White House Conducts Press Briefing, November 6
Targeted News Service |
Jim.
Q Thanks, Jay. Democrats and Republicans on the Hill are proposing legislation that would make good on the President's promise that anyone who likes their health care coverage can keep it, even if it offers fewer benefits than the law requires. Senator Landrieu has a proposal like that. I wonder how -- is there anything wrong with that idea? Would the President support something like that? Doesn't it live up to his pledge?
When it comes to that provision within the law that grandfathered in plans that existed before the Affordable Care Act was passed, that is obviously what the President was referring to. He was also referring more broadly to the general principle and promise of the Affordable Care Act, which is that if you're one of the 80 percent of Americans who is insured or covered through an employer plan or through
If you're one of the 15 percent of Americans who are uninsured, whose only recourse for health care is the emergency room, then you have nothing but better options because you have available to you potentially free or very affordable health coverage -- free if it goes through
If you're one of those Americans in what makes up only 5 percent of the population who currently receive -- get coverage of some kind through the individual market, and had a plan before the law passed that has not been changed by your insurance company, hasn't been canceled by your insurance company, downgraded by your insurance company, you can keep it. It's written into the law and was explained by Secretary Sebelius when the rule associated with that provision of the law was published in 2010.
However, if you are in the individual market and your insurance company changed your plan, downgraded it, your insurance has to meet the basic standard set by the Affordable Care Act. And what our job is -- and the failure of the website to function effectively has made this job more difficult -- is to make sure that those Americans, that portion of 5 percent of the population, are getting the information they need to know that they can avail themselves, half of them, of tax credits that will make their insurance cheaper than it otherwise would be; that in all situations for them, the insurance options they have available to them is better, more quality coverage than what they're getting now. And as the President said in
But we're focused on all these aspects of getting this implementation on track so that Americans across the country are able to get the benefits that the Affordable Care Act promises.
Q While those percentages might be small, the actions represent millions, millions of people who are getting these notifications. And the Chief of Staff,
So I'm wondering -- clearly this is in the forefront of the
I think that the broader principle is that if you're going to assert that insurance companies can continue to offer substandard plans, bad apple plans, for example, that do not provide hospitalization or have carve-outs that exempt from coverage the very chronic condition you may have -- often in a way that the purchasers of this insurance don't even know -- that that undermines the fundamental promise of the Affordable Care Act, which is that everyone in America should have access to affordable, quality health care coverage.
But again, that's not in response to any specific idea that people are bandying about on the Hill. I think that that is the explanation for the broader approach, which is that back when the law was being written, and the provision that the President insisted be part of the Affordable Care Act that allowed for the grandfathering in of existing plans on the individual market -- so that if you had that plan and you wanted to keep it, even though it was substandard, you could -- that you couldn't apply that hypothetically to plans that did not exist, because basically you would be undermining the central promise of the Affordable Care Act, which is a sort of bottom baseline of coverage that everyone should enjoy -- which means that mental health services are covered, preventive services are covered, there are no annual or lifetime caps; there are all sorts of benefits that are basic to every plan offered under the Affordable Care Act. You can't be charged double if you're a woman, which was something that insurance companies regularly did because they could.
And it's important, as we have this discussion, that we remember that the status quo ante here -- the world back to which many critics want us to go -- is a world in which insurers have that power to say that your relative who has a preexisting condition either has no chance of getting coverage or is going to be charged so much that he or she can't afford it.
So the whole here is important to look at, even as we talk about slices. The whole is based on a principle that there ought to be affordable, quality health care coverage available to every American.
Q Is the President, though, troubled by the anecdotal evidence that these notifications are going out? And it's ample evidence, that they're going out.
So, yes, he is frustrated by that. And we are committed to do a better job of getting that information to the American people who deserve it. And there's no question about that. When it comes to -- some of these anecdotes, as we've discussed, turn out to be a little different upon closer inspection, in part because of the problems I just described: If the individuals aren't getting the information they need, they often don't know what the future looks like for them.
So, for example, the I think very sensational report last week that focused on a woman from
This is all important, and it's all on us, and that's why we're working every day to get that information to the Americans who need it.
Q Thanks.
Q This morning,
The marketplaces are set up for that universe of people who don't get insurance currently through their employers or through
So I don't have a specific plan to describe to you beyond the imperative that we get that information to everyone who needs it. And that's --
Q So it's not some sort of specific outreach to these people?
