WASHINGTON – President Barack Obama made the following remarks and answered the following questions on Thursday November 14, 2013 on the Affordable Care Act and the issues that have went along with it since the program was launched on October 1.
According to the White House, “President Obama announced a solution to address the cancellation notices that some people in the individual health insurance market have received in recent weeks, keeping with his pledge to make adjustments and improvements where they’re warranted as the Affordable Care Act takes effect.”
Statement and interview from President Obama:
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.
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