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Public Statements

Remarks by the President on the Affordable Care Act

Location: Largo, MD

THE PRESIDENT: Hello, Maryland! (Applause.) Hello, PGCC! (Applause.) It's good to be back in PG County. (Applause.)

Give it up for one of the hardest-working, most effective governors in the country, Governor Martin O'Malley. (Applause.)



THE PRESIDENT: I love you back. It's wonderful being here. (Applause.)




There's been a lot of things said, a lot of misinformation, a lot of confusion. But there are few things more fundamental to the economic security of the middle class and everybody who's trying to get into the middle class than health care.




And I remember looking around that emergency room and thinking -- what about the parents who aren't that lucky? What about the parents who get hit with a bill of $20,000 or $30,000 and they've got no idea how to pay for it? What about those parents whose kids have a chronic illness like asthma and have to keep on going back to the emergency room because they don't have a regular doctor, and the bills never stop coming? Who is going to stand up for them?


In the United States of America, health care is not a privilege for the fortunate few -- it is a right. And I knew that if we didn't do something about our unfair and inefficient health care system, it would keep driving up our deficits, it would keep burdening our businesses, it would keep hurting our families, and it would keep holding back economic growth.

That's why we took on a broken health care system. That's why, with the help of folks like Steny and Ben and Donna, we got it through Congress. That's why we've been implementing it. That's why we are going to see it through. The Affordable Care Act is here. (Applause.)




Preexisting conditions, whether it's back pain or allergies that were sticking you with sky-high premiums, those no longer will prevent you from getting affordable coverage that you need. That's going to happen in five days.

Now, of course, the closer we've gotten to this date, the more irresponsible folks who are opposed to this law have become. Some of the same Republicans who warned three years ago that this law would be "Armageddon" -- that's what they said -- "Armageddon" -- now they're threatening steps that actually would badly hurt our entire economy -- not because of the Affordable Care Act but because of what they're threatening to do.

Some have threatened a government shutdown if they can't shut down this law. Others have actually threatened an economic shutdown by refusing to pay America's bills if they can't delay the law.


THE PRESIDENT: That's not going to happen as long as I'm President. (Applause.) The Affordable Care Act is here to stay. (Applause.)

Now, let's start with the fact that even before the Affordable Care Act fully takes effect, about 85 percent of Americans already have health insurance --- either through their job, or through Medicare, or through the individual market. So if you're one of these folks, it's reasonable that you might worry whether health care reform is going to create changes that are a problem for you -- especially when you're bombarded with all sorts of fear-mongering.

So the first thing you need to know is this: If you already have health care, you don't have to do anything. In fact, for the past few years, since I signed the Affordable Care Act, a lot of you have been enjoying new benefits and protections that you didn't before even if you didn't know they were coming from Obamacare. (Applause.)


Because of the Affordable Care Act, 3 million young adults under age 26 have gained coverage by staying on their parents' plan. (Applause.)

Because of the Affordable Care Act, millions of seniors on Medicare have saved hundreds of dollars on their prescription medicine. They've been getting their prescription drugs cheaper. (Applause.)


Because of the Affordable Care Act, insurance companies can no longer put lifetime limits on the care your family needs, or discriminate against children with preexisting conditions. And starting on January 1st, they won't be able to charge women more for their insurance just because they're women. (Applause.) That's a good thing.


Those are the benefits of Obamacare -- the law that Republicans want to repeal. Although it's interesting -- when you ask Republicans whether they'd repeal the benefits I just mentioned, when you say to them, well, do you think it's the right thing to do to let young people stay on their parents' plans so they can keep insurance, or do you want to prevent seniors from getting more discounts on their prescription drugs, then they'll say, no, no, no, we like those. Those things are okay. (Laughter.) So they don't like Obamacare in theory, but some of the component parts, at least those that poll well, they don't mind.

But that's already in place. Now, here's the second thing you need to know. If you're one of over 40 million Americans who don't have health insurance --- including hundreds of thousands of folks right here in Maryland --- starting on Tuesday, five days from now, you'll finally have the same chance to buy quality, affordable health care as everybody else.


