Barack Obama on Health Care

Democratic incumbent President; IL Senator (2004-2008)


Prioritize finding a cure for cancer

Last year, Vice President Biden said that with a new moonshot, America can cure cancer.˙Last month, he worked with this Congress to give scientists at the National Institutes of Health the strongest resources that they've had in over a decade. For the loved ones we've all lost, for the families that we can still save, let's make America the country that cures cancer once and for all.
Source: 2016 State of the Union address to Congress , Jan 20, 2016

All kids should get vaccinated, but not by law

Sen. Rand Paul (R-KY) continued to walk back his comments that parents should be allowed to choose whether to vaccinate their children, saying he holds the same position as President Barack Obama on the matter.

President Barack Obama said parents should get their kids vaccinated. "The science is pretty indisputable," Obama said. "We've looked at this again and again. There is every reason to get vaccinated, but there aren't reasons to not."

The White House has stopped short of saying that there should be a law requiring parents to get their children vaccinated. "The president believes it shouldn't require a law for people to exercise common sense and do the right thing," a White House press secretary said. "And again, this is the right thing for them to do both by their own children, but by also other children in the community. They have a responsibility to do this. "

Source: Huffington Post 2015 coverage of 2016 presidential hopefuls , Feb 4, 2015

ObamaCare didn't crush jobs nor explode deficits

In the past year alone, about ten million uninsured Americans finally gained the security of health coverage. At every step, we were told our goals were misguided or too ambitious; that we would crush jobs and explode deficits. Instead, we've seen the fastest economic growth in over a decade, our deficits cut by two-thirds, a stock market that has doubled, and health care inflation at its lowest rate in fifty years.

So the verdict is clear. Middle-class economics works. Expanding opportunity works. And these policies will continue to work, as long as politics don't get in the way. We can't slow down businesses or put our economy at risk with government shutdowns or fiscal showdowns. We can't put the security of families at risk by taking away their health insurance, or unraveling the new rules on Wall Street, or refighting past battles on immigration when we've got a system to fix. And if a bill comes to my desk that tries to do any of these things, it will earn my veto.

Source: 2015 State of the Union address , Jan 20, 2015

Ebola teaches us how to prevent future pandemics

In West Africa, our troops, our scientists, our doctors, our nurses and healthcare workers are rolling back Ebola--saving countless lives and stopping the spread of disease. I couldn't be prouder of them, and I thank this Congress for your bipartisan support of their efforts. But the job is not yet done--and the world needs to use this lesson to build a more effective global effort to prevent the spread of future pandemics, invest in smart development, and eradicate extreme poverty.
Source: 2015 State of the Union address , Jan 20, 2015

FactCheck: Yes, 10 million newly insured last year

Obama said, "In the past year alone, about 10 million uninsured Americans finally gained the security of health coverage."

FactCheck: We don't know for sure how many uninsured Americans have gotten coverage through the Affordable Care Act, but Obama's math is in line with estimates published last year in the New England Journal of Medicine. That analysis--which was conducted in part by Health and Human Services--estimated that 10.3 million Americans gained insurance due to ObamaCare, based on the decline in the uninsured rate and 2014 census estimates.

That estimate is more generous to ObamaCare than the most recent Gallup Poll, but Gallup still found the percentage of Americans without health insurance is lower than it's ever been. The polling firm said earlier this month that roughly 13 percent of Americans lack health insurance--a steep drop of more than 4 percent since ObamaCare enrollment began.

Source: National Journal FactCheck on 2015 State of the Union , Jan 20, 2015

An AIDS-free generation is within our reach

Progress in the most impoverished parts of our world enriches us all. In many places, people live on little more than a dollar a day. So the US will join with our allies to eradicate such extreme poverty in the next two decades: by connecting more people to the global economy and empowering women; by helping communities to feed, power, and educate themselves; by saving the world's children from preventable deaths; and by realizing the promise of an AIDS-free generation.
Source: 2013 State of the Union Address , Feb 12, 2013

We reduced senior Rx prices & pushed preventive care

OBAMA: in Medicare, what we did was we said, we are going to have to bring down the costs if we're going to deal with our long-term deficits, but to do that, let's look where some of the money's going. $716 billion we were able to save from the Medicare program by no longer overpaying insurance companies by making sure that we weren't overpaying providers. And using that money, we were actually able to lower prescription drug costs for seniors by an average of $600, and we were also able to make a significant dent in providing them the kind of preventive care that will ultimately save money throughout the system.

ROMNEY: That's $1 for every $15 you've cut. They're smart enough to know that's not a good trade. I want to take that $716 billion you've cut and put it back into Medicare. By the way, we can include a prescription program if we need to improve it. But the idea of cutting $716 billion from Medicare to be able to balance the additional cost of ObamaCare is, in my opinion, a mistake.

Source: First Obama-Romney 2012 Presidential debate , Oct 3, 2012

I don't think Medicare vouchers are the way to go

ROMNEY: With regards to young people coming along, I've got proposals to make sure Medicare and Social Security are there for them without any question.

OBAMA: I think it's important for Governor Romney to present this plan that he says will only affect folks in the future. And the essence of the plan is that you would turn Medicare into a voucher program. It's called premium support, but it's understood to be a voucher program.

Q: And you don't support that?

OBAMA: I don't. And let me explain why.

ROMNEY: Again, that's for future people, not for current retirees.

OBAMA: The idea, which was originally presented by Congressman Ryan, your running mate, is that we would give a voucher to seniors and they could go out in the private marketplace and buy their own health insurance. The problem is that because the voucher wouldn't necessarily keep up with health care inflation, it was estimated that this would cost the average senior about $6,000 a year.

Source: First Obama-Romney 2012 Presidential debate , Oct 3, 2012

Voucher system puts seniors at mercy of insurance companies

ROMNEY: For people coming along that are young, allow them either to choose the current Medicare program or a private plan. Their choice. And if the government can be as efficient as the private sector and offer premiums that are as low as the private sector, people will be happy to get traditional Medicare or they'll be able to get a private plan.

OBAMA: Medicare has lower administrative costs than private insurance does, which is why seniors are generally pretty happy with it. And private insurers have to make a profit. Nothing wrong with that. That's what they do. And so you've got higher administrative costs, plus profit on top of that. And if you are going to save any money through what Governor Romney's proposing, what has to happen is, is that the money has to come from somewhere. And when you move to a voucher system, you are putting seniors at the mercy of those insurance companies. And over time, if traditional Medicare has decayed or fallen apart, then they're stuck.

Source: First Obama-Romney 2012 Presidential debate , Oct 3, 2012

Too many Americans skip preventive care due to cost

Q: What actions would you support to enforce vaccinations?

A: Today, there are too many Americans who do not get the preventive health care services they need to stay healthy. Many people put off preventive care because the deductibles and copays are too expensive. That's why I fought for the Affordable Care Act, which will make sure all Americans have access to quality preventive health care services. Under the Affordable Care Act, Americans can now get vital preventive services--including the full suite of routine vaccines recommend by the Advisory Committee on Immunization Practices--with no co-pay or deductible. The health care law also created the Prevention and Public Health Fund, an investment in promoting wellness, preventing disease, and investing in public health infrastructure across the country. Ultimately, I believe the health care law is a significant step forward in ensuring that every American has access to the preventive care and immunizations that they need to stay healthy.

Source: The Top American Science Questions, by sciencedebate.org , Sep 4, 2012

FactCheck: ObamaCare covers only 1/2 of 30 million uninsured

Obama said in the State of the Union, "Our health care law relies on a reformed private market, not a government program."

THE FACTS: That's only half true. About half of the more than 30 million uninsured Americans expected to gain coverage through the health care law will be enrolled in a government program. Medicaid, the federal-state program for low-income people, will be expanded starting in 2014 to cover childless adults living near the poverty line.

The other half will be enrolled in private health plans through new state-based insurance markets. But many of them will be receiving federal subsidies to make their premiums more affordable. And that's a government program, too.

Starting in 2014 most Americans will be required to carry health coverage, either through an employer, by buying their own plan, or through a government program.

Source: Fox News FactCheck on 2012 State of the Union speech , Jan 24, 2012

OpEd: Incremental plan builds on patchwork system

Obama's plan would try to achieve close to universal coverage by building on the present system. Americans who had insurance and liked it could keep it. For those who could not afford insurance, there would be government subsidies. There would also be a "Medicare-like" public program, which individuals under age 65, or employers, could buy into. Employers who failed to provide decent insurance would have to pay a tax. Obama hopes that costs would be contained among plans and by increasing emphasis on public health and other wellness initiatives. He would also permit the importation of prescription drugs, and would rely on new computerized record keeping to achieve other cost savings.

The main problem with Obama's current approach is that his plan builds on, and further complicates a patchwork profit-driven system that is inherently inefficient. By expanding coverage without addressing the fundamental drivers of escalating cost, Obama (or his successor) risks a draconian cut in services later on.