And they can go on the website now. I mean, there are folks obviously who may have experienced real difficulties in the early days after the launch, who, if they go on now, will find that while it is still below where we need it to be in terms of functionality, it's better than it was, and they are able to access important information about the plan options available to them.
So this is an all-hands-on-deck effort to make sure that Americans who need this information are getting it.
Q Can you tell us more about the meeting that
This morning,
He reiterated the administration's commitment to finalizing these fixes as quickly as possible and working to open new doors to enrollment.
And finally, he emphasized the need for all involved in the marketplaces, including the administration, issuers and other stakeholders, both federal and private, to ramp up communication and education efforts to consumers who have received or might receive letters about their individual market plans changing.
And that goes to what we were talking about before. We need to ensure that that portion of the 5 percent who might be getting these letters are made aware that they have a pretty broad array of options available to them. The letters, depending -- it's different for each issuer -- may include an effort by the insurer to, understandably, retain the business of the individual and might point out the options that that insurer has, the plans that that insurer has -- may even suggest one -- but would not necessarily include information about whether that individual is qualified to receive a tax credit, which could reduce significantly the premium that he or she might pay; would not, obviously, include information about plans their competitors are offering. And in state after state after state, there are more plans available and there is more competition because of the Affordable Care Act.
So we need to get that information to the American people.
Q So he's telling them to give them that extra information?
And there's an interest by insurers in making sure that they compete for that business, and that's a good thing. It helps keep prices manageable. We've seen, since the passage of the Affordable Care Act, the lowest growth rates for three straight years that we've seen in 50 years. And I would remind folks that opponents of the Affordable Care Act during the legislative process assured the country that growth rates that were already huge in the health care market would explode as a result of the passage of the Affordable Care Act. But the opposite has happened, and that has been a good thing.
So if you're a company out there that was projecting costs five years ago based on the expected rate of growth in health care costs overall, you've welcomed the news that those costs have come in so much lower than expected, because that affects, positively, everybody's bottom line, including the federal government's bottom line -- because when the cost of health care goes down or the rate of growth slows, that saves taxpayers money, saves the government money, because we administer, obviously,
Jim.
Q Last night at the OFA event, the President said, "If you have or had one of these plans before the Affordable Care Act came into law and you really liked that plan, what we said was you could keep it if it hasn't changed since the law was passed." But that's clearly not what the President said repeatedly over and over again in selling this plan to the American people. How does the President account for that? Why is he adding these caveats that he did not issue to the American people years ago? And why doesn't the President just admit he misspoke or just should have been more complete in his comments at the time?
So the principal --
Q The President didn't use those words.
Now, I understand --
Q Does the President acknowledge that that pledge that he made over and over again -- if you like your plan, you can keep it -- does he now acknowledge that that was a mistake, that that was problematic, that he shouldn't have said it?
Q Just a yes or no -- do you know whether or not the President has said that to you or --
Q But it's not complicated, Jay. He used --
Q All right.
I acknowledge that we need to, as I just said, make sure that folks who fall in that 5 percent and had their plans canceled by their insurers in the past three years, that we need to do a better job of getting information to them so that they know what their options are, and they know that they will, without question, have higher quality insurance because of this than they currently have.
Q Let me try it a different way.
And don't forget, as
Q So if the President could go back, he would use the same words again?
And there's no question that this rollout has not gone as smoothly as we had hoped. And there's no question that the website has caused a lot of problems for Americans trying to get information about the options available to them because of these marketplaces. And it's a reality that because those marketplaces are designed for a segment of the population, that the segment of that segment that are finding out that their insurance plans are substandard and have been changed since 2010 and don't meet the minimum benefit requirements of the Affordable Care Act, that that existing coverage is discontinued on
And we have to make sure that they're getting the information they need so that they can enjoy the benefits of the Affordable Care Act: better coverage, tax credits, minimum benefits, including free preventive care that will have a positive effect for all of us. So even the folks the President talked about both last night and in
Q But you said the President meant to keep this promise, that this is a promise not kept. Is that right?
Q Words are words. The President's words are important, this pledge is important.
Q I just want to get the record straight.
The promise was that -- and it's written into law, and it was specifically spelled out in the rule that was issued as a result of the law, and I can point you to the stories written about it -- was that if insurers canceled your plan, they couldn't come back and say, well, I canceled the plan that qualified for grandfathering, and I'm going to give you something even worse, and then say that the Affordable Care Act made me do it.