THE PRESIDENT: And I want to break this down for you. I want you to know exactly how it works. The major reason why people don't have health insurance is either they don't have a job, or they do have a job but their employer doesn't offer health insurance, or they're self-employed. If you've ever tried to buy health insurance on your own, you know it is really, really expensive.


THE PRESIDENT: It's even worse if you have a preexisting condition --- and up to half of all Americans have a preexisting condition. See, the reason it's really expensive if you're buying it on your own is because you're not part of a big group, you're not part of a group plan. And what groups do is they spread risk between sick and healthy people, between older and younger people. And groups -- because insurance companies want the business of groups -- that's a lot of customers -- they'll negotiate a better deal with a group than they will with an individual.

So if you're on your own, you're out there trying to negotiate with an insurance company, they're looking and they're saying, well, you take it or leave it, I'm going to charge you a whole lot of money. And if you've got a preexisting condition, they'll say, we don't even want to insure you because we think you might get sick later on and we don't really want to pay, we just want to take in premiums.

So if you're not part of a group, you're either uninsurable, or you need to spend a small fortune on insurance that oftentimes is not very good. That's what's happening right now. The Affordable Care Act was designed to solve that problem. And here's how we do it.

Starting on Tuesday, every American can visit HealthCare.gov to find out what's called the insurance marketplace for your state. Here in Maryland, I actually think it's called MarylandHealthConnection.gov. (Applause.) MarylandHealthConnection.gov. But if you go to HealthCare.gov, you can look and they'll tell you where to go. They'll link to your state.


It's buying insurance on the private market, but because now you're part of a big group plan -- everybody in Maryland is all logging in and taking a look at the prices -- you've got new choices. Now you've got new competition, because insurers want your business. And that means you will have cheaper prices. (Applause.)

So you enter in some basic information about yourself, what level of coverage you're looking for. After that, you'll be presented with a list of quality, affordable plans that are available in your area. It will say clearly what each plan covers, what each plan costs. The price will be right there. It will be fully transparent.

Before this law, only a handful of states required insurance companies to offer you instant price quotes, but because of this law, insurers in all 50 states will have to offer you instant price quotes. And so if you've ever tried to buy insurance on your own, I promise you this is a lot easier. It's like booking a hotel or a plane ticket.

And here's another thing about these new plans. If you're one of those folks who has a preexisting condition, these plans have to offer you coverage. They can't use your medical history to charge you more than anybody else. If you couldn't afford coverage for your child because he had asthma, he's covered. If you couldn't afford coverage because you were told heartburn was a preexisting condition, you're covered. (Laughter.) If you're one of the 45 million Americans with a mental illness, you are covered.

If you're a young adult or entrepreneur striking out on your own, you're covered. (Applause.) If you're a young couple who previously had insurance that didn't include maternity benefits and now suddenly you need some maternity benefits, you're covered. (Applause.) If you lose your job and your health care with it, you're covered. (Applause.)









Knowing you can offer your family the security of health care -- that's priceless. Now you can do it for the cost of your cable bill. Probably less than your cellphone bill. (Laughter and applause.) Think about that. Good health insurance for the price of your cellphone bill, or less.

And let's say you're a young woman, you just turned -- I'm interested in this, because I got two daughters, right? Let's say you just turned 26. Let's say you can't stay on your parents' plan anymore. If you buy health care through the marketplace, your plan has to cover free checkups, flu shots, contraceptive care. So you might end up getting more health care each month than you're paying for the premiums.

All told, nearly 6 in 10 Americans without health insurance today will be able to get covered for $100 or less. It would actually be 8 in 10 if every governor were working as hard as Governor O'Malley to make the Affordable Care Act work for their citizens. (Applause.)

Unfortunately, we've still got a few Republican governors who are so opposed to the very idea of the law -- or at least they're doing it for politics -- that they haven't lifted a finger to help cover more people. Some of them have actually tried to harm the law before it takes effect.

But a lot of Republican governors are putting politics aside and doing the right thing. (Applause.) And they deserve congratulations for that. It wasn't easy for them. But you've got conservative governors in Ohio, in Michigan, in Pennsylvania and Arizona -- about eight Republican governors in all, they've decided to expand Medicaid through the Affordable Care Act to cover more people in their states. And millions of Americans without insurance will get coverage through these programs.