Source: Obama`s Challenge, by Robert Kuttner, p.167-168 , Aug 25, 2008

2003 Rx Drug Bill combined worst of public & private sectors

Obama writes, a little disingenuously, "We know that our health-care system is broken. But ideology & political gamesmanship result in inaction, except for 2003, when we got a prescription drug bill that somehow managed to combine the worst aspects of th public and private sectors--price gouging and bureaucratic confusion, gaps in coverage and an eye-popping bill for taxpayers."

Reading that sentence, you get the feeling that Obama assigns roughly symmetrical blame for that outcome. But it wasn't "ideology & political gamesmanship" in general that produced such a wretched excuse for a program; it was George W. Bush's alliance with the insurance and drug industries that added red tape, inflated costs, and cut net benefits. On the other hand, the bill would not have passed unless conservative Democrats had chosen to be Bush's enablers. So Obama's criticism of both parties had some substance--it was not just calculated positioning as an anti-Washington outsider.

Source: Obama`s Challenge, by Robert Kuttner, p. 13 , Aug 25, 2008

Give more help to those denied a life of dignity & respect

When any human being is denied a life of dignity and respect, no matter whether they live in Anacostia or Appalachia or a village in Africa; when people are trapped in extreme poverty we know how to curb or suffering from diseases we know how to prevent; when they’re going without the medicines that they so desperately need--we have more work to do.
Source: McCain-Obama speeches at 99th NAACP Convention , Jul 12, 2008

Address minority health needs by more coverage & targeting

Q: Currently there are major disparities in both access to insurance and health care for racial and minorities. How will your plan address this issue?

A: One of the biggest reasons that there are disparities is that African-Americans & Latino Americans are much more likely not to have health insurance. And so if we set up a system in which everybody’s got health insurance, some of those disparities are immediately going to be reduced. Folks who are working but don’t have health care benefits- those groups are disproportionately minority. [Covering them via their employer] would be the first step. There are some particular issues within the minority community that I think we can address in a targeted way. Lead paint may seem like an ancillary issue except for the fact that incidence of lead poisoning among African-American & Latino youths is sky high. It has huge ramifications in terms of their long-term health. Obesity and diabetes in minority communities is more severe.

Source: SEIU Democratic Health Care Forum in Las Vegas , Mar 24, 2007

Allow prescription drug re-importation

Barack Obama called for a vote on a bi-partisan bill that would allow the re-importation of safe prescription drugs from industrialized countries at lower prices. “I ask for a Senate vote to allow safe imports of US-approved drugs that are manufactured in US-approved plants,” Obama said. “And, I urge Jack Ryan to stop siding with the drug manufacturers and put aside his opposition to the re-importation of lower-priced prescription drugs from Canada.”
Source: Press Release, “Prescription Drug Re-Importation” , May 21, 2004

Barack Obama on AIDS

Lead eradication of malaria and HIV, like we did with Ebola

There is a smarter approach [than just being a military superpower], that uses every element of our national power. It says on issues of global concern, we will mobilize the world to work with us.

That's how we stopped the spread of Ebola in West Africa. Our military, our doctors, our development workers--they were heroic. They set up the platform that then allowed other countries to join in behind us and stamp out that epidemic. Hundreds of thousands--maybe a couple million lives were saved.

When we help African countries care for the sick, It's the right thing to do, and it prevents the next pandemic from reaching our shores. Now right now, we are on track to end the scourge of HIV/AIDS, that's within our grasp, and we have the chance to accomplish the same thing with malaria, something I'll be pushing this Congress to fund this year. That's American strength. That's American leadership. And that kind of leadership depends on the power of our example.

Source: 2016 State of the Union address , Jan 12, 2016

Advocated condom use to avoid AIDS at Saddleback Church

In Dec. 2006 Obama took part in an event at the Saddleback megachurch. It was World AIDS Day, and Obama appeared alongside Sen. Sam Brownback (R, KS). Brownback remarked, "Welcome to my house," prompting peals from the crowd. When Obama's turn came, he remarked, "There is one thing I've gotta say: This is my house, too. This is God's house." He quoted Corinthians and advocated the use of condoms to prevent the spread of HIV. The huge crowd of conservative Evangelists awarded him a standing ovation.
Source: Game Change, by Heilemann & Halpern, p. 69 , Jan 11, 2010

CDC estimate: a half million would follow Obama's AIDS test

In a staged public event at the Kenya Medical Research Institute in Kisian, Obama and his wife took an AIDS test, to demonstrate to the local people in a public forum that the test was safe. At the door of a mobile AIDS testing facility provided by the U.S. Centers for Disease Control, Obama was photographed with a microphone, speaking to the assembled crowd. The primary message of the AIDS event was a universal message, namely, that AIDS testing is safe: "One of the reasons we are here today is becaus HIV/AIDS has ravaged the community," Obama told the assembled crowd. "Too many people, too many children have gotten sick. So one of the things we're going to do here in front of this van today is that my wife and I are going to get tested for HIV/AIDS, because if you know your status, you can prevent illness." The Centers for Disease Control suggested to Obama that as many as a half-million Kenyans would take the HIV/AIDS test after they saw him and his wife safely do it themselves.
Source: Obama Nation, by Jerome Corsi, p. 95 , Aug 1, 2008

Use whatever works with AIDS, including teaching abstinence

Q: The ministry called True Love Waits, has been credited with lowering the AIDS infection rate in Uganda dramatically from 30% to 6%. It is an abstinence-based program--what is your opinion?

A: When Michelle and I were traveling in Kenya, we took an AIDS test. I compliment George Bush on the PEPFAR program [President’s Emergency Plan for AIDS Relief]. My view is that we should use whatever the best approaches are, the scientifically sound approaches are, to reduce this devastating disease. Part of that should be a strong education component and I think abstinence education is important. I also think that contraception is important; I also think that treatment is important; I also think that we have to do more to make antiviral drugs available to people who are in extreme poverty. So I don’t want to pluck out one facet of it. Now, that doesn’t mean that non-for-profit groups can’t focus on one thing while the government focuses on other things. I think we want to have a comprehensive approach.

Source: 2008 Democratic Compassion Forum at Messiah College , Apr 13, 2008

We need condom distribution to deal with the scourge of AIDS

I’m somebody who is willing to talk about these issues, even when it’s hard, in front of black ministers. I’m willing to talk about AIDS at Saddleback Church to evangelicals and talk about why we need to have condom distribution to deal with the scourge of AIDS. So that’s the kind of political courage that I hope all of you recognize is going to be necessary in order for us to create the kind of America that we all want.
Source: 2007 HRC/LOGO debate on gay issues , Aug 9, 2007

Homophobia prevents talking about HIV/AIDS

One of the things we’ve got to overcome is a stigma that still exists in our communities. We don’t talk about HIV/AIDS. We don’t talk about it in the schools. Sometimes we don’t talk about it in the churches. It has been an aspect of sometimes homophobia that we don’t address this issue as clearly as it needs to be.
Source: 2007 Democratic Primary Debate at Howard University , Jun 28, 2007

Got tested for AIDS, with wife, in public, in Kenya

Q: African-Americans, though 17% of all American teenagers, are 69% of the population of teenagers diagnosed with HIV/AIDS. What is the plan to protect these young people from this scourge?

BIDEN: You’re asking, how do we prevent these 17-year-olds from getting HIV? All the things that were said here [by other candidates] are good ideas; but they don’t prevent that. I spent last summer going through the black sections of my town, trying to get black men to understand it is not unmanly to wear a condom, getting women to understand they can say no, getting people in the position where testing matters. I got tested for AIDS. I know Barack got tested for AIDS. There’s no shame in being tested for AIDS.

OBAMA: I just got to make clear--I got tested with Michelle, when we were in Kenya in Africa. I don’t want any confusion here about what’s going on.

BIDEN: And I got tested to save my life, because I had 13 pints of blood transfusion.

OBAMA: I was tested with my wife. In public.