That's not what happened here -- because every insurer who offered a plan on the individual market prior to the passage of the law could have maintained that plan, could have continued to offer that plan, and as long as it wasn't significantly changed it's grandfathered in. For some individuals who enjoy that benefit, they may still look at the options available to them through the marketplace and find that they'd rather have better coverage than what their current plan offers.
But the fact is, we were able to write into the law a clause that grandfathered in existing plans. There are those who --
Q That was written into the law. But has the President expressed to you or anybody in this
And it is on us -- and let me be clear, I am embracing the responsibility that the administration has and that everyone involved in the marketplaces has to make sure that those individuals are getting the information they need and are finding out what their options are, and that it is made clear to them -- as was, I think, now made clear to that woman in
Mara, and then Major.
Q Starting in December, when the website is fixed, a big push to get young people to sign up. I mean, I guess there is really no point telling them to go there if they can't access it. You said one of the problems is even if they're being canceled --
Now, as I said before and I've tried to say all along, the fact that the website is not functioning as well as it should doesn't mean it's not functioning at all. There are people who are -- you can get information on it, you can sign up and enroll on it, but there are too many troubles, too many problems, too many bottlenecks and glitches. And until that's resolved, we'll have challenges associated with the website. But the effort overall continues. And you're absolutely right that making sure young people know what options are available to them is a key component of the Affordable Care Act.
Q Well, I guess everybody always expected older, sicker people to be the first people to sign up. Obviously, they have more incentive to want it. But there are reports that the initial enrollment is more skewed to older and sicker people than insurers even thought it would be. So they're getting even less young, healthy people than they thought they would get and much less than they need to make the whole system work.
And what
And for those of us who either have kids -- or some of you who are young enough to remember what you were like at that age -- it has always been the expectation and the case that younger Americans will wait until the last minute before they make a decision and apply and enroll.
So our expectation was always that that would be the case, and we've tried to telegraph that in general about enrollment and the crescendo that we expect. There's no question that the problems with the website have exacerbated the trend, which is why we have to work all the harder to make sure that it gets up and running, and that we do everything we can to make sure that folks are applying and enrolling.
David. I'm sorry, I did say Major, then David. Major, sorry.
Q In her opening statement at the hearing today,
Q Although she mentioned others.
So, look, there's no question that the problems --
Q That's not alarmist rhetoric is sort of my question.
And we need to -- we're working on making sure that we address these problems, both at the website and in the communication of the options to those Americans who need to know what their options are.
Q Let me ask you a philosophical question about one of the characterizations you've made about the law, and the bad insurance that people may have had before. Is it possible, and does the
And so when it comes to should there be minimum benefit standards, that is obviously the President's view, the administration's view, and that was foundational to what the Affordable Care Act provides. It was what the battle in
But obviously that didn't mean that once that election was won or the law was passed, that all opposition to it would cease to exist, that all philosophical opposition to or ideological opposition to the idea that there should be minimum standards of insurance.
I mean, it's not entirely different to somebody who is opposed to wearing a helmet in a state where there's a helmet law for motorcyclists, right? You can be ideologically opposed to it. You may think it's wrong, that it's government overreach. But the legislative body that passed that law disagreed and has been elected or appointed. Or, for example, basic car insurance that is a requirement in state after state after state -- there may be individuals who say, "You know what, my conception of personal liberty says that I'm a safe driver and I shouldn't have to buy insurance." Well, the decision is made by --
Q Okay. But I think you would acknowledge that there is a difference between not wearing a helmet and never buying insurance, and having insurance that you've actually sorted out, looked at competitively. You may have done some shopping. You may have actually run the numbers for yourself or your family, and said, you know what --
He feels very strongly, and a lot of people feel very strongly, that insurance companies that take advantage of and have taken advantage of, for years, individuals in this market who have so little recourse by charging women double -- I mean, my guess is the person here is not a woman, because if a woman wanted to say, "I like paying double, because my insurance company is taking advantage of me and my gender for years or decades," that would be an odd position to take. But if she had that policy before 2010 and wanted to keep it and wanted to pay double for worse coverage, she could.
But it is absolutely the case that the President believes there ought to be minimum standards of coverage. And that philosophical and ideological debate was engaged. And I'm sure it won't go away because I'm sure the House will, at least a couple more dozen times, vote to repeal.
