- if their life circumstance is such where, for now at least, they want to keep the old car, even if the new car is better, we should be able to give them that option.  And that's what we want to do.

And, by the way, that's what we should have been able to do in drafting the rules in the first place.  So, again, these are two fumbles on something that -- on a big game, which -- but the game is not over.

With respect to the politics of it, I'll let you guys do a lot of the work on projecting what this means for various political scenarios.  There is no doubt that our failure to roll out the ACA smoothly has put a burden on Democrats, whether they're running or not, because they stood up and supported this effort through thick and thin.  And I feel deeply responsible for making it harder for them rather than easier for them to continue to promote the core values that I think led them to support this thing in the first place -- which is, in this country, as wealthy as we are, everybody should be able to have the security of affordable health care.  And that's why I feel so strongly about fixing it.

My first and foremost obligation is the American people, to make sure that they can get what's there -- if we can just get the darn website working and smooth this thing out -- which is plans that are affordable, and allow them to take advantage of tax credits and give them a better deal.

But I also do feel an obligation to everybody out there who supported this effort.  When we don't do a good job on the rollout, we're letting them down.  And I don't like doing that.  So my commitment to them is, we're going to just keep on doing better every day until we get it done.

And in terms of the impact on me -- I think to some extent I addressed it when I talked to Julie -- there are going to be ups and downs during the course of my presidency.  And I think I said early on when I was running -- I am not a perfect man, and I will not be a perfect President, but I'll wake up every single day working as hard as I can on behalf of Americans out there from every walk of life who are working hard, meeting their responsibilities, but sometimes are struggling because the way the system works isn't giving them a fair shot.

And that pledge I haven't broke.  That commitment, that promise, continues to be -- continues to hold -- the promise that I wouldn't be perfect, number one, but also the promise that as long as I've got the honor of having this office, I'm just going to work as hard as I can to make things better for folks.  And what that means specifically in this health care arena is we can't go back to the status quo.

I mean, right now everybody is properly focused on us not doing a good job on the rollout, and that’s legitimate and I get it.  There have been times where I thought we were kind of slapped around a little bit unjustly.  This one is deserved.  Right?  It’s on us.

But we can’t lose sight of the fact that the status quo before the Affordable Care Act was not working at all.  If the health care system had been working fine, and everybody had high-quality health insurance at affordable prices, I wouldn’t have made it a priority; we wouldn’t have been fighting this hard to get it done -- which is why, when I see sometimes folks up on Capitol Hill, and Republicans in particular, who have been suggesting repeal, repeal, let’s get rid of this thing, I keep on asking what is it that you want to do?  Are you suggesting that the status quo was working?  Because it wasn’t, and everybody knows it.  It wasn’t working in the individual market and it certainly wasn’t working for the 41 million people who didn’t have health insurance.

And so what we did was we chose a path that was the least disruptive, to try to finally make sure that health care is treated in this country like it is in every other advanced country -- that it’s not some privilege that just a certain portion of people can have, but it’s something that everybody has some confidence about.  And we didn’t go far left and choose an approach that would have been much more disruptive.  We didn’t adopt some more conservative proposals that would have been much more disruptive.  We tried to choose a way that built off the existing system.  But it is complicated, it is hard, but I make no apologies for us taking this on -- because somebody sooner or later had to do it.  I do make apologies for not having executed better over the last several months.

Q    And do you think that execution and the flaws in the rollout will affect your ability to do other things, like immigration reform and other policy priorities?

THE PRESIDENT:  Well, look, if it comes to immigration reform, there is no reason for us not to do immigration reform.  And we’ve already got strong bipartisan support for immigration reform out of the Senate.  You’ve got -- I met with a number of traditionally very conservative clergy who are deeply committed to immigration reform.  We’ve got the business community entirely behind immigration reform.  So you’ve got a bunch of constituencies that are traditionally much more -- have leaned much more heavily towards the Republicans who are behind this.

So if people are looking for an excuse not to do the right thing on immigration reform, they can always find an excuse --  we’ve run out of time, or this is hard, or the list goes on and on.  But my working assumption is people should want to do the right thing.  And when you’ve got an issue that would strengthen borders, make sure that the legal immigration system works the way it’s supposed to, that would go after employers who have been doing the wrong thing when it comes to hiring undocumented workers, and would allow folks who are here illegally to get right with the law and pay a fine, and learn English and get to the back of the line, but ultimately join fully our American community -- when you’ve got a law that makes sense, you shouldn’t be looking for an excuse not to do it.  And I’m going to keep on pushing to make sure it gets done.

Am I going to have to do some work to rebuild confidence around some of our initiatives?  Yes.  But part of this job is the things that go right, you guys aren’t going to write about; the things that go wrong get prominent attention.  That’s how it has always been.  That’s not unique to me as President.  And I’m up to the challenge.  We’re going to get this done.

All right?  Thank you, everybody.

END

PRESIDENT OBAMA'S REMARKS ON THE AFFORDABLE CARE ACT

FROM:  THE WHITE HOUSE 

Remarks by the President and Governor Deval Patrick on the Affordable Care Act

Faneuil Hall
Boston, Massachusetts

3:50 P.M. EDT

GOVERNOR PATRICK:  How are you?  Good afternoon, everybody.  (Applause.)  How’s Red Sox Nation this afternoon?  (Applause.)

Ladies and gentlemen, brothers and sisters, fellow citizens, I have the high honor of introducing to you the President of the United States.  (Applause.)  But, of course, you folks already know him.  (Laughter.)  So as the President is standing just offstage, I want to take my time here at the podium -- (laughter) -- to introduce all of you to him. 

In this storied hall today, Mr. President, are the architects and advocates for health care reform in Massachusetts. (Applause.)  This gathering right here is the broad coalition -- providers, payers, patients, consumers, policymakers, academics, business and labor, from both political parties, or no party at all -- who came together to invent health care reform in Massachusetts and then, importantly, stuck together to refine it as we moved forward.  (Applause.)