Source: 2007 Democratic Primary Debate at Howard University , Jun 28, 2007

Curing AIDS must be all-hands-on-deck effort

We are all sick because of AIDS and we are all tested by the crisis. Neither philanthropist nor scientist; neither government nor church can solve this problem on their own. AIDS must be an all hands on deck effort. I don’t think we can deny that there is a moral and spiritual component to prevention--I heard stories of men and women contracting HIV because sex was no longer part of a sacred covenant but a mechanical physical act. Having said that, I also believe that we cannot ignore that abstinence--may not be the reality. If condoms and potentially microbicides can prevent millions of deaths, they should be made more widely available.
Source: In His Own Words, edited by Lisa Rogak, p. 10 , Mar 27, 2007

Lead global fight against AIDS

[The US should] lead the global fight against the AIDS virus. The US must give its fair share to the Global Fund to Fight AIDS, Tuberculosis and Malaria to avoid both a humanitarian and economic crisis. President Bush’s budget this year actually cuts the U.S. contribution to the Global Fund by 65 percent. As Senator, I will hold President Bush to his word and fully fund our commitment to the war on AIDS. We must also increase the availability of generic drugs to AIDS victims around the world.
Source: Press Release, “Renewal of American Leadership ” , Jul 12, 2004

Barack Obama on ObamaCare

18 millions people have gained health insurance

The Affordable Care Act is about filling the gaps in employer-based care so that when you lose a job, or you go back to school, or you strike out and launch that new business, you'll still have coverage. Nearly 18 million people have gained coverage so far and in the process, health care inflation has slowed.˙
Source: 2016 State of the Union address to Congress , Jan 20, 2016

FactCheck: 7M new Medicaid includes woodwork & normal churn

Obama said, "We've got close to 7 million Americans who have access to health care for the first time because of Medicaid expansion."

Is it true? The Facts: ObamaCare expands Medicaid to individuals with incomes of up to 138% of the poverty level. So far, 25 states have expanded Medicaid. Because of the ACA, the number of Americans on Medicaid will increase by 8 million in 2014.

That figure includes some people who were previously eligible for Medicaid but had never signed up before all the publicity about new health-care options (known as people coming out of the "woodwork"), and also includes people previously enrolled in Medicaid who are deemed eligible for another year (in other words, "normal churn").

[Those two categories add up to as much as 4.8 million people, although states don't report those figures well, so much is left to guesswork. Obama's estimate would mean those two categories are only 1 million people]. No matter how you slice it, it does not add up to 7 million.

Source: PolitiFact 2013 fact-checking on 2016 presidential hopefuls , Feb 20, 2014

12 million covered; zero denied for pre-existing conditions

For decades, few things exposed hard-working families to economic hardship more than a broken health care system. A pre-existing condition used to mean that someone like Amanda Shelley, a physician assistant and single mom from Arizona, couldn't get health insurance. But on Jan. 1st, she got covered. On Jan. 3rd, she felt a sharp pain. On Jan. 6th, she had emergency surgery. Just one week earlier, Amanda said, that surgery would've meant bankruptcy.

That's what health insurance reform is all about--the peace of mind that if misfortune strikes, you don't have to lose everything. Already, because of the Affordable Care Act, more than 3 million Americans under age 26 have gained coverage under their parents' plans. More than 9 million Americans have signed up for private health insurance or Medicaid coverage.

And here's another number: zero. Because of this law, no American can ever again be dropped or denied coverage for a preexisting condition.

Source: 2014 State of the Union address , Jan 28, 2014

Boards of experts identify best practices & keep costs down

ROMNEY: ObamaCare puts in place an unelected board that's going to tell people ultimately what kind of treatments they can have. I don't like that idea.

OBAMA: When Governor Romney talks about this "unelected" board that we've created, is a group of health care experts, doctors etc., to figure out, how can we reduce the cost of care in the system overall? So what this board does is basically identifies best practices and says, let's use the purchasing power of Medicare and Medicaid to help to institutionalize all these good things that we do.

ROMNEY: In order to bring the cost of health care down, we don't need to have a board of 15 people telling us what kinds of treatments we should have. We instead need an incentive: performance pay, for doing an excellent job, for keeping costs down,

OBAMA: This board that we're talking about can't make decisions about what treatments are given. That's explicitly prohibited in the law.

Source: First Obama-Romney 2012 Presidential debate , Oct 3, 2012

ObamaCare says insurance companies can't jerk you around

Q: You want the Affordable Care Act repealed. Why?

ROMNEY: I sure do. It's expensive. It has killed jobs.

OBAMA: Well, four years ago, it wasn't just that small businesses were seeing costs skyrocket, but it was families who were worried about going bankrupt if they got sick. If they had a pre-existing condition, they might not be able to get coverage at all. If they did have coverage, insurance companies might impose an arbitrary limit. And let me tell you exactly what ObamaCare did. Number one, if you've got health insurance, it doesn't mean a government takeover. You keep your own insurance. You keep your own doctor. But it does say insurance companies can't jerk you around. They can't impose arbitrary lifetime limits. They have to let you keep your kid on your insurance plan until you're 26 years old. And it also says that you're going to have to get rebates if insurance companies are spending more on administrative costs and profits than they are on actual care.

Source: First Obama-Romney 2012 Presidential debate , Oct 3, 2012

Ignored advice to postpone reform, because it was needed

When it comes to the health of our families, Barack refused to listen to all those folks who told him to leave health reform for another day, another president. He didn't care whether it was the easy thing to do politically--that's not how he was raised--he cared that it was the right thing to do.

He did it because he believes that here in America, our grandparents should be able to afford their medicine; our kids should be able to see a doctor when they're sick; and no one in this country should ever go broke because of an accident or illness.

And he believes that women are more than capable of making our own choices about our bodies and our health care--that's what my husband stands for.

Source: Michelle Obama's 2012 Democratic National Convention speech , Sep 4, 2012

They called ObamaCare "Armageddon", but no asteroids fell

Far from the conciliatory campaigner of 2008, Obama was feisty in the days after he signed the health-care bill, even cocky. He bypassed the Senate by appointing fifteen new staffers while Republican congressmen were away on recess. He traveled to deliver celebratory health-care speeches and once gloated onstage: "Leaders of the Republican Party, they called the passage of this bill 'Armageddon. End of the freedom as we know it.' So, after I signed the bill, I looked around to see if there were any asteroids falling or some cracks opening up in the earth. It turned out it was a nice day. Birds were chirping. Folks were strolling down the Mall. People still have their doctors." But what people no longer had was the illusion of government accord.
Source: Ten Letters, by Eli Saslow, p.134 , Oct 11, 2011

Repealing healthcare reform would cost $250B

The bipartisan fiscal commission concluded that the only way to tackle our deficit is to cut excessive spending wherever we find it--in domestic spending, defense spending, health care spending, and spending through tax breaks and loopholes.

This means further reducing health care costs, including programs like Medicare and Medicaid, which are the single biggest contributor to our long-term deficit. The health insurance law we passed last year will slow these rising costs, which is part of the reason that nonpartisan economists have said that repealing the health care law would add a quarter of a trillion dollars to our deficit. Still, I'm willing to look at other ideas to bring down costs, including one that Republicans suggested last year--medical malpractice reform to rein in frivolous lawsuits.

Source: 2011 State of the Union speech , Jan 26, 2011

Medicare is major driver of our long-term liabilities

Pres. OBAMA: The major driver of our long-term liabilities, is Medicare and Medicaid and our health care spending. That's going to be what our children have to worry about. Now, [Rep. Paul Ryan's] approach--if I understand it correctly, would say we're going to provide vouchers of some sort for current Medicare recipients at the current level.

Rep. RYAN: No.

Pres. OBAMA: No?

Rep. RYAN: People 55 and above are grandfathered in.

Pres. OBAMA: But just for future beneficiaries, the basic idea would be that at some point we hold Medicare cost per recipient constant as a way of making sure that that doesn't go way out of whack, right?

Rep. RYAN: We drew it as a blend of inflation and health inflation. Medicare is a $38 trillion unfunded liability-- it has to be reformed for younger generations because it's going bankrupt. And the premise of our idea is, why not give people the same kind of health care plan we here have in Congress?

Source: Obama Q&A at 2010 House Republican retreat in Baltimore , Jan 29, 2010

Zero fines & no mandate for small business

McCAIN: Sen. Obama wants, if you’ve got [a small business with] employees, if you don’t adopt the health care plan that Sen. Obama mandates, he’s going to fine you. Now, Sen. Obama, I’d still like to know what that fine is going to be.

OBAMA: Here’s your fine--zero.

McCAIN: Zero?

OBAMA: Zero, because as I said in our last debate and I’ll repeat, I exempt small businesses from the requirement for large businesses that can afford to provide health care to their employees, but are not doing it. I exempt small businesses from having to pay into a kitty. But large businesses that can afford it, we’ve got a choice. Either they provide health insurance to their employees or somebody has to. Right now, what happens is those employees get dumped into either the Medicaid system, which taxpayers pick up, or they’re going to the emergency room for uncompensated care, which everybody picks up in their premiums.

Source: 2008 third presidential debate against John McCain , Oct 15, 2008

No exclusions for pre-existing conditions

Q: Do you believe health care should be treated as a commodity?

A: Here’s what I would do. If you’ve got health care already, and probably the majority of you do, then you can keep your plan if you are satisfied with it. You can keep your choice of doctor. We’re going to work with your employer to lower the cost of your premiums by up to $2,500 a year. And we’re going to do it by investing in prevention. We’re going to do it by making sure that we use information technology so that medical records are actually on computers instead of you filling forms out in triplicate when you go to the hospital. That will reduce medical errors and reduce costs. If you don’t have health insurance, you’re going to be able to buy the same kind of insurance that Sen. McCain and I enjoy as federal employees. Because there’s a huge pool, we can drop the costs. And nobody will be excluded for pre-existing conditions, which is a huge problem.