So that's what the Affordable Care Act is. That's what all the fuss is about. We're giving more benefits and protections for folks who already have health insurance, and we created a new market -- basically a big group plan -- for folks without health insurance so that they get a better deal, and then we're providing tax credits to help folks afford it.

You would think that would not be so controversial. (Laughter.) You would think people would say, okay, let's go ahead and let's do this so everybody has health insurance coverage. The result is more choice, more competition, real health care security.


Over the past five years, we've more than doubled the adoption of electronic health records for physicians. So that means they can track what's going on better and make fewer mistakes. New technology startup companies are coming up with new inventions to monitor patient health, prevent infections. There's innovation going on all across the country. As a consequence, today, Medicare costs per enrollee are rising at the slowest rate in years. Employer-based health care costs are growing at about one-third the rate of a decade ago.


So let's think about this. If you got health insurance, you're getting better protections, better benefits. If you don't have health insurance, you're now getting to be part of a group plan. And health care costs overall are rising much more slowly than they did before we signed the law. So far, so good. So what's all the fuss about? What is it that everybody -- what is that these Republicans are just so mad about?


THE PRESIDENT: No, no, no, look, I want to be honest. There are parts of the bill that some folks don't like. To help pay for the program, the wealthiest Americans --- families who make more than $250,000 a year --- will have to pay a little bit more. Extremely costly health insurance plans will no longer qualify for unlimited tax breaks. And most people who can afford health insurance now have to take responsibility to buy health insurance, or pay a penalty. (Applause.)

Right? Now, the reason we do that is, when uninsured people who can afford to get health insurance don't, and then they get sick or they get hit by a car, and they show up at the emergency room, who do you think pays for that?


THE PRESIDENT: You do, in the form of higher premiums. Because the hospitals, they've got to get their money back somehow. So if they're treating somebody who doesn't have health insurance, they jack up premiums for everybody who does have health insurance. It's like a hidden tax of $1,000 per family every year who has got health insurance. So we're saying that's not fair. If you can afford to get health insurance, don't dump the costs on us. The law also requires employers with more than 50 employees to either provide health insurance for your workers or pay a penalty.

Now, some folks say, well, that's not fair. But if you are an employer, you can afford to provide health insurance, you don't, your employees get sick, they go to the emergency room or they end up on Medicaid because you're not doing what you're doing -- you should be doing -- why is it everybody else should be bearing those costs?


So this idea that you've got responsibilities -- everybody -- that's what Massachusetts did when they passed their health care plan a few years ago. And, by the way, today, in Massachusetts, almost everybody is covered and the system works pretty well. (Applause.)



They said this would be a disaster in terms of jobs. There's no widespread evidence that the Affordable Care Act is hurting jobs. One of John McCain's former economic advisors admitted just this week -- and I'm quoting here -- "I was expecting to see it. I was looking for it," but "it's not there." It's not there. (Applause.)

The reason is reforming health care is going to help the economy over the long term. Not only will it help lower costs for businesses, not only will it help families, it will free up entrepreneurship in this country. Because if you've got a great idea for your own business but you've never tried it because your spouse had a preexisting condition and you didn't want to lose your employer-based coverage, you've got the ability now to get your own coverage. That's security. That's freedom.

So we're now only five days away from finishing the job.

AUDIENCE MEMBER: Five days away.


Tell your friends, tell your classmates, tell your family members about the new health care choices. Talk to folks at your church, in your classroom. You're going to a football game, basketball game -- talk to them. Tell them what the law means.

And over the next few months, state and local leaders from across the country are going to hold events to help get the word out. Go out there and join them. Secretary of Health and Human Services Kathleen Sebelius is in Texas right now, working with folks on the ground to make sure this law works for Texas families. All across the country, people are getting ready. All kinds of people are working hand-in-hand because we're all in this together -- that's when America is at its best. That's what this country is all about.


That's all I'm asking. Make up your own mind. I promise you, if you go on the website and it turns out you're going to save $100, $200, $300 a month on your insurance, or you'll be able to buy insurance for the first time, even if you didn't vote for me -- (laughter) -- I'll bet you'll sign up for that health care plan. (Applause.)


Look, part of the reason I need your help to make this law work is because there are so many people out there working to make it fail. One of the biggest newspapers in the country recently published an editorial I thought was pretty good. They said, the Republicans in Congress are poisoning Obamacare, then trying to claim it's sick. (Laughter.) That's exactly what's been happening.