Q As you've learned, the language from this building and this podium is very important as this health care debate goes forward. Last week, what we were told is that the website would be fully operational for most users by the end of November. On the CMS call yesterday afternoon, that was amended slightly to it will be vastly improved by the end of November. I would like for you, as best as you're able to, set the benchmark that the President has set for what this website will be in terms of its functionality and usability by
Q But it sounded yesterday on the call as if they were sort of dialing that back --
Q But I mean, the President has set the standard on this.
Q Okay. One other thing on the insurance companies -- because there was a lawsuit filed yesterday in
Q I'm not asking you to comment on the litigation.
But, in general, I think that what's -- it's in everybody's interest here that Americans in this market get all the information that they deserve about their options. So we're working with every interested party to make sure they get that information. I don't know the specific cases here. I think that --
Q But is the administration concerned that insurance companies are not being clear enough with consumers about their options?
Now, we have -- part of our effort has been to provide other avenues for these Americans to get information through call-in centers or in-person centers or downloading an application and sending it in by mail. And we've improved the website so that they can get more information from the website.
So what I said at the top remains, that the fact that a lot of those Americans aren't getting the information they need and may, therefore, be concerned about what options they have is partly on us, at least partly on us, and we accept that responsibility and we're working to fix it.
Q Last topic -- on the TSA shooting at LAX. The administration obviously has had some time, perhaps the President has, to digest all the facts there. Any new thoughts about a different type of approach to TSA security having maybe a companion police force within the agency? You probably don't have a conclusion on that. And do the facts of this case renew in the President's mind, and will we see any demonstration of this in the near term, about the need for gun control?
But I haven't been part of discussions; maybe DHS or TSA can fill you in on their views in the wake of that. What I know the President believes is that the TSA employee who was killed was serving his country and making Americans safer, and those who fly in and out of American airports safer. And he deserves -- his family deserves our prayers because of his sacrifice.
Ed. I'm sorry, I said David after Major. It was so long ago, that I --
Q Back to the fraction of a fraction of 5 percent -- a fraction of those people are going to have to pay more. It may be a better policy, but they're going to have to pay more. We started to hear what the President is going to say. What would the President's message be to somebody who, say, paid
The fact is, as the President said, a subsection of that slice will potentially pay more because they earn too much to qualify for either
Q That's not what the President told them two years ago.
Q Well, if you have your insurance and you like it -- and you said --
Q No, I'm not confusing --
So he never said that everybody would pay less. If you're saying that's what he said, I don't think you could find that.
Q And you said that these insurance companies that have stripped these on, these are junk policies -- these insurance companies were offering some coverage to these individuals who found that that was what they wanted.
Q But that's what they wanted. A woman who doesn't want to have children doesn't have to have maternity care, doesn't need insurance for that. Now she has to have it. She couldn't keep the policy that she had and she liked.
Q But --
But going back to my basic point, yes, we believe, and the Affordable Care Act makes law, that there should be minimum standards for basic health care coverage, health insurance coverage. And if you had a plan that did not meet those minimum standards and your insurance company hasn't downgraded it in the interim, you can keep it. It's grandfathered in forever if you want to keep it and choose not to avail yourself of other options and better coverage.
But look, I think it's worth studying -- if you're going to do reporting on the individual market -- studying what we're talking about here. And one of the reasons why that area of the insurance market so desperately needed reform is because it was the area where insurers could so easily take advantage of consumers because consumers had so few options. They had a chronic preexisting condition. They had maybe one carrier in their area that could offer them coverage. They did not have the options that are now available to them through the Affordable Care Act.
Q You've said that there is great interest among the young Americans with this new survey data. Whose data is that? What is the data? And will you share it with us?
Q Did something come new from the CMS in the last couple of days?
Q Anything from CMS of late?
Q Jay, obviously the words the President said three years ago have been picked over many times. But what about what he said just over a month ago?
Q But it's not true. He didn't say yes. It's not true.
Q But did he just not anticipate that cancellation letters would come out? I mean, you've been bashing the insurance companies and saying they kick people off all the time anyway; we knew that even before the Affordable Care Act kicked in. So how did that get in the President's remarks? Nobody here at the
But our focus, Ed, is on implementing the law and getting these benefits to the American people.
Q But part of implementing it is communicating with the American people about if you have this plan or you have that plan, how you deal with it. And here is the President of
So that's on us, and I accept that. And --
Q Okay. But when you keep saying this is only 5 percent, and you keep -- earlier in the briefing, you said, I understand there were mistakes with the website, we own that, et cetera, et cetera -- isn't this more, though? Isn't it about the -- it's been said the President's words matter, but also his credibility with the American people. Even if it's only involving 5 percent of the American people, it's still millions of people. Doesn't his credibility matter in what he communicates?