Source: 2008 second presidential debate against John McCain , Oct 7, 2008

Health care is a right: something’s fundamentally wrong now

Q: Is health care in America a privilege, a right, or a responsibility?

McCAIN: I think it’s a responsibility, in this respect, in that we should have available and affordable health care to every American citizen, to every family member. And with the plan that I have, that will do that. But government mandates I’m always a little nervous about. But it is certainly my responsibility. It is certainly small-business people and others, and they understand that responsibility. American citizens understand that.

OBAMA: Well, I think it should be a right for every American. In a country as wealthy as ours, for us to have people who are going bankrupt because they can’t pay their medical bills--for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they’re saying that this may be a pre-existing condition and they don’t have to pay her treatment, there’s something fundamentally wrong about that.

Source: 2008 second presidential debate against John McCain , Oct 7, 2008

Ban insurance companies from discriminating against the sick

Now is the time to finally keep the promise of affordable, accessible health care for every single American. If you have health care, my plan will lower your premiums. If you don’t, you’ll be able to get the same kind of coverage that members of Congress give themselves. And as someone who watched my mother argue with insurance companies while she lay in bed dying of cancer, I will make certain those companies stop discriminating against those who are sick and need care the most.
Source: Speech at 2008 Democratic National Convention , Aug 27, 2008

Include everyone who wants insurance in national pool

During the South Carolina debate, Obama described what has become the trademark of his proposal: an extension of the private health insurance system that would include everyone who wanted to purchase health insurance. "Number one, I think we should have a national pool that people can buy into if they don't have health insurance," he said, "similar to the ones that most of us who are in Congress enjoy right now." Obama made clear that his objections to lack of universal health care were based primarily on "fairness," just as were his objections to a low capital gains tax rate. "It doesn't matter to me that my bosses, the taxpayers, may not have health insurance that I enjoy," he continued. "And we can provide subsidies for those who can't afford the group rates that are available."
Source: Obama Nation, by Jerome Corsi, p.247 , Aug 1, 2008

I’ve got a health plan and a plan to get it implemented

I’ve got a plan for creating universal health care, shepherding that through Congress so that I can actually sign a bill, then executing and implementing that. You know, those are things that I worry about.
Source: ABC News: 2008 election interview with Charlie Gibson , Jun 4, 2008

Voluntary universal participation, like in Medicare Part B

OBAMA: Her mandate is not a mandate for the government to provide coverage to everybody; it is a mandate that every individual purchase health care.

CLINTON: [Obama’s plan] would be as though Franklin Roosevelt said let’s make Social Security voluntary --let’s let everybody get in it if they can afford it--or if Pres. Johnson said let’s make Medicare voluntary. Now, if you want to say that we shouldn’t try to get everyone into health insurance, that’s a big difference.

OBAMA: I believe that if we make it affordable, people will purchase it. In fact, Medicare Part B is not mandated, it is voluntary. And yet people over 65 choose to purchase it, Hillary, and the reason they choose to purchase it is because it’s a good deal. And if people end up seeing a plan that is affordable for them, I promise you they are snatching it up because they are desperate to get health care. And that’s what I intend to provide as president of the United States.

Source: 2008 Democratic Debate in Cleveland , Feb 26, 2008

Buy private insurance via National Health Insurance Exchange

National Health Insurance Exchange:
The Obama plan will create a National Health Insurance Exchange to help individuals who wish to purchase a private insurance plan. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participat-ing insurance plans to ensure fairness and to make individual coverage more affordable and accessible. Insurers would have to issue every applicant a policy, and charge fair and stable premiums that will not depend on how healthy you are. The Exchange will require that all the plans offered are at least as generous as the new public plan and have the same standards for quality and efficiency. The Exchange would evaluate plans and make the differences among the plans, including cost of services, public.
Source: Campaign booklet, “Blueprint for Change”, p. 6-9 , Feb 2, 2008

Against enforcement mechanism for mandating insurance

CLINTON: [Obama & I] do have differences on health care. I believe absolutely passionately that we must have universal health care. It is a moral responsibility [to] move us to universal health care.

OBAMA: About 95% of our plans are similar. We both set up a government plan that would [cover] pre-existing conditions. We both want to emphasize prevention. But I emphasize reducing costs. If we provide subsidies to those who can’t afford it, they will buy it. Sen. Clinton has a different approach. She believes that we have to force people who don’t have health insurance to buy it, or there will be a lot of people who don’t get it. But if you are going to mandate the purchase of insurance & it’s not affordable, then there’s going to have to be some enforcement mechanism that the government uses. And they may charge fines to people who already don’t have health care, or take it out of their paychecks. And that, I don’t think, is helping those without health insurance. That is a genuine difference.

Source: 2008 Democratic debate in Los Angeles before Super Tuesday , Jan 30, 2008

Subsidies to people who can’t afford care--not single payer

If, in fact, we are not making healthcare affordable enough, which is what’s happening right now, and you mandate on families to buy health insurance that they can’t afford and if they don’t buy it you fine them or in some other way take money for them. What is happening in Massachusetts right now, which is that folks are having to pay fines and they don’t have health care. They’d rather go ahead and take the fine because they can’t afford the coverage. My core belief is that people desperately want coverage, and my plan provides those same subsidies. If they are provided those subsidies and they have good, quality care that’s available, then they will purchase it. That is my belief. I never said that we should try to go ahead and get single payer. What I said was that if I were starting from scratch, if we didn’t have a system in which employers had typically provided health care, I would probably go with a single-payer system.
Source: 2008 Congressional Black Caucus Democratic debate , Jan 21, 2008

Problem isn’t mandating coverage, but affording it

I do provide universal health care. The only difference between Clinton’s plan and mine is that she thinks the problem for people without health care is that nobody has mandated, forced them to get health care. What I see are people who would love to have health care & can’t afford it. My plan that makes sure that it is affordable to get health care as good as the health care that I have as a member of Congress. That’s what the American people are looking for & what I intend to provide as president.
Source: 2007 Democratic debate in Las Vegas, Nevada , Nov 15, 2007

Cautious incremental plan offers choice & subsidy

[Obama’s record] leads to the conclusion that caution and synthesis would be his standard operating procedure.

You can see these tendencies in Obama’s healthcare plan, which bars insurers from refusing coverage to anyone, lets people choose between private plans and a public one, and offers subsidies to those who cannot afford the rates. This approach borrows heavily from John Edward’s much-praised scheme, but it falls short of his call for universal coverage. At any rate, The New Republic estimates that Obama’s plan would leave about fifteen million American uninsured.

It can be argued that an incremental attitude is the best way to pass liberal legislation these days. Obama has said as much. “For a political leader to get things done, he or she ideally should be ahead of the curve, but not too far ahead.”

Source: The Contenders, by Laura Flanders, p. 72 , Nov 11, 2007

Tackle insurance companies on reimbursement system

We need to deal with the insurance companies. On Medicare and Medicaid, the reimbursement system is not working the way it should. Instituting a universal health-care system that emphasizes prevention will free up dollars that potentially then can go to reimbursing doctors a little bit more.
Source: 2007 Democratic debate at Drexel University , Oct 30, 2007

Government healthcare like members of Congress have

Q: You favor universal coverage for everyone without exception?

A: That’s correct. Part of the reason that you’re confused about the candidates’ differences is because the differences probably matter less than the commonalties. All of the major Democratic candidates are advocating some form of universal health care. The question is, how do we get there? My proposal says:

Source: Huffington Post Mash-Up: 2007 Democratic on-line debate , Sep 13, 2007

Morally wrong that terminally ill must consider money

Q: Why is it so difficult to make health care accessible to everyone in the world’s richest country?

A: It shouldn’t be. And it’s wrong. You know, my mother died of ovarian cancer when she was 53 years old. And I remember in the last month of her life, she wasn’t thinking about how to get well, she wasn’t thinking about coming to terms with her own mortality, she was thinking about whether or not insurance was going to cover the medical bills and whether our family would be bankrupt as a consequence. That is morally wrong. It’s objectionable. That’s why I put forward a comprehensive legislation for universal health care so that all people could get coverage. My attitude is, that since you are paying my salary as taxpayers, you should have health care that is at least as good as mine. And the key to that is not only a good plan, but we’ve also got to overcome the drug & insurance company lobbies, that spent $1 billion over the last 10 years to block reform. As president, I am going to take them on.