You are the leaders who, when we learned a hard lesson or hit a wall, stuck with it and with each other because of the shared value that health care is a public good and that every citizen deserves access to quality, affordable care.  (Applause.)

Quality, affordable care accessible to all improves lives, and in many cases, saves lives.  It gives peace of mind and economic security to working families.  It increases productivity for large and small employers alike.  It creates jobs and contributes to the strength of the Massachusetts economy.  It is a powerful statement of who we are as a commonwealth.  (Applause.)

And by every reasonable measure, it has been a success for us here in the Commonwealth of Massachusetts.  (Applause.)  How do we know?  Virtually, every resident in the commonwealth is insured today.  (Applause.)  More private companies offer insurance to their employees than ever before.  Over 90 percent of our residents have a primary care physician.  Preventive care is up and health disparities are down.  (Applause.)  Most important of all, on a whole range of measures, we are healthier both physically and mentally.

Over all these years, expansion itself has added only about 1 percent of state spending to our budget.  And thanks to the collective, continued hard work of this coalition, premiums are finally easing up.  Premium base rates were increasing over 16 percent just a few years ago.  Today, increases average less than 2 percent.  (Applause.)

And thanks to the President, America can look forward to the successes that Massachusetts has experienced these last seven years.  (Applause.) 

The truth is policy only matters when and where it touches people.  I know this policy matters because I've met people all across the commonwealth, in every walk of life, whose lives have been improved or saved because of the care our reforms made possible.  A couple of them are here today. 

Laura Ferreira -- where are you, Laura?  There you are.  Owns her own hair salon and is responsible for providing health insurance to her family of five, including her son, Mason, who’s right here with her.  Mason has a rare genetic condition.  Laura is able to afford his medicine because they found coverage through our Connecter, our version of the ACA marketplace.  This policy matters.  (Applause.)

David Gilloran works as a waiter.  Where are you David?  There you are.  Thank you for being here.  Soon after getting coverage through the Connector, David was diagnosed with Hodgkin’s lymphoma.  His treatment was covered, and he is back to his old life and swimming for exercise.  God bless you, David.  (Applause.) 

Brian Thurber left his law firm job to become an entrepreneur in Massachusetts.  Brian, where are you?  There he is.  Because he was able to access quality insurance directly through the Connector, he is chasing his entrepreneurial dreams and on his way to becoming a creator of jobs for others without  -- being exposed to a health emergency along the way.  Keep going.  Good luck to you.  (Applause.)

Hundreds of thousands of Massachusetts people don’t fear going bankrupt from medical bills, or being thrown off their insurance if they get really sick, or being declared ineligible for insurance because they were seriously ill sometime in the past. 

If policy matters where it touches people, Mr. President, this policy matters a lot.  Health care reform is working for the people of Massachusetts, and it will work for the people of America.  (Applause.)

My Republican predecessor signed the legislation to expand health care reform in Massachusetts right here in this room, on this very stage.  His chief legislative partner was the Democratic state senator, Robert Travaglini, who was here then and is here today.  Where are you, Trav?  Thank you.  (Applause.)

So was our beloved Ted Kennedy.  So were many of the members of the coalition who are here again today.  And they have worked right alongside my team and me these last seven years to refine and improve the means while staying true to the ends.  I am proud of what we and they have accomplished, and I think they’re proud, too, and ought to be.  (Applause.) 

 But our launch seven years ago was not flawless.  (Laughter.)  We asked an IT staffer who has been at our Connector since the beginning what the start of implementing reform was like.  And this is what he said, and I’m quoting:  “We didn’t have a complicated eligibility process back then, but we did have outages caused by traffic peaks.  We experienced some issues with data mapping of plan detail that carriers called us on.  Our provider searches were not good, and the website was a constant work in progress over the first few years.  But other than that, it was smooth.”  (Laughter.) 

Any of this sound familiar, Mr. President?

So we started out with a website that needed work.  We had a lot of people with a lot of reasonable questions and not a good enough way to get them the answers.  But people were patient, we had good leadership, and that same coalition stuck with it and with us to work through the fixes, tech surge and all.  Why?  Why?  Because health reform in Massachusetts, like the Affordable Care Act, is not a website.  It’s a values statement.  (Applause.)  It's about insuring people against a medical catastrophe.  It's about being our brothers' and our sisters' keeper by helping others help themselves. 

The website glitches are inconvenient and annoying.  They must be fixed and I am confident they will be.  But I hope you know, Mr. President, that the same folks who pretend to be outraged about the website not working didn’t want the ACA to work in the first place.  (Applause.)  The urgency of fixing what's not working is, as we all know, about the American people who need simple, reliable and convenient access to information about coverage -- not about silencing critics who will never be silenced.

You and the Congress looked to Massachusetts, Mr. President, as a model for how to insure working people, and through that, how to help them lead better, more productive lives.  As you turn to the vital work of making that federal IT system work, we also want to be a model for how to keep your eye on the prize, and how, working together, you put people first.  (Applause.)  The people here, all in this coalition, totally get that.

So, Mr. President, welcome to the capital of Red Sox Nation. (Applause.)  And welcome, also, to the future of affordable, accessible health care for everybody.  (Applause.)  

Ladies and gentlemen, the President of the United States.  (Applause.) 

THE PRESIDENT:  Hello, Boston!  (Applause.)  It's good to be back in Boston.  (Applause.)  It's good to be back in Boston because one of America's best governors introduced me -- Deval Patrick.  Give him a big round of applause.  (Applause.)  

It's good to see Congressman Bill Keating here.  Give Bill a big round of applause.  (Applause.)  I want to praise somebody who's not here -- I just left him -- but he wears his heart on his sleeve.  He loves this city so much, and it shows in what he's been doing for years now -- one of America's best mayors, Tom Menino.  (Applause.) 

And it's good to see all of you.  I was just at the airport -- Deval was kind enough to meet me, along with Mayor Menino.  And Mayor Menino went back to city hall to work so he could wrap up in time for the first pitch.  I understand that.  (Laughter.) I am well aware that a presidential visit is not the biggest thing going on today in Boston.  (Laughter and applause.)  I understand that.  I tried to grow a beard, but Michelle, she wasn't having it.  (Laughter.)  