I mean, they have tried to put up every conceivable roadblock. They cut funding for efforts to educate people about what's in the law. Some of them said if their constituents called them, we won't even try to explain to them what's in the law. They actually opened up an investigation into people who try to help churches and charities understand how to help people sign up for the law.


AUDIENCE: Right! (Applause.)






So what is it that they're so scared about?

AUDIENCE MEMBER: You! (Laughter and applause.)

THE PRESIDENT: They have made such a big political issue out of this, trying to scare everybody with lies about "death panels" and "killing granny" -- (laughter) -- right? "Armageddon." So if it actually works, they'll look pretty bad. If it actually works, that will mean that everything they were saying really wasn't true and they were just playing politics.

AUDIENCE: That's right!

THE PRESIDENT: Just the other day, one Republican in Congress said we need to shut this thing down before the marketplaces open and people get to see that they'll be getting coverage and getting these subsidies because -- and I'm going to quote him here -- he said, "It's going to prove almost impossible to undo Obamacare." (Laughter.) Right? So in other words, we've got to shut this thing down before people find out that they like it. (Laughter and applause.) That's a strange argument. Don't you think that's a strange argument?


THE PRESIDENT: And the closer we get, the more desperate they get. I mean, over the last few weeks the rhetoric has just been cranked up to a place I've never seen before. One congressman said that Obamacare is "the most dangerous piece of legislation ever passed." (Laughter.) Ever. In the history of America, this is the most dangerous piece of legislation. (Laughter.) Creating a marketplace so people can buy group insurance plans -- the most dangerous ever.

You had a state representative somewhere say that it's "as destructive to personal and individual liberty as the Fugitive Slave Act."




THE PRESIDENT: I mean, these are quotes. I'm not making this stuff up. And here's one more that I've heard -- I like this one -- we have to -- and I'm quoting here -- "We have to repeal this failure before it literally kills women, kills children, kills senior citizens." Now, I have to say -- that one was from six months ago -- I just want to point out we still have women -- (laughter) -- we still have children, we still have senior citizens. (Applause.)

All this would be funny if it wasn't so crazy. And a lot of it is just hot air. A lot of it is just politics. I understand that. But now the tea party Republicans have taken it to a whole new level because they're threatening either to shut down the government, or shut down the entire economy by refusing to let America pay its bills for the first time in history -- unless I agree to gut a law that will help millions of people.



Think about how that would impact Maryland. This is an area where lots of people would be badly hurt by a government shutdown. A lot of people around here wake up and go to serve their country every single day in the federal government -- civilians who work at military bases, analysts, scientists, janitors, people who process new veterans' and survivors' benefit claims. They'd all have to stay home and not get paid. And we all know it would badly damage the economy.

Whatever effect Obamacare might have on the economy is far less than even a few days of government shutdown. (Applause.) I mean, even if you believe that Obamacare somehow was going to hurt the economy, it won't hurt the economy as bad as a government shutdown. And by the way, the evidence is that it's not going to hurt the economy. Obamacare is going to help the economy. And it's going to help families and help businesses. (Applause.)







And, meanwhile, we're going to keep implementing the law.

AUDIENCE MEMBER: It's the law!


So we may not get that same level of cooperation from Republicans right now. But the good news is I believe eventually they'll come around. Because Medicare and Social Security faced the same kind of criticism. Before Medicare came into law, one Republican warned that "one of these days, you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free." That was Ronald Reagan. And eventually, Ronald Reagan came around to Medicare and thought it was pretty good, and actually helped make it better.



But I'm always willing to work with anybody from either party. If you've got a serious idea for making the Affordable Care Act better, or making our broader health care system better, I'm happy to work with you -- because that's what the majority of the American people want. They don't want posturing; they want governing. They don't want politics; they want us to work together to make the lives of ordinary Americans a little bit better, a little bit more secure. (Applause.)


So tell your friends, tell your family. Get covered. Get on that website. Answer the questions of folks who don't know what this is all about. Point them to HealthCare.gov. Teach them how to use the website. Make sure they sign up. Let's help our fellow Americans get covered. (Applause.)



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