Source: 2007 Democratic primary debate on Univision in Spanish , Sep 9, 2007

Increase competition in the insurance and drug markets

Source: 2008 Presidential campaign website, BarackObama.com “Flyers” , Aug 26, 2007

National Health Insurance Exchange for private coverage

Source: 2008 Presidential campaign website, BarackObama.com “Flyers” , Aug 26, 2007

Give people the choice to buy affordable health care

We’ve got these savings and we’re still going to have to do a little bit more, partly because you’ve got to invest up front in, for example, information technology so that rural hospitals that don’t have computers are able to buy them. And they’re going to need some help. But on this issue of mandatory versus non-mandatory, people are not going around trying to avoid buying health care coverage. If you look at auto insurance, in California there’s mandatory auto insurance. Twenty-five percent of the folks don’t have it. The reason is because they can’t afford it. I’m committed to starting the process. Everybody who wants it can buy it and it’s affordable. If we have some gaps remaining, we will work on that. You take it from the opposite direction, but you’re still going to have some folks who aren’t insured under your plan, John, because some of them will simply not be able to afford to buy the coverage they’re offered.
Source: 2007 Dem. debate at Saint Anselm College , Jun 3, 2007

Employers are going to have to pay or play

Employers are going to have to pay or play. I think that employers either have to provide health care coverage for their employees or they’ve got to make a decision that they’re going to help pay for those who don’t have coverage outside the employer system. So I think that’s one important principle, & the second important principle is that we’re going to have to put more money into prevention, chronic care management, & medical technology, because that is how we’re going to accrue the needed savings
Source: SEIU Democratic Health Care Forum in Las Vegas , Mar 24, 2007

The market alone can’t solve our health-care woes

President Clinton took a stab at creating a system of universal coverage, but was stymied. Since then, public debate has been deadlocked.

Given the money we spend on health care, we should be able to provide basic coverage to everyone. But we have to contain costs, including Medicare and Medicaid.

The market alone cannot solve the problem--in part because the market has proven incapable of creating large enough insurance pools to keep costs to individuals affordable. Overall, 20% of all patients account for 80% of the care, and if we can prevent disease or manage their effects, we can dramatically improve outcomes and save money.

With the money saved through increased preventive care and lower administrative and malpractice costs, we would provide a subsidy to low-income families and immediately mandate coverage for all uninsured children.

There is no easy fix, but the point is that if we commit to making sure everyone has decent care, there are ways to do it.

Source: The Audacity of Hope, by Barack Obama, p.183-185 , Oct 1, 2006

Health care tied to balancing costs and taxes nation wide

We know that as progressives we believe in affordable health care for all Americans, and that we’re going to make sure that Americans don’t have to choose between a health care plan that bankrupts the government and one that bankrupts families, the party that won’t just throw a few tax breaks at families who can’t afford their insurance, but will modernize our health care system and give every family a chance to buy insurance at a price they can afford.
Source: Annual 2006 Take Back America Conference , Jun 14, 2006

2008: must be national system; not state-level pilots

I asked Senator Obama whether, if he became president, he would grant Michigan permission to pilot a health care program that would provide access to millions of our citizens. I was struck by his forceful response: He had no intention of doing any more state-level health care pilots. He planned to roll out a national system similar to the one in Massachusetts, and he'd move on it during his 1st year in office.
Source: A Governor's Story, by Jennifer Granholm, p.161 , Oct 1, 2005

Will expand health coverage & allow meds to be re-imported

Obama has proposed a detailed health plan that covers every child in America, allows those near retirement to buy into Medicare, and ensures coverage for those losing jobs through no fault of their own. He will allow re-importation of drugs from other industrialized nations and fight for a Medicare prescription drug law that allows the federal government to negotiate drug prices.
Source: 2004 Senate campaign website, ObamaForIllinois.com , May 2, 2004

Barack Obama on Obamacare Criticism

OpEd: Passing ObamaCare with no GOP caused long-term rancor

Obama referred to the Republicans as enemies. Many of the party probably see themselves as his enemies, largely because of the Affordable Care Act, which was passed without a single Republican vote.

During the bill's passage, I spoke to one of the president's senior staffers and said that this unilateral act would create an unprecedented level of dissension and rancor that could preclude cordial working relationships for an extended time. The response I got was, "So what? That's nothing new."

This "my way or the highway" approach has resulted in disaster. Influenced by special interest groups, like some of the insurance companies that stood to benefit from the exchanges, and the Trial Lawyers Association, which supports anything that doesn't include tort reform, Democrats tried to create a bandwagon effect.

The Democrats now have an albatross around their necks with ObamaCare and will forever be blamed for destroying a reasonable healthcare system that was working for 85% of the populace.

Source: One Nation, by Dr. Ben Carson, p. 64 , May 20, 2014

FactCheck: Some Medicare premiums went up under ObamaCare

OBAMA: "Because of [ObamaCare], no American can ever again be dropped or denied coverage for a preexisting condition like asthma, back pain or cancer. No woman can ever be charged more just because she's a woman. And we did all this while adding years to Medicare's finances, and keeping Medicare premiums flat."

THE FACTS: Some Medicare premiums have gone up, not stayed flat.

As Obama said, insurers can no longer turn people down because of medical problems, and they can't charge higher premiums to women because of their sex. The law also lowered costs for seniors with high prescription drug bills. But Medicare's monthly premium for outpatient care has gone up in recent years.

Although the basic premium remained the same this year at $104.90, it increased by $5 a month in 2013, up from $99.90 in 2012. Obama's health care law also raised Medicare premiums for upper-income beneficiaries, and both the president and Republicans have proposed to expand that.

Source: AP/Fox News FactCheck on 2014 State of the Union , Jan 29, 2014

FactCheck: Yes, 9M signed up, but only 3M are newly insured

OBAMA: "More than 9 million Americans have signed up for private health insurance or Medicaid coverage."

THE FACTS: That's not to say 9 million more Americans have gained insurance under the law. The administration says about 6 million people have been determined to be eligible for Medicaid since Oct. 1 and an additional 3 million roughly have signed up for private health insurance through the new markets created by the health care law. That's where Obama's number of 9 million comes from. But it's unclear how many in the Medicaid group were already eligible for the program or renewing existing coverage.

Likewise, it's not known how many of those who signed up for private coverage were previously insured. One large survey suggests the uninsured rate for US adults dropped by 1.2 percentage points in January, to 16.1%. That would translate to roughly 2 million to 3 million newly insured people since the law's coverage expansion started Jan. 1.

Source: AP/Fox News FactCheck on 2014 State of the Union , Jan 29, 2014

Lie of the Year: 'If you like your plan, you can keep it'

It was a catchy political pitch and a chance to calm nerves about his dramatic and complicated plan to bring historic change to America's health insurance system: "If you like your health care plan, you can keep it," Pres. Barack Obama said--many times-- of his landmark new law. But the promise was impossible to keep.

So this fall, as cancellation letters were going out to approximately 4 million Americans, the public realized Obama's breezy assurances were wrong. Out of a total insured population of about 262 million, that was less than 2%, but there was no shortage of powerful anecdotes about canceled coverage. Obama and his team made matters worse by suggesting they had been misunderstood all along. The stunning political uproar led to this: a rare presidential apology.

For all of these reasons, PolitiFact has named "If you like your health care plan, you can keep it," the Lie of the Year for 2013. Readers in a separate online poll overwhelmingly agreed with the choice.

Source: Angie Holan, on PolitiFact.com summary of 2013 , Dec 12, 2013

ObamaCare and RomneyCare both expand private insurance

OBAMA: Governor Romney said "what we did in Massachusetts could be a model for the nation." We used the same advisers, and they say it's the same plan.

ROMNEY: The right answer is not to have the federal government take over health care and start mandating to the providers across America, telling a patient and a doctor what kind of treatment they can have. That's the wrong way to go.

OBAMA: There's a reason why Governor Romney set up the plan that he did in Massachusetts. It wasn't a government takeover of health care. It was the largest expansion of private insurance. But what it does say is that "insurers, you've got to take everybody."

ROMNEY: The federal government taking over health care for the entire nation and whisking aside the 10th Amendment, which gives states the rights for these kinds of things, is not the course for America to have a stronger, more vibrant economy.

Source: First Obama-Romney 2012 Presidential debate , Oct 3, 2012

OpEd: ObamaCare passed by constitutionally suspect tactics

Barack Obama was muscling his trillion-dollar health-care bill through Congress. The more Americans learned about the president's plan, the less they liked it. So the president did what he'd said he wouldn't do and went around the American people. Throughout the winter and early spring of 2010, he and his allies in Congress resorted to backroom deals, and constitutionally suspect tactics to force the bill through Congress. It was everything that was wrong with government on full display: the arrogance of the establishment, the bullying tactics of the feds, and the absolute disregard for the taxpayers who would be paying the bill.

People in South Carolina were outraged by what they were seeing in Washington. As far as I was concerned, the health-care law was a part of the same DC mentality that had given us the bailouts: Don't fix the problem, just throw it back on the taxpayers and have them pay for it.