I am also old enough to remember a time when the Red Sox were not in the World Series three times in 10 years.  (Laughter.)  But I know the chance to win one at home for the first time since 1918 is a pretty special thing.  (Applause.)  So I promise we will be done here in time -- (laughter) -- for everybody to head over to Fenway and maybe see Big Papi blast another homer.  (Applause.) 

And maybe the other Sox will do better next year.  (Laughter.)  You can hope.  You can dream.  (Laughter.)    

The reason I’m here, though, is because this is the hall where, seven years ago, Democrats and Republicans came together to make health reform a reality for the people of Massachusetts. It’s where then-Governor Mitt Romney, Democratic legislators, Senator Ted Kennedy, many of the folks who are here today joined forces to connect the progressive vision of health care for all with some ideas about markets and competition that had long been championed by conservatives.

And as Deval just said, it worked.  (Applause.)  It worked. Health reform --

PROTESTORS:  Mr. President -- don't punish me.  For our generation, stop the pipeline!  Mr. President --

THE PRESIDENT:  Okay.  We're talking about health care today, but we will --

PROTESTORS:  Mr. President --

AUDIENCE:  Booo --

THE PRESIDENT:  No, no, no, it’s okay.  That is the wrong rally.  (Laughter and applause.)  We had the climate change rally back in the summer.  (Laughter.)  This is the health care rally. (Applause.) 

So health care reform in this state was a success.  That doesn’t mean it was perfect right away.  There were early problems to solve.  There were changes that had to be made.  Anybody here who was involved in it can tell you that.  As Deval just said, enrollment was extremely slow.  Within a month, only about a hundred people had signed up -- a hundred.  But then 2,000 had signed up, and then a few more thousand after that.  And by the end of the year, 36,000 people had signed up. 

And the community all came together.  You even had the Red Sox help enlist people to get them covered.  And pretty soon, the number of young uninsured people had plummeted.  When recession struck, the financial security of health care sheltered families from deeper hardship.  And today, there is nearly universal coverage in Massachusetts, and the vast majority of its citizens are happy with their coverage.  (Applause.)

And by the way, all the parade of horribles, the worst predictions about health care reform in Massachusetts never came true.  They're the same arguments that you're hearing now.  Businesses didn’t stop covering workers; the share of employers who offered insurance increased.  People didn’t get left behind; racial disparities decreased.  Care didn’t become unaffordable; costs tracked what was happening in other places that wasn’t covering everybody.

Now, Mitt Romney and I ran a long and spirited campaign against one another, but I’ve always believed that when he was governor here in Massachusetts, he did the right thing on health care.  And then Deval did the right thing by picking up the torch and working to make the law work even better.  And it’s because you guys had a proven model that we built the Affordable Care Act on this template of proven, bipartisan success.  Your law was the model for the nation’s law.  (Applause.)

So let’s look at what’s happened.  Today, the Affordable Care Act requires insurance companies to abide by some of the strongest consumer protections this country has ever known -- a true Patient’s Bill of Rights.  (Applause.)  No more discriminating against kids with preexisting conditions.  (Applause.)  No more dropping your policy when you get sick and need it most.  (Applause.)  No more lifetime limits or restrictive annual limits.  (Applause.)  Most plans now have to cover free preventive care like mammograms and birth control.  (Applause.)  Young people can stay on their parents’ plans until they turn 26.  All of this is in place right now.  It is working right now.  (Applause.)

Now, the last element of this began on October 1st.  It’s when the Affordable Care Act created a new marketplace for quality, private insurance plans for the 15 percent or so of Americans who don’t have health care, and for the 5 percent of Americans who have to buy it on their own and they’re not part of a group, which means they don't get as good a deal. 

And this new marketplace was built on the Massachusetts model.  It allows these Americans who have been locked out to get a better deal from insurers -- they’re pooling their purchasing power as one big group.  And insurers want their business, which means they give them a better deal, and they compete for that business.  And as a result, insurers in the marketplace, they can't use your medical history to charge you more.  If you’ve been sick, you finally have the same chance to buy quality, affordable health care as everybody else. 

A lot of people will qualify for new tax credits under this law that will bring down costs even further, so that if you lose your job, or you start a new business, or you’re self-employed, or you're a young person trying several jobs until you find that one that sticks, you’re going to be able to be insured -- insurance that goes with you and gives you freedom to pursue whatever you want, without fear that accident or illness will derail your dreams.

Now, this marketplace is open now.  Insurance companies are competing for that business.  The deal is good; the prices are low.  But, let’s face it, we've had a problem.  The website hasn’t worked the way it’s supposed to over these last couple of weeks.  And as a consequence, a lot of people haven’t had a chance to see just how good the prices for quality health insurance through these marketplaces really are. 

Now, ultimately, this website, healthcare.gov, will be the easiest way to shop for and buy these new plans, because you can see all these plans right next to each other and compare prices and see what kind of coverage it provides.  But, look, there’s no denying it, right now, the website is too slow, too many people have gotten stuck.  And I am not happy about it.  And neither are a lot of Americans who need health care, and they’re trying to figure out how they can sign up as quickly as possible.  So there’s no excuse for it.  And I take full responsibility for making sure it gets fixed ASAP.  We are working overtime to improve it every day.  (Applause.)  Every day. 

And more people are successfully buying these new plans online than they were a couple of weeks ago, and I expect more people will be able to buy conveniently online every single day as we move forward.  We’re going to get these problems resolved. 

Now, in the meantime, you can still apply for coverage over the phone, or by mail, or in person, because those plans are waiting and you’re still able to get the kind of affordable, reliable health insurance that’s been out of reach for too many people for too long.

So I am old enough to remember when there was not such a thing as a website.  (Laughter.)  I know that’s shocking to people.  (Laughter.)  But the point is I’m confident these marketplaces will work, because Massachusetts has shown that the model works and we know what’s being offered by these insurers.  (Applause.)  We know it’s going to work. 