And again, the opposite has happened to what critics at the time said would happen. And it kind of reminds me of critics in 1993 swearing that the Clinton economic plan would bring about economic ruin, and in fact what happened after that was the largest peacetime expansion ever, and substantial economic growth and job creation. It's funny, if you go back and ask the Republicans who made those claims, they don't really want to talk about what actually happened.
Well, what has actually happened here is that health care costs have slowed to their slowest rate of growth in half a century. That's a significant thing for something that's such a big part of our economy. For employers, for employees, for the government, this is a big deal, and the Affordable Care Act is part of the reason why that's happening. And the President's focus on living up to the promises he made is ensuring that that affordable health care coverage, that quality health care coverage is available to Americans across the country.
Peter.
Q A very quick question.
Q The head of the CMS,
Q Sure. Has the President seen what the numbers are that will be the first numbers to be released yet?
Q I know you have a lot to --
Q On a separate topic, noting that you have a lot of different tabs in that briefing book, I want to try to get to a different one if I can quickly. The President, during today's event that the pool wasn't able to go to but we could watch remotely, noted that he was watching the
This
I have not had a conversation with the President about the story involving the
Q Quick question.
We will have more information for you on the review when it's concluded at the end of the year. And we'll -- in keeping with what has been a unprecedented level of declassification when it comes to NSA activities, we'll endeavor to provide as much information as we can, understanding that the very things we're talking about here involve intelligence-gathering and, therefore, necessarily need to be protected.
We've spoken openly about addressing the concerns that some of these revelations have raised among our allies directly with our allies. I read out the phone call that the President had with Chancellor Merkel in which this was discussed and he offered her reassurances. And we've made clear that this has been a point of discussion between the President and other leaders, as well as obviously in government-to-government diplomatic communications. And those communications continue.
Beyond that, I don't have anything specifically to say about that article, except that it does reflect that this review is underway and that it is looking at these very matters.
Q Just quickly, on the Morsy trial, is that something that the President is following? Is that something that the President or other senior administration officials are taking up with
Now, the interim government that replaced Morsy had the support of millions of Egyptians, as we all know, who believed the revolution had taken a wrong turn. But the interim government also has made decisions inconsistent with inclusive democracy, and we've pointed those out.
So this is an ongoing priority in the foreign policy realm for the President, for the Secretary, for the National Security Advisor and others. We have made clear when it comes to our view on the need -- we've made clear that
So
April.
Q Jay, going back to what Peter asked, when you ask the President about his bullying issue, can you find out does he separate bullying for children versus adult bullying? Or is it all the same?
Q I was hoping you'd take --
Q And what's the
Data that we keep getting reflects that -- the unemployment claims, the confidence figures. I think we can expect that data going forward will reflect the hit that our economy took because some lawmakers decided it was more important to wage an ideological battle -- once again, over health care reform -- than to fulfill their basic responsibilities to the American people when it comes to not inflicting wounds on the economy gratuitously. Because that's what they did.
And we've moved on here, in this room and elsewhere across
And so when it comes to the issue that Americans care about the most, we saw a gratuitous insult to the American people by the decision to shut down the government and flirt with default, and we're going to pay a price as an economy for a while now because of that decision.
Q Jay, just a quick one -- thank you. Do you think you can get us a list of the insurers that
Q And are you asking, or does the
When it comes to substandard plans, they need to know that there are better options available to them -- that they might qualify for
Q Jay, were the President's remarks yesterday at the OFA event an effort by him to fix the 'if you like it, you can keep it' statements that he had made previously, by elaborating on them?
What we're trying to do here is make sure that Americans have all the information they need. And we accept that because of the problems with the website and other issues that it's on us to make sure that they're getting that information. And we need to do everything we can to improve the means by which those people can get the information they deserve and that they get, then, the benefits that they have and deserve under the law.
Q Is
The purpose here is to fulfill the promise of the law. And everything that has happened because of the website that has made that harder is something that frustrates him enormously. But he's focused on the American people for whom the benefits were designed.
And I understand -- and I think this goes to what I was saying before -- that there's a lot of focus here in
And to the extent they're focused on health care because maybe they're not one of the 80 percent that is covered by their employer or
That's our focus. This goes to economic security, princ
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