Source: Can't Is Not an Option, by Gov. Nikki Haley, p.122 , Apr 3, 2012

2009: Accused of "Obamunism" and "Chains We Can Believe In"

Obama left Washington a few days after the passage of health-care reform. He hoped to explain the new legislation directly to constituents, highlighting how it would affect students, small-business owners, and people with preexisting conditions. Instead, political discourse had turned into an angry shouting match.

On one sidewalk, liberals wore Obama t-shirts while chanting "Yes we did!". On the other sidewalk, middle-aged conservatives and retirees from rural Iowa waved homemade signs.

"This bill is Communism!" one protester shouted. "Obamunism!" yelled another.

Millions of Americans believed their government had ignored their wishes by forging ahead with health-care reform despite a mounting wave of opposition. Polls showed that Obama's signature bill remained stunningly unpopular. 2/3 of Americans thought it would cost too much; 44% expected the quality of their health care to decline, while only 8% expected it to improve.

A homemade sign read "Chains We Can Believe In."

Source: Ten Letters, by Eli Saslow, p.106-107 , Oct 11, 2011

OpEd: True cost of ObamaCare was end of bipartisanship

About half of the letters in February and March of 2010 focused on health-care reform. Much of the mail was negative and some was nasty. One typical email was from a writer in Plano, Texas, who implored Obama to "stop and listen to all the American people!"

By the time the true cost of his health-care reform bill had already become clear, it had triggered the official, ugly end to his campaign vision of accord and bipartisanship. The same president who insisted during his speech on election night that the country "resist the temptation to fall back on the same partisanship and pettiness and immaturity that has poisoned our politics for so long," now found himself at the center of a political climate that he described with the same word. "It's poisonous," he said.

All his talk of bipartisanship had yielded few results, with not one Republican voting for his budget or his stimulus package, and only one Republican voting for his health-care bill.

Source: Ten Letters, by Eli Saslow, p.131-133 , Oct 11, 2011

OpEd: No authority to micromanage citizens' healthcare

If members of Congress recognized that they have no authority to micromanage the healthcare decisions of over 300 million US citizens, then the Patient Protection Affordable Care Act of 2010, aka "ObamaCare," would never have become law. And had Congress refused to pass ObamaCare, we could have avoided a new debt burden that will soon amount to trillions of dollars. This is just one of many examples demonstrating a simple principle: Congress spends more money when its members believe, however mistakenly, that they have authority to enact any piece of legislation that embodies what they see as a good idea.
Source: The Freedom Agenda, by Sen. Mike Lee, p. 62 , Jul 18, 2011

FactCheck: healthcare reform saves $2B to $10B, not $250B

Obama has frequently promised that the health care law will lower the growth of medical costs, saying last night: "The health insurance law we passed last year will slow these rising costs."

The truth is that this largely remains to be seen. Many of the cost-saving measures the president has touted are untested, such as changes in the way care is delivered, new payment models and pilot projects that some experts applaud, and others question.

The nonpartisan Congressional Budget Office expects that for most Americans, who get their insurance through work, health insurance premium costs won't change significantly from what they would have been without the law. CBO estimated that the major parts will cost $10 billion over the 2010-2019 period, while Medicare's Office of the Actuary determined savings of only $2 billion.

Overall, Medicare's chief actuary expects total spending on health care to rise over 10 years--but that's because about 34 million persons will gain health care coverage.

Source: FactCheck.org on 2011 State of the Union speech , Jan 26, 2011

OpEd: Obama's public responsibility for health is socialism

At its core, Obamacare represents the closest this country has ever come to outright socialism. Those on the Left note that they are unhappy this bill did not go even further--to what they innocuously call a single-payer system, in which government takes over the entire field of medicine. Instead of keeping the public option in the bill (thus stirring up the ire of millions of Americans), Democrats instead offered a public plan that competes with private insurance--only the government sets the rules of the competition. The result will be the bankrupting of private plans, and then a public option to rescue health care from the abyss and the supposedly greedy profiteers of private insurance. The liberals are not stupid enough about health care--they are insidious.

Obamacare mandates that the American people must go out and buy government-approved health insurance in the private market. I defy anyone to show me the clause in the Constitution that gives Washington the authority to do this.

Source: Fed Up!, by Gov. Rick Perry, p. 79 , Nov 15, 2010

OpEd: Slices $500B from Medicare; repeals Medicare Advantage

Source: Take Back America, by Dick Morris, p.277-278 , Apr 13, 2010

OpEd: Obamacare decides when life is worth preserving

Instead of making a universal commitment to do what it takes to extend human life as long as possible, the Obama health-care system sees geriatrics only through the prism of cost control. Time and again, it is forcing doctors and hospitals to answer the question: Is it worth it? Is this particular patients' life of sufficient quality and likely to last sufficiently long to justify the expenditure needed to prolong it?

Human beings have no standing to ask this question. Only God does. But Obamacare preempts divine authority, and arrogates to men and women the responsibility for deciding when life is worth preserving and when it is not.

To a certain extent, all doctors and all families have always faced this excruciating decision. Now, Obama is demanding that it be decided by a calculation of Quality Adjusted Life Years (QALYs), in which physicians, with bureaucrats peering over their shoulders and cost accounting peering over theirs, must equate life with money and come up with an answer.

Source: Take Back America, by Dick Morris, p. 69 , Apr 13, 2010

OpEd: authority to require private insurance purchases?

At the core of the Obama health-care program is the "individual mandate" that requires everyone to have health insurance. Clearly, the government would have the authority to tax each person and use the money to provide insurance. But can it make everyone buy a privately provided product from a third party?

Nowhere in the Constitution is Congress given the power to mandate that an individual enter into a contract with a private party or purchase a good or service. The authors of the Obama Bill say that requiring people to buy health insurance is covered by the Constitution's interstate commerce clause, which allows Congress to regulate a "class of activity."

But where is the interstate commerce? Congress has refused specifically and repeatedly t allow health insurance companies to compete across state lines. Republicans have been seeking this authority for years as a way to use private competition to hold down costs, but the Democrats have always refused.

Source: Take Back America, by Dick Morris, p.112-113 , Apr 13, 2010

OpEd: ObamaCare was achieved by Cuba 50 years ago

We harbor no antagonism toward Obama, much less toward the US people. We believe that health reform has been an important battle and a success for his government. It would seem, however, to be something truly unusual, 234 years after the Declaration of Independence that the US government has passed [a law for] medical attention for the vast majority of its citizens, something that Cuba achieved for its entire population half a century ago.

I cannot stop thinking about a world in which more than 1/3 of the population lacks the medical attention and medicines essential to ensuring its health.

Source: Obama and the Empire, by Fidel Castro, p.121 , Mar 24, 2010

OpEd: cut $622B in Medicare despite claiming no cuts

President Obama has governed in a manner far different than he advertised in his campaign. He has governed from the left rather than the center, pressing for massive federal takeover of health care after running campaign ads calling "government-run health care...extreme."

Obama said ObamaCare would not add to the deficit, would bend the cost curve down, and would reduce premiums, while the evidence shows just the opposite. Obama said that under his plan people could keep the insurance they had. Independent groups have shown this claim is simply false. At one point, President Obama was even so brash as to claim his plan would not cut Medicare benefits--even though the White House's own fact sheet said at the time that two-thirds of health-care reform would be paid for by $622 billion in Medicare and Medicaid cuts. The deceptions have badly injured his credibility.

Source: Courage and Consequence, by Karl Rove, p.513 , Mar 9, 2010

High-risk pool for uninsured, now in plan, was GOP idea

I know how bitter and contentious the issue of health insurance reform has become. And I will eagerly look at the ideas and better solutions on the health care front. From the start, I sought out and supported ideas from Republicans. I even talked about an issue that has been a holy grail for a lot of you, which was tort reform, and said that I'd be willing to work together as part of a comprehensive package to deal with it. I just didn't get a lot of nibbles.

Creating a high-risk pool for uninsured folks with preexisting conditions, that wasn't my idea, it was Senator McCain's. And I supported it, and it got incorporated into our approach. Allowing insurance companies to sell coverage across state lines to add choice and competition--that's a [GOP] idea that was incorporated into our package. And I support it, provided that we do it hand in hand with broader reforms. So when you say I ought to be willing to accept Republican ideas on health care, let's be clear: I have.

Source: Obama Q&A at 2010 House Republican retreat in Baltimore , Jan 29, 2010

Cross-state-line insurance leads to cherry-picking

Rep. BLACKBURN: We have over 50 bills--if those good ideas aren't making it to you, maybe it's the House Democrat leadership that is an impediment.