And so far, choice and competition in the new national marketplaces have helped keep costs lower than even we projected. In fact, nearly half of all single, uninsured 18-to-34-year-olds may be able to buy insurance for 50 bucks a month or less.  Less than your cellphone bill, less than your cable bill.  (Applause.) And one study shows that nearly 6 in 10 uninsured Americans may find coverage for 100 bucks a month or less, even if they’re older than 34. 

And, frankly, if every governor was working as hard as Deval, or Governor O’Malley in Maryland, or Governor Cuomo in New York, to make this law work for their citizens, as opposed to thinking politically, about 8 in 10 Americans would be getting health insurance for less than 100 bucks a month.  (Applause.)

And, by the way, it’s not just in Massachusetts.  Look at Kentucky.  Governor Steve Beshear, who’s a Democrat, is like a man possessed with helping more people get covered.  He thinks it’s the right thing to do.  Keep in mind I did not win in Kentucky.  (Laughter.)  But there are a lot of uninsured people in Kentucky, and they’re signing up. 

Oregon has covered 10 percent of its uninsured citizens already because of the Affordable Care Act.  Ten percent of the uninsured have already gotten coverage.  (Applause.) 

Arkansas -- I didn’t win that state either -- (laughter) -- has covered almost 14 percent of its uninsured already.  (Applause.)  That’s already happened. 

And you’ve got some Republican governors, like Governor Kasich of Ohio, who’ve put politics aside and they’re expanding Medicaid through this law to cover millions of people. 

Now, unfortunately, there are others that are so locked in to the politics of this thing that they won't lift a finger to help their own people, and that’s leaving millions of Americans uninsured unnecessarily.  That’s a shame.  Because if they put as much energy into making this law work as they do in attacking the law, Americans would be better off.  (Applause.)  Americans would be better off.   

So that’s the Affordable Care Act:  Better protections for Americans with insurance; a new marketplace for Americans without insurance; new tax credits to help folks afford it; more choice, more competition; real health care security not just for the uninsured or underinsured, but for all of us -- because we pay more in premiums and taxes when Americans without good insurance visit the emergency room.  (Applause.)  We get taxed.

And since we all benefit, there are parts of this law that also require everybody to contribute, that require everybody to take some measure of responsibility.  So, to help pay for the law, the wealthiest Americans –- families who make more than $250,000 a year –- they've got to pay a little bit more.  The most expensive employer health insurance plans no longer qualify for unlimited tax breaks.  Some folks aren't happy about that, but it's the right thing to do. 

Just like in Massachusetts, most people who can afford health insurance have to take responsibility to buy health insurance, or pay a penalty.  And employers with more than 50 employees are required to either provide health insurance to their workers or pay a penalty -- again, because they shouldn’t just dump off those costs onto the rest of us.  Everybody has got some responsibilities.   

Now, it is also true that some Americans who have health insurance plans that they bought on their own through the old individual market are getting notices from their insurance companies suggesting that somehow, because of the Affordable Care Act, they may be losing their existing health insurance plan.  This has been the latest flurry in the news.  Because there's been a lot of confusion and misinformation about this, I want to explain just what's going on. 

One of the things health reform was designed to do was to help not only the uninsured, but also the underinsured.  And there are a number of Americans –- fewer than 5 percent of Americans -– who've got cut-rate plans that don’t offer real financial protection in the event of a serious illness or an accident.  Remember, before the Affordable Care Act, these bad-apple insurers had free rein every single year to limit the care that you received, or use minor preexisting conditions to jack up your premiums or bill you into bankruptcy.  So a lot of people thought they were buying coverage, and it turned out not to be so good. 

Before the Affordable Care Act, the worst of these plans routinely dropped thousands of Americans every single year.  And on average, premiums for folks who stayed in their plans for more than a year shot up about 15 percent a year.  This wasn’t just bad for those folks who had these policies, it was bad for all of us -- because, again, when tragedy strikes and folks can’t pay their medical bills, everybody else picks up the tab. 

Now, if you had one of these substandard plans before the Affordable Care Act became law and you really liked that plan, you’re able to keep it.  That’s what I said when I was running for office.  That was part of the promise we made.  But ever since the law was passed, if insurers decided to downgrade or cancel these substandard plans, what we said under the law is you've got to replace them with quality, comprehensive coverage  -- because that, too, was a central premise of the Affordable Care Act from the very beginning.

And today, that promise means that every plan in the marketplace covers a core set of minimum benefits, like maternity care, and preventive care, and mental health care, and prescription drug benefits, and hospitalization.  And they can’t use allergies or pregnancy or a sports injury or the fact that you're a woman to charge you more.  They can't do that anymore.  (Applause.)  They can't do that anymore. 

If you couldn’t afford coverage because your child had asthma, well, he’s now covered.  If you’re one of the 45 million Americans with a mental illness, you’re now covered.  If you’re a young couple expecting a baby, you’re covered.  You’re safer.  The system is more secure for you and it’s more secure for everybody. 

So if you’re getting one of these letters, just shop around in the new marketplace.  That’s what it’s for.  Because of the tax credits we’re offering, and the competition --

PROTESTOR:  Mr. President, ban the Keystone Pipeline!  For our generation, you need to do this!

THE PRESIDENT:  Because of the tax credits that we’re offering and the competition between insurers, most people are going to be able to get better, comprehensive health care plans for the same price or even cheaper than projected.  You’re going to get a better deal.

Now, there’s a fraction of Americans with higher incomes who will pay more on the front end for better insurance with better benefits and protections like the Patient’s Bill of Rights.  And that will actually save them from financial ruin if they get sick.  But nobody is losing their right to health care coverage. And no insurance company will ever be able to deny you coverage, or drop you as a customer altogether.  Those days are over.  And that’s the truth.  (Applause.)  That is the truth.  

So for people without health insurance, they’re finally going to be able to get it.  For the vast majority of people who have health insurance that works, you can keep it.  For the fewer than 5 percent of Americans who buy insurance on your own, you will be getting a better deal.

So anyone peddling the notion that insurers are cancelling people’s plan without mentioning that almost all the insurers are encouraging people to join better plans with the same carrier, and stronger benefits and stronger protections, while others will be able to get better plans with new carriers through the marketplace, and that many will get new help to pay for these better plans and make them actually cheaper -- if you leave that stuff out, you’re being grossly misleading, to say the least.  (Applause.)  

But, frankly, look, you saw this in Massachusetts -- this is one of the challenges of health care form.  Health care is complicated and it’s very personal, and it’s easy to scare folks. And it’s no surprise that some of the same folks trying to scare people now are the same folks who’ve been trying to sink the Affordable Care Act from the beginning.  (Applause.)  And frankly, I don’t understand it.  Providing people with health care, that should be a no-brainer.  (Applause.)  Giving people a chance to get health care should be a no-brainer.  (Applause.) 

And I’ve said before, if folks had actually good ideas, better ideas than what’s happening in Massachusetts or what we’ve proposed for providing people with health insurance, I’d be happy to listen.  But that’s not what’s happening.  And anyone defending the remnants of the old, broken system as if it was working for people, anybody who thinks we shouldn’t finish the job of making the health care system work for everybody -– especially when these folks offer no plan for the uninsured or the underinsured, or folks who lose their insurance each year -- those folks should have to explain themselves.  (Applause.) 

Because I don’t think we should go back to discriminating against kids with preexisting conditions.  (Applause.)  I don’t think we should go back to dropping coverage for people when they get sick, or because they make a mistake on their application.  (Applause.)  I don’t think we should go back to the daily cruelties and indignities and constant insecurity of a broken health care system.  And I’m confident most Americans agree with me.  (Applause.) 

So, yes, this is hard, because the health care system is a big system, and it’s complicated.  And if it was hard doing it just in one state, it's harder to do it in all 50 states -- especially when the governors of a bunch of states and half of the Congress aren't trying to help.  Yes, it's hard.  But it's worth it.  (Applause.)  It is the right thing to do, and we're going to keep moving forward.  (Applause.)  We are going to keep working to improve the law, just like you did here in Massachusetts.  (Applause.) 

We are just going to keep on working at it.  We're going to grind it out, just like you did here in Massachusetts -- and, by the way, just like we did when the prescription drug program for seniors known as Medicare Part D was passed by a Republican President a decade ago.  That health care law had some early challenges as well.  There were even problems with the website.  (Laughter.)  And Democrats weren’t happy with a lot of the aspects of the law because, in part, it added hundreds of billions of dollars to the deficit, it wasn't paid for -- unlike the Affordable Care Act, which will actually help lower the deficit.  (Applause.) 

But, you know what, once it was the law, everybody pitched in to try to make it work.  Democrats weren’t about to punish millions of seniors just to try to make a point or settle a score.  So Democrats worked with Republicans to make it work.  And I'm proud of Democrats for having done that.  It was the right thing to do.  (Applause.)  Because now, about 90 percent of seniors like what they have.  They've gotten a better deal. 

Both parties working together to get the job done –- that’s what we need in Washington right now.  (Applause.)  That's what we need in Washington right now. 

You know, if Republicans in Congress were as eager to help Americans get covered as some Republican governors have shown themselves to be, we'd make a lot of progress.  I'm not asking them to agree with me on everything, but if they’d work with us like Mitt Romney did, working with Democrats in Massachusetts, or like Ted Kennedy often did with Republicans in Congress, including on the prescription drug bill, we’d be a lot further along.  (Applause.) 

So the point is, we may have political disagreements -- we do, deep ones.  In some cases, we've got fundamentally different visions about where we should take the country.  But the people who elect us to serve, they shouldn’t pay the price for those disagreements.  Most Americans don’t see things through a political lens or an ideological lens.  This debate has never been about right or left.  It’s been about the helplessness that a parent feels when she can’t cover a sick child, or the impossible choices a small business faces between covering his employees or keeping his doors open. 

I want to give you just -- I want to close with an example. A person named Alan Schaeffer, from Prattsburgh, New York, and he's got a story to tell about sacrifice, about giving up his own health care to save the woman he loves.  So Alan wrote to me last week, and he told me his story.

Four years ago, his wife, Jan, who happens to be a nurse, was struck with cancer, and she had to stop working.  And then halfway through her chemo, her employer dropped coverage for both of them.  And Alan is self-employed; he's got an antique business.  So he had to make sure his wife had coverage, obviously, in the middle of cancer treatments, so he went without insurance. 

Now, the great news is, today, Jan is cancer-free.  She's on Medicare, but Alan’s been uninsured ever since.  Until last week -- (applause) -- when he sat down at a computer and -- I'm sure after multiple tries -- (laughter) -- signed up for a new plan under the Affordable Care Act, coverage that can never be taken away if he gets sick.  (Applause.) 

So I just want to read you what he said in this letter.  He says, “I’ve got to tell you I’ve never been so happy to pay a bill in my entire life."  (Laughter.)  "When you don’t have insurance at my age, [it can] really feel like a time bomb waiting to go off.  The sense of relief from knowing I can live out my days longer and healthier, that’s just a tremendous weight off my shoulders.” 

So two days later, Alan goes over to his buddy Bill’s house. He sits Bill down, and his wife, Diana, at their computer.  And after several tries -- (laughter) -- Alan helped lift that weight from their shoulders by helping them to sign up for a new plan also.  And compared to their current plan, it costs less than half as much and covers more. 

See, that's why we committed ourselves to this cause -- for Alan, and Jan; for Bill, Diana. 

AUDIENCE MEMBER:  Annie.

THE PRESIDENT:  For Annie.  For anyone who wrote letters, and shared stories, and knocked on doors because they believed what could happen here in Massachusetts could happen all across the country.  (Applause.)  And for them, and for you, we are going to see this through.  (Applause.)  We’re going to see this through.  (Applause.)  We are going to see this through.  (Applause.)  

This hall is home to some of the earliest debates over the nature of our government, the appropriate size, the appropriate role of government.  And those debates continue today, and that’s healthy.  They’re debates about the role of the individual and society, and our rugged individualism, and our sense of self-reliance, our devotion to the kind of freedoms whose first shot rang out not far from here.  But they are also debates tempered by a recognition that we’re all in this together, and that when hardship strikes -- and it could strike any of us at any moment  -- we’re there for one another; and that as a country, we can accomplish great things that we can't accomplish alone.  (Applause.)  We believe that.  We believe that.  (Applause.)         

And those sentiments are expressed in a painting right here in this very hall:  “Liberty and Union, now and forever, one and inseparable.”  That’s the value statement Deval was talking about.  That’s what health care reform is about.  That’s what America is about.  We are in this together, and we are going to see it through.  (Applause.)

Thank you.  God bless you.  God bless the United States of America.  (Applause.) 

PRESIDENT OBAMA ADDRESSES HEALTHCARE ROLLOUT PROBLEMS

FROM:  U.S. WHITE HOUSE 
Remarks by the President on the Affordable Care Act
Rose Garden
11:33 A.M. EDT

THE PRESIDENT:  Everybody, have a seat.

MS. BAKER:  Hello.  My name is Janice Baker.  I have the privilege to say that I'm the first person in the state of Delaware to enroll for health insurance through the new marketplace.  (Applause.)  Like many consumers out there, it took me a number of frustrating attempts before I could apply for and select my plan.  I kept trying because I needed access to the new health care options.

I had applied to three private insurance companies only to be rejected due to preexisting health conditions.  I am too young for Medicare, but I'm too old not to have some health issues.  I was able to find a policy I am thrilled with, saving $150 a month, and much lower deductibles than my previous policy that I held through my small business.

I'm here today to encourage other people like me who needs access to quality, affordable insurance, and to tell them to have patience with such a new system.  Without this ability to get this insurance, I know that a single hospital stay could have bankrupted me and my business.

Thank you all.  And I am now honored to introduce the President of the United States.  (Applause.)

THE PRESIDENT:  Great job.

MS. BAKER:  Thank you.  Thank you.

THE PRESIDENT:  Thank you.  (Applause.)  Thank you, everybody.  Well, thank you, Janice.  And thanks to everybody here for coming on this beautiful day.  Welcome to the White House.

About three weeks ago, as the federal government shut down, the Affordable Care Act’s health insurance marketplaces opened for business across the country.  Well, we’ve now gotten the government back open for the American people, and today I want to talk about how we’re going to get the marketplaces running at full steam, as well.  And I’m joined today by folks who have either benefited from the Affordable Care Act already, or who are helping their fellow citizens learn about what this law means for them and how they can get covered.

Of course, you’ve probably heard that HealthCare.gov –- the new website where people can apply for health insurance, and browse and buy affordable plans in most states –- hasn't worked as smoothly as it was supposed to work.  And the number of people who have visited the site has been overwhelming, which has aggravated some of these underlying problems.

Despite all that, thousands of people are signing up and saving money as we speak.  Many Americans with a preexisting condition, like Janice, are discovering that they can finally get health insurance like everybody else.

So today, I want to speak to every American who’s looking to get affordable health insurance.  I want you to know what’s available to you and why it may be a good deal for you.  And for those who’ve had some problems with the website, I want to tell you what we’re doing to make it work better and how you can sign up to get covered in other ways.

But before I do that, let me remind everybody that the Affordable Care Act is not just a website.  It's much more.  For the vast majority of Americans -- for 85 percent of Americans who already have health insurance through your employer or Medicare or Medicaid -– you don’t need to sign up for coverage through a website at all.  You've already got coverage.  What the Affordable Care Act does for you is to provide you with new benefits and protections that have been in place for some time.  You may not know it, but you're already benefiting from these provisions in the law.

For example, because of the Affordable Care Act, young people like Jasmine Jennings, and Jessica Ugalde, and Ezra Salop, all of whom are here today, they’ve been able to stay on their parents’ plans until they’re 26.  Millions of other young people are currently benefiting from that part of the law.  (Applause.)  Another part of the Affordable Care Act is providing seniors with deeper discounts on their prescription medicine.  Billions of dollars have been saved by seniors already.  That’s part of the law.  It’s already in place.  It’s happening right now.

Already, because of the Affordable Care Act, preventive care like mammograms and birth control are free through your employers.  That’s part of this law.  (Applause.)  So there are a wide range of consumer protections and benefits that you already have if you’ve got health insurance.  You may not have noticed them, but you’ve got them, and they’re not going anywhere.  And they’re not dependent on a website.

Here’s another thing that the Affordable Care Act does.  In states where governors and legislatures have wisely allowed it, the Affordable Care Act provides the opportunity for many Americans to get covered under Medicaid for the first time.  So in Oregon, for example, that’s helped cut the number of uninsured people by 10 percent just in the last three weeks.  Think about that.  That’s 56,000 more Americans who now have health care.  (Applause.)  That doesn’t depend on a website.

Now, if you’re one of the 15 percent of Americans who don’t have health insurance -- either because you can’t afford it or because your employer doesn’t offer it, or because you’re a small businessperson and you have to go out on the individual market and buy it on your own and it’s just too expensive -- October 1st was an important date.  That’s when we opened the new marketplaces where people without health insurance, or who can’t afford health insurance, or who aren’t part of a group plan, can finally start getting affordable coverage.

And the idea is simple.  By enrolling in what we’re calling these marketplaces, you become part of a big group plan -- as if you were working for a big employer -- a statewide group plan that spreads risk between sick people and healthy people, between young and old, and then bargains on your behalf for the best deal on health care.  What we’ve done is essentially create a competition where there wasn’t competition before.  We created these big group plans, and now insurers are really interested in getting your business.  And so insurers have created new health care plans with more choices to be made available through these marketplaces.

And as a result of this choice and this competition, prices have come down.  When you add the new tax credits that many people are eligible for through the law, then the prices come down even further.  So one study shows that through new options created by the Affordable Care Act, nearly 6 in 10 uninsured Americans will find that they can get covered for less than $100 a month.  Think about that.  (Applause.)

Through the marketplaces, you can get health insurance for what may be the equivalent of your cell phone bill or your cable bill, and that’s a good deal.

So the fact is the product of the Affordable Care Act for people without health insurance is quality health insurance that’s affordable.  And that product is working.  It’s really good.  And it turns out there’s a massive demand for it.  So far, the national website, HealthCare.gov, has been visited nearly 20 million times.  Twenty million times.  (Applause.)  And there’s great demand at the state level as well, because there are a bunch of states that are running their own marketplaces.

We know that nearly one-third of the people applying in Connecticut and Maryland, for example, are under 35 years old.  They understand that they can get a good deal at low costs, have the security of health care, and this is not just for old folks like me -- that everybody needs good quality health insurance.  And all told, more than half a million consumers across the country have successfully submitted applications through federal and state marketplaces.  And many of those applications aren’t just for individuals, it’s for their entire families.  So even more people are already looking to potentially take advantage of the high quality, affordable insurance that is provided through the Affordable Care Act.

So let me just recap here.  The product is good.  The health insurance that’s being provided is good.  It’s high quality and it’s affordable.  People can save money, significant money, by getting insurance that’s being provided through these marketplaces.  And we know that the demand is there.  People are rushing to see what’s available.  And those who have already had a chance to enroll are thrilled with the result.  Every day, people who were stuck with sky-high premiums because of preexisting conditions are getting affordable insurance for the first time, or finding, like Janice did, that they’re saving a lot of money.  Every day, women are finally buying coverage that doesn’t charge them higher premiums than men for the same care.  (Applause.)  Every day, people are discovering that new health insurance plans have to cover maternity care, mental health care, free preventive care.

So you just heard Janice’s story -- she owns her own small business.  She recently became the first woman to enroll in coverage through Delaware’s exchange.  And it’s true, it took her a few tries, but it was worth it after being turned down for insurance three times due to minor preexisting conditions.  So now she’ll be covered, she’ll save 150 bucks a month, and she won’t have to worry that one illness or accident will cost her her business that she’s worked so hard to build.

And Janice is not alone.  I recently received a letter from a woman named Jessica Sanford in Washington State.  And here’s what she wrote:  “I am a single mom, no child support, self-employed, and I haven’t had insurance for 15 years because it’s too expensive.  My son has ADHD and requires regular doctor visits and his meds alone cost $250 per month.  I have had an ongoing tendinitis problem due to my line of work that I haven’t had treated.  Now, finally, we get to have coverage because of the ACA for $169 per month.  I was crying the other day when I signed up.  So much stress lifted.”

Now, that is not untypical for a lot of folks like Jessica who have been struggling without health insurance.  That’s what the Affordable Care Act is all about.  The point is, the essence of the law -- the health insurance that’s available to people -- is working just fine.  In some cases, actually, it’s exceeding expectations -- the prices are lower than we expected, the choice is greater than we expected.

 But the problem has been that the website that’s supposed to make it easy to apply for and purchase the insurance is not working the way it should for everybody.  And there’s no sugarcoating it.  The website has been too slow, people have been getting stuck during the application process.  And I think it’s fair to say that nobody is more frustrated by that than I am -- precisely because the product is good, I want the cash registers to work.  I want the checkout lines to be smooth.  So I want people to be able to get this great product.  And there’s no excuse for the problems, and these problems are getting fixed.

 But while we’re working out the kinks in the system, I want everybody to understand the nature of the problem.  First of all, even with all the problems at HealthCare.gov, the website is still working for a lot of people -- just not as quick or efficient or consistent as we want.  And although many of these folks have found that they had to wait longer than they wanted, once they complete the process they’re very happy with the deal that’s available to them, just like Janice’s.

Second, I want everybody to remember that we’re only three weeks into a six-month open enrollment period, when you can buy these new plans.  (Applause.)  Keep in mind the insurance doesn’t start until January 1st; that’s the earliest that the insurance can kick in.  No one who decides to purchase a plan has to pay their first premium until December 15th.  And unlike the day after Thanksgiving sales for the latest Playstation or flat-screen TVs, the insurance plans don’t run out.  They’re not going to sell out.  They’ll be available through the marketplace -- (applause) -- throughout the open enrollment period.  The prices that insurers have set will not change.  So everybody who wants insurance through the marketplace will get insurance, period.  (Applause.)  Everybody who wants insurance through the marketplace will get insurance.

Third, we are doing everything we can possibly do to get the websites working better, faster, sooner.  We’ve got people working overtime, 24/7, to boost capacity and address the problems.  Experts from some of America’s top private-sector tech companies who, by the way, have seen things like this happen before, they want it to work.  They're reaching out.  They're offering to send help.  We’ve had some of the best IT talent in the entire country join the team.  And we’re well into a “tech surge” to fix the problem.  And we are confident that we will get all the problems fixed.

Number four -- while the website will ultimately be the easiest way to buy insurance through the marketplace, it isn’t the only way.  And I want to emphasize this.  Even as we redouble our efforts to get the site working as well as it’s supposed to, we’re also redoubling our efforts to make sure you can still buy the same quality, affordable insurance plans available on the marketplace the old-fashioned way -- offline, either over the phone or in person.

And, by the way, there are a lot of people who want to take advantage of this who are more comfortable working on the phone anyway or in person.  So let me go through the specifics as to how you can do that if you’re having problems with the website or you just prefer dealing with a person.

Yesterday, we updated the website’s home page to offer more information about the other avenues to enroll in affordable health care until the online option works for everybody.  So you’ll find information about how to talk to a specialist who can help you apply over the phone or to receive a downloadable application you can fill out yourself and mail in.

We’ve also added more staff to the call centers where you can apply for insurance over the phone.  Those are already -- they've been working.  But a lot of people have decided first to go to the website.  But keep in mind, these call centers are already up and running.  And you can get your questions answered by real people, 24 hours a day, in 150 different languages.  The phone number for these call centers is 1-800-318-2596.  I want to repeat that -- 1-800-318-2596.  Wait times have averaged less than one minute so far on the call centers, although I admit that the wait times probably might go up a little bit now that I've read the number out loud on national television.  (Laughter.)

But the point is the call centers are available.  You can talk to somebody directly and they can walk you through the application process.  And I guarantee you, if one thing is worth the wait, it’s the safety and security of health care that you can afford, or the amount of money that you can save by buying health insurance through the marketplaces.  (Applause.)

Once you get on the phone with a trained representative, it usually takes about 25 minutes for an individual to apply for coverage, about 45 minutes for a family.  Once you apply for coverage, you will be contacted by email or postal mail about your coverage status.

But you don't have to just go through the phone.  You can also apply in person with the help of local navigators -– these are people specially trained to help you sign up for health care, and they exist all across the country, or you can go to community health centers and hospitals.  Just visit LocalHelp.HealthCare.gov to find out where in your area you can get help and apply for insurance in person.

And finally, if you’ve already tried to apply through the website and you’ve been stuck somewhere along the way, do not worry.  In the coming weeks, we will contact you directly, personally, with a concrete recommendation for how you can complete your application, shop for coverage, pick a plan that meets your needs, and get covered once and for all.

So here’s the bottom line.  The product, the health insurance is good.  The prices are good.  It is a good deal.  People don’t just want it; they’re showing up to buy it.  Nobody is madder than me about the fact that the website isn’t working as well as it should, which means it’s going to get fixed.  (Laughter and applause.)

And in the meantime, you can bypass the website and apply by phone or in person.  So don’t let problems with the website deter you from signing up, or signing your family up, or showing your friends how to sign up, because it is worth it.  It will save you money.  If you don't have health insurance, if you’ve got a preexisting condition, it will save you money and it will give you the security that your family needs.

In fact, even with the website issues, we’ve actually made the overall process of buying insurance through the marketplace a lot smoother and easier than the old way of buying insurance on your own.  Part of the challenge here is that a lot of people may not remember what it’s like to buy insurance the traditional way.

The way we’ve set it up, there are no more absurdly long application forms.  There’s no medical history questionnaire that goes on for pages and pages.  There’s no more getting denied because you’ve had a preexisting condition.  Instead of contacting a bunch of different insurers one at a time, which is what Janice and a lot of people who are shopping on the individual market for health insurance had to do, there’s one single place you can go shop and compare plans that have to compete for your business.  There’s one single phone number you can call for help.  And once the kinks in the website have been ironed out, it will be an even smoother and even easier.  But in the meantime, we will help you sign up -- because consumers want to buy this product and insurance companies want to sell it to you.

Now, let me close by addressing some of the politics that have swirled around the Affordable Care Act.  I recognize that the Republican Party has made blocking the Affordable Care Act its signature policy idea.  Sometimes it seems to be the one thing that unifies the party these days.  (Laughter.)  In fact, they were willing to shut down the government and potentially harm the global economy to try to get it repealed.  And I’m sure that given the problems with the website so far, they’re going to be looking to go after it even harder.  And let's admit it -- with the website not working as well as it needs to work, that makes a lot of supporters nervous because they know how it's been subject to so much attack, the Affordable Care Act generally.

But I just want to remind everybody, we did not wage this long and contentious battle just around a website.  That’s not what this was about.  (Applause.)  We waged this battle to make sure that millions of Americans in the wealthiest nation on Earth finally have the same chance to get the same security of affordable quality health care as anybody else.  That’s what this is about.  (Applause.)  And the Affordable Care Act has done that.

People can now get good insurance.  People with preexisting conditions can now afford insurance.  And if the launch of this website proves anything, it’s that people across the country don’t just need that security, they want that security.  They want it.  (Applause.)  And in the meantime -- I’ve said many times -- I’m willing to work with anyone on any idea to make this law perform even better.  But it’s time for folks to stop rooting for its failure, because hardworking, middle-class families are rooting for its success.  (Applause.)  And if the product is good, they're willing to be patient.

I got a letter last week from a self-employed man named John Mier in Leetsdale, Pennsylvania.  He used the new marketplace to get himself and his wife covered and save a lot of money.  And here’s what he said, because it pretty much sums up my message today:  “Yes, the website really stank for the first week.”  (Laughter.)  “But instead of paying $1,600 per month for a group insurance plan, we have a plan that will only cost us $692 a month –- a savings of $900 per month.”  (Applause.)  John said that while he saw -- when he saw what they’d be paying, he turned to his wife and told her, “We might just pull through.  We can afford this.”  And John eventually predicted that “the website will work like a champ.”

So John, he was frustrated by the website, but he's feeling a little less frustrated once he found out that he was saving 900 bucks a month on his health insurance.  (Applause.)  And John is right, the website is going to get fixed and the law works.  That's why we fought so hard to pass this law -- to save folks like John money; to give people who don't have health insurance the chance to get it for the first time; to lift from the American people the crushing burden of unaffordable health care; to free families from the pervasive fear that one illness -- (on-stage participant becomes ill) -- there you go, you are ok.  I'm right here.  I got you.  (Laughter.)  No, no -- you're okay.  This happens when I talk too long.  (Laughter.)  You'll be okay.  Here, why don't you go.  (Applause.)

Good catch, by the way, whoever was here.  (Laughter.)

But that's always our goal, to free families from the pervasive fear that one illness or one injury might cost you everything that you dedicated a lifetime to build.  Our goal has always been to declare that in this country the security of health care is not a privilege for a fortunate few.  It's a right for all to enjoy.  (Applause.)  That's what the Affordable Care Act is all about.  That's its promise.  And I intend to deliver on that promise.

Thank you very much, everybody.  God bless you.  (Applause.)

 END