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!
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