Pres. OBAMA: Actually, I've gotten many of your ideas. Some of the ideas we have embraced in our package Some of them are embraced with caveats. So let me give you an example. One of the proposals that has been focused on by the Republicans as a way to reduce costs is allowing insurance companies to sell across state lines. We actually include that as part of our approach. But the caveat is, we've got to do so with some minimum standards, because otherwise what happens is that you could have insurance companies circumvent a whole bunch of state regulations--mammograms as part of preventive care, for example. Part of what could happen is insurance companies could go into states and cherry-pick and just get those who are healthiest and leave behind those who are least healthy, which would raise everybody's premiums who weren't healthy.

Source: Obama Q&A at 2010 House Republican retreat in Baltimore , Jan 29, 2010

Tort reform only saves $5B per year; not enough to matter

Rep. PRICE: Our bill, HR3400, has more co-sponsors than any health care bill in the House--it is a bill that would provide health coverage for all Americans; would correct the significant insurance challenges of affordability and preexisting; would solve the lawsuit abuse issue, which isn't addressed significantly in the other proposals that went through the House; and does all of that without raising taxes by a penny.

Pres. OBAMA: I am willing to work with you tort reform, but the CBO says, at best, this could reduce health care costs relative to where they're growing by a couple of percent, or save $5 billion a year, and it will not bend the cost curve long term or reduce premiums significantly. If we're going to do multi-state insurance so that people can go across state lines, I've got to be able to go to an independent health care expert, who can tell me that this won't result in cherry-picking and the least healthy being worse off. I've read your legislation, and the good ideas we take.

Source: Obama Q&A at 2010 House Republican retreat in Baltimore , Jan 29, 2010

Didn't tackle healthcare for political benefit, it's needed

We still need health insurance reform. I didn't choose to tackle this issue to get some legislative victory under my belt. And by now it should be fairly obvious that I didn't take on health care because it was good politics. I took on health care becaus of the stories I've heard from Americans with preexisting conditions whose lives depend on getting coverage; patients who've been denied coverage; families--even those with insurance--who are just one illness away from financial ruin.

After nearly a century of trying--Democratic administrations, Republican administrations--we are closer than ever to bringing more security to the lives of so many Americans. The approach we've taken would protect every American from the worst practices of the insurance industry. It would give small businesses and uninsured Americans a chance to choose an affordable health care plan in a competitive market. It would require every insurance plan to cover preventive care.

Source: 2010 State of the Union Address , Jan 27, 2010

FactCheck: Obama's estimate of $1T saved is closer to $132B

Obama touted an optimistic--and highly uncertain--estimate on how the Senate health care bill could affect the deficit. Obama said, "our approach would bring down the deficit by as much as $1 trillion over the next two decades."

It's true that the CBO's admittedly rough estimate said the bill could reduce the deficit below its projected level by "as much as" about $1 trillion over 20 years--but it also said the reduction could be half of that amount. And it noted the estimate is subject to a great deal of uncertainty.

CBO normally gives estimates for 10-year periods, and the nonpartisan entity doesn't like to go beyond that. It said the Senate bill could produce a net deficit reduction of $132 billion over 2010-2019. For the next decade, CBO said the reduction would be "in a broad range between 1/4% and 1/2% of GDP." Senate Democrats estimated that would mean a reduction of $650 billion to $1.3 trillion. But CBO emphasized how squishy that large range is [while Obama did not].

Source: FactCheck.org on 2010 State of the Union speech , Jan 27, 2010

FactCheck: Exempts small business, but no $2,500/yr savings

Obama said his health care plan would lower insurance premiums by up to $2,500 a year. Experts we’ve consulted see little evidence such savings would materialize.

McCain misstated Obama’s health care plan, claiming it would levy fines on “small businesses” that fail to provide health insurance. Actually, Obama’s plan exempts “small businesses.”

Source: FactCheck.org on 2008 second presidential debate , Oct 7, 2008

$15B subsidies to private insurers was a lobbyist giveaway

We right now give $15 billion every year as subsidies to private insurers under the Medicare system. It doesn’t work any better through this private insurers; they just skim off $15 billion. That was a giveaway, and part of the reason is because lobbyists are able to shape how Medicare works. They did it on the prescription drug bill. They’ve done it with respect to Medicare.
Source: 2008 first presidential debate, Obama vs. McCain , Sep 26, 2008

End-of-life self-medication ok; euthanasia by others not ok

Q: In “The Audacity of Hope,” you write very movingly about your mother’s fight with cancer, and the pain she was in, especially at the end. In that situation, if someone wanted to take active steps to end his or her own life, do you think that would be OK morally?

A: I believe in everybody having a living will so that their views on these issues can be factored in by family members. I don’t think that it’s appropriate to empower doctors themselves to make that decision. But I think that it is important for us to be able to allow people who are terminally ill, in excruciating pain, to get the medicine they need to relieve that pain.

Q: By “relieve that pain” you mean hasten the end of life if they choose to?

A: I think that there has to be very strict guidelines to ensure that somebody who is making a decision to relieve their pain [is acting appropriately]. That is distinguished from euthanasia in which someone else is making the decision for them.

Source: 2008 Democratic Compassion Forum at Messiah College , Apr 13, 2008

AdWatch: punishing uninsured families doesn’t make sense

Hillary’s health care plan forces everyone to buy insurance, even if you can’t afford it. Is that the best we can do for families struggling with high health care costs?

Hillary’s health care plan forces everyone to buy insurance, even if you can’t afford it... and you pay a penalty if you don’t.

Punishing families who can’t afford health care to begin with just doesn’t make sense. Bill Clinton’s own Secretary of Labor, Robert Reich, wrote, “I’ve compared the two plans in detail... But in my view Obama’s would insure more people, not fewer, than HRC’s.“

Source: FactCheck's AdWatch of 2008 healthcare mailer , Feb 4, 2008

FactCheck: Yes, Obama favored single-payer, despite denial

Clinton charged that Obama’s position has shifted on health care, from favoring a single-payer, universal system when he was a Senate candidate to the plan he favors now, which has no requirement. Obama denied that he had ever said he would work to get a single-payer plan, saying, “I never said that we should try to get single-payer. I said that if I were starting from scratch, I would probably go with a single-payer system.”

But Obama’s denial doesn’t hold up. In a speech in June 2003, Obama said: “I happen to be a proponent of a single-payer health care program. I see no reason why the US cannot provide basic health insurance to everybody. A single-payer health care plan, a universal health care plan. And that’s what I’d like to see.“

After his election, Obama tempered his position, saying in May 2007, ”If you’re starting from scratch, then a single-payer system would probably make sense. But managing the transition would be difficult. So we may need a system that’s not so disruptive.

Source: FactCheck.org on 2008 Congressional Black Caucus Dem. Debate , Jan 21, 2008

FactCheck: OPPORTUNITY to insure all, but no GUARANTEE

Obama’s ad touting his health care plan quotes phrases from newspaper articles and an editorial, but makes them sound more laudatory and authoritative than they actually are.
Source: FactCheck's AdWatch of 2008 campaign ad, “Interest” , Jan 3, 2008

FactCheck: Reducing obesity would save $18B, not $1T

Obama used an estimate of uncertain provenance when discussing Medicare savings, saying “If we went back to the obesity rates that existed in 1980, that would save the Medicare system a trillion dollars.”

Obama got this claim from a “candidate briefin book” put out by the Center for American Progress, a liberal think tank run by former Clinton chief of staff John Podesta. CAP cites the CDC & the Commonwealth Fund as sources for the estimate, but representatives from both organizations told us that the claim was unfamiliar to them.

We worked up our own back-of-the-envelope estimate: The CDC officially estimates that obesity cost $75 billion in 2003; & that approximately half of the cost burden for both overweight and obese people is borne by Medicaid and Medicare; & obesity rates doubled between 1980 and 2000. So if obesity rates returned to “rates that existed in 1980” they would be cut in half, and Medicare & Medicaid would save about a quarter of $75 billion, or roughly $18.75 billion per year.

Source: FactCheck on 2007 Des Moines Register Democratic debate , Dec 13, 2007

FactCheck: Correct that insurance lobbying cost $1B

Obama used a figure that sounded dubious to us, but it turned out to be correct. Obama said, “We’ve also got to overcome the drug company lobbies, the insurance company lobbies, that spent $1 billion over the last 10 years to block reform.”

According to the Center for Responsive Politics, the pharmaceutical and insurance industries spent $1.2 billion and $949 million, respectively, on all lobbying efforts since 1998. Moreover, the two industries combined shelled out about $193 million in political donations and expenditures backing Republicans, about twice as much as they spent supporting Democrats. So it is reasonable to conclude that the pharmaceutical and insurance industries have indeed spent at least $1 billion combating legislation that Obama favors.

Source: FactCheck on 2007 Democratic primary debate on Univision , Sep 9, 2007

Reform failed in ‘90s because of drug company lobbying

[All of the candidates] are going to have a plan [for universal coverage]. I’ve got a plan. But we’ve had plan before, under a Democratic president in the ‘90s and a Democratic Congress. We couldn’t get it done because the drug and insurance companies are spending $1 billion over the last decade on lobbying. And that’s why we’ve got to have a president who is willing to fight to make sure that they don’t have veto power.
Source: 2007 YouTube Democratic Primary debate, Charleston SC , Jul 23, 2007

Barack Obama on Universal Coverage

Shifting Medicaid to states means some people don't get help

OBAMA: When you talk about shifting Medicaid to states, we're talking about potentially a 30% cut in Medicaid over time. Now, you know, that may not seem like a big deal when it just is numbers on a sheet of paper, but if we're talking about a family who's got an autistic kid and is depending on that Medicaid, that's a big problem.

ROMNEY: I would like to take the Medicaid dollars that go to states: you're going to get what you got last year, plus inflation, plus 1%, and then you're going to manage your care for your poor in the way you think best. Don't have the federal government tell everybody what kind of training programs they have to have and what kind of Medicaid they have to have. Let states do this.

OBAMA: Governors are creative. But they're not creative enough to make up for 30% of revenue on something like Medicaid. What ends up happening is some people end up not getting help.

ROMNEY: If a state gets in trouble, well, we can step in and see if we can find a way to help them.

Source: First Obama-Romney 2012 Presidential debate , Oct 3, 2012

Add 2,000 new primary-care residency spots

While Obama's health-care legislation contains several superficial incentives for medical school graduates to enter family practice or internal medicine, the harsh fact is that his program threatens to further rob us of all kinds of doctors, including family and internal medicine practitioners.

The president's program would add 2,000 new residency spots for primary-care doctors and general surgeons. The proposal originally called for 15,000, but it was trimmed to hold down costs. 2,000 extra doctors is a pitiful response to the problems of providing care for 30 million new patients!

The legislation increases funding for the National Health Service Corps, which helps repay up to $50,000 in student loans for doctors, nurse practitioners, and dentist who work in under-served parts of the country. These incentives to encourage people to go into medicine fly in the face of the fact that Obama is financing his program by slashing reimbursement rates for doctors. The results will be lower-quality care.

Source: Take Back America, by Dick Morris, p. 75-76 , Apr 13, 2010

2009: Expanded SCHIP by loosening eligibility standards

Republicans created SCHIP in 1997 to cover health insurance for low-income children whose families were not poor enough to qualify for Medicare.

In August 2007, Congress passed a bill to extend the program by loosening eligibility standards, providing incentives for states to enroll more customers, and making it easier for states to enroll higher-income families. Funded by raising cigarette taxes, the measure was vetoed by President Bush, who argued the expansion violated the program's original purpose. Democrats passed it a second time, and Bush vetoed it again. Eventually Democrats settled on passing a temporary reauthorization of the program until March 2009, when there would be a new president. And sure enough, Congress passed a bill expanding SCHIP in January 2009, and President Obama signed it as soon as he took office.

Source: Obamanomics, by Timothy P. Carney, p. 75 , Nov 30, 2009

Reduce premiums and uninsured get same coverage as Congress

OBAMA: If you’ve got insurance through your employer, you can keep your insurance. We estimate we can cut the average family’s premium by about $2,500 per year. If you don’t have health insurance, then we’re going to provide you the option of buying into the same kind of federal pool that both Sen. McCain and I enjoy as federal employees. We’re going to make sure insurance companies can’t discriminate on the basis of pre-existing conditions. We’ll negotiate with the drug companies for the cheapest available prices. We are going to invest in information technology to eliminate bureaucracy and make the system more efficient. We’ve got to put more money into preventive care.

McCAIN: I want to give every family a $5,000 refundable tax credit. Take it and get anywhere in America the health care that you wish. [For employers], if you want to do the right thing with your employees and provide them health insurance, we’ll give you a 50% credit so that you will actually be able to afford it.

Source: 2008 third presidential debate against John McCain , Oct 15, 2008

When your child gets sick, you don't shop for best bargain

Obama had identified an area of injustice in our economic system: the unjust power of monopolies, collusion among supposed competitors, and the ensuing damage both to consumers and entrepreneurs. Obama has spoken directly about his concerns that the healthcare insurance industry may be too concentrated, with the top two competitors controlling one-third of the entire market nationally. Obama adds, "The market alone can't solve our healthcare woes--in part because the market has proven incapable of creating large enough insurance pools to keep costs to individuals affordable, in part because healthcare is not like other products or services (when your child gets sick, you don't go shopping for the best bargain)."
Source: Obamanomics, by John R. Talbott, p. 44-45 , Jul 1, 2008

If we started from scratch, one-payer system would be best

Obama has said that if we were starting over with a completely blank slate he would favor the one-payer system that is used in almost every developed country in the world. But we aren't starting from scratch. Obama's plan is to create a health insurance system that will cover all Americans, including the self-employed and small businesses. From his healthcare position paper entitled, "Plan for a Healthy America":Obama, a realist, believes that you must start with the system's current situation and try to make incremental progress.
Source: Obamanomics, by John R. Talbott, p.147-148&154 , Jul 1, 2008

Universal health care means anyone who wants it can get it

CLINTON: I think it’s imperative that we stand as Democrats for universal health care. I’ve staked out a claim for that. Sen. Edwards did. Others have. But Sen. Obama has not.

OBAMA: Well, look, I believe in universal health care, as does Sen. Clinton. And the point of the debate, is that Sen. Clinton repeatedly claims that I don’t stand for universal health care. And, you know, for Sen. Clinton to say that, I think, is simply not accurate. Every expert has said that anybody who wants health care under my plan will be able to obtain it. President Clinton’s own secretary of Labor has said that my plan does more to reduce costs and as a consequence makes sure that the people who need health care right now, all across America, will be able to obtain it. And we do more to reduce costs than any other plan that’s been out there.

CLINTON: [Leaving out a mandate is the same as saying] that we shouldn’t try to get everyone into health insurance.

Source: 2008 Democratic Debate in Cleveland , Feb 26, 2008

Mandating kids’ insurance ok; mandating adults has problems

CLINTON: Sen. Obama has a mandate in his plan. It’s a mandate on parents to provide health insurance for their children. That’s about 150 million people.

OBAMA: I have no objection to Sen. Clinton thinking that her approach is superior. But we still don’t know how Sen. Clinton intends to enforce a mandate.

CLINTON: Sen. Obama would enforce the mandate by requiring parents to buy insurance for their children.

OBAMA: This is true.

CLINTON: If you have a mandate, it has to be enforceable. So there’s no difference here.

OBAMA: No, there is a difference. I do provide a mandate for children, because we have created programs in which we can have greater assurance that those children will be covered at an affordable price. But we don’t want to put adults in a situation in which, on the front end, we are mandating them, we are forcing them to purchase insurance, and if the subsidies are inadequate, the burden is on them, and they will be penalized. And that is what Sen. Clinton’s plan does.

Source: 2008 Democratic Debate in Cleveland , Feb 26, 2008

Young adults up to age 25 can be covered under parents’ plan

CLINTON: About 20% of the people who are uninsured have the means to buy insurance. They’re often young people who think they’re immortal.

OBAMA: Which is why I cover them.

CLINTON: Except when the illness or the accident strikes. And what Sen. Obama has said, that then, once you get to the hospital, you’ll be forced to buy insurance, I don’t think that’s a good idea. We ought to plan for it, and we ought to make sure we cover everyone. That is the only way to get to universal health care coverage. But if we don’t even have a plan to get there, and we start out by leaving people, you’ll never ever control costs, improve quality, and cover everyone.

OBAMA: With respect to the young people, my plan specifically says that up until the age of 25 you will be able to be covered under your parents’ insurance plan, so that cohort that Sen. Clinton is talking about will, in fact, have coverage.

Source: [X-ref Clinton] 2008 Democratic Debate in Cleveland , Feb 26, 2008

Adults will get health care as they can afford it

When Clinton says a mandate, it’s not a mandate on government to provide health insurance, it’s a mandate on individuals to purchase it. Massachusetts has a mandate right now. They have exempted 20% of the uninsured because they have concluded that that 20% can’t afford it. There are people who are paying fines and still can’t afford it, so now they’re worse off than they were. They don’t have health insurance and they’re paying a fine. To force people to get health insurance, you’ve got to have a very harsh penalty, and Clinton has said that we won’t go after their wages. The reason a mandate for children can be effective is we’ve got an ability to make affordable health care available to that child, right now. There are no excuses. If a parent is not providing health care for that child, it’s because the parent’s not being responsible, under my plan. Those children don’t have a choice. But adults are going to be able to see that they can afford it and will get it under my plan.
Source: 2008 Democratic debate at University of Texas in Austin , Feb 21, 2008

No one turned away due to illness or pre-existing condition

Source: Campaign booklet, “Blueprint for Change”, p. 6-9 , