Topics:

President on Obamacare: 'Still A Big Complicated Piece Of Business'

Apr 30, 2013

Here is a transcript of President Barack Obama's remarks on health care during his news conference today:

CHUCK TODD, NBC NEWS: Max Baucus, Democratic senator, referred to the implementation of your health-care as a potential train wreck. (We've had ?) other Democrats been whispering nervousness about the implementation and the impact -- (inaudible) -- the impact that it might have on their own political campaigns in 2014. Why do you keep -- just curious, why does Senator Baucus, somebody who extensively helped write your bill, believe that this is going to be a train wreck? And why do you believe he's wrong?

PRESIDENT OBAMA: Well, I -- you know, I think that any time you're implementing something big, there is going to be people who are nervous and anxious about is it going to get done until it's actually done. But -- but let's just step back for a second and -- and -- and make sure the American people understand what it is that we're doing. The Affordable Care Act, 'Obamacare,' has now been with us for three years. It's gone through Supreme Court tests. It's gone through efforts to repeal. A huge chunk of it's already been implemented.

And for the 85 to 90 percent of Americans who already have health insurance, they're already experiencing most of the benefits of the Affordable Care Act even if they don't know it. Their insurance is more secure. Insurance companies can't drop them for bad reasons. Their kids are able to stay on their health insurance until they're 26 years old. They're getting free preventive care.

So there are a whole host of benefits that -- for the average American out there, for the 85 to 90 percent of Americans who already have health insurance, this thing's already happened, and their only impact is that their insurance is stronger, better, more secure than it was before. Full stop. That's it. Now they don't have to worry about anything else.

The implementation issues come in for those who don't have health insurance, maybe because they have a pre-existing condition and the only way they can get health insurance is to go out on the individual market and they're paying 50 percent or a hundred percent more than those of us who are lucky enough to have group plans. People who are too poor to get health insurance and the employers don't offer them. Maybe they work for a small business and that small business can't afford right now to provide health insurance.

So all the implementation issues that are coming up are implementation issues related to that small group of people, 10 to 15 percent of Americans -- now, it's still 30 million Americans, but relatively narrow group -- who don't have health insurance right now or are on the individual market and are paying exorbitant amounts for coverage that isn't that great.

And what we're doing is we're setting up a pool so that they can all pool together and get a better deal from insurance companies. And those who can't afford it, we're going to provide them with some subsidies. That's it. I mean, that's what's left to implement because the other stuff's been implemented and it's working fine.

The challenge is that, you know, setting up a market-based system, basically an online marketplace where you can go on and sign up and figure out what kind of insurance you can afford and figuring out how to get the subsidies, that's still a big complicated piece of business. 

And when you're doing it nationwide, relatively fast, and you've got half of Congress who is determined to try to block implementation and not adequately funding implementation, and then you've got a number of members of -- or governors -- Republican governors who know that it's bad politics for them to try to implement this effectively -- and some even who have decided to implement it and then their Republican-controlled state legislatures say don't implement and won't pass enabling legislation -- when you have that kind of situation, that makes it harder.

But having said all that, we've got a great team in place. We are pushing very hard to make sure that we're hitting all the deadlines and the benchmarks. I'll give you an example -- a recent example. You know, we put together initially an application form for signing up for participation in the exchanges that was initially about 21 pages long.

And immediately everybody sat around the table and said: 'Well, this is too long, especially, you know, in this age of the Internet. People aren't going to have the patience to sit there for hours on end. Let's streamline this thing.'

So we cut what was a 21-page form now down to a form that's about three pages for an individual, a little more than that for a family, well below the industry average. So those kinds of refinements, we're going to continue to be working on.

But I think the main message I want to give to the American people here is despite all the hue and cry and, you know, sky-is-falling predictions about this stuff, if you've already got health insurance, then that part of "Obamacare" that affects you, it's pretty much already in place. And that's about 85 percent of the country.

What is left to be implemented is those provisions to help the 10 to 15 percent of the American public that is unlucky enough that they don't have health insurance. And by the way, you know, some of you who have health insurance right now, at some point you may lose your health insurance, and if you've got a pre-existing condition, this structure will make sure that you are not left vulnerable.

But it's still a big undertaking. And what we're doing is making sure that every single day we are constantly trying to hit our marks so that it will be in place.

And -- and the last point I'll make, even if we do everything perfectly, there'll still be, you know, glitches and bumps, and there'll be stories that can be written that says, oh, look, this thing's, you know, not working the way it's supposed to, and this happened and that happened. And that's pretty much true of every government program that's ever been set up.

But if we stay with it and we understand what our long-term objective is, which is making sure that in a country as wealthy as ours, nobody should go bankrupt if they get sick and that we would rather have people getting regular checkups than going to the emergency room because they don't have health care -- if -- if we keep that in mind, then we're going to be able to drive down costs, we're going to be able to improve efficiencies in the system, we're going to be able to see people benefit form better health care, and that will save the country money as a whole over the long term.

QUESTION: Do you think without the cooperation of a handful of governors, particularly large states like Florida and Texas, that you can fully implement it?

PRESIDENT OBAMA: I think it's harder; there's no doubt about it.

QUESTION: But can you do it without those?

PRESIDENT OBAMA: We -- we will implement it. There will be -- we have a backup federal exchange. If states aren't cooperating, we set up a federal exchange, so that people can access that federal exchange.
But yes, it puts more of a burden on us. And it's ironic, since all these folks say that they believe in empowering states, that they're going to end up having the federal government do something that we'd actually prefer states to do if they were properly cooperating.

We want to hear from you: Contact Kaiser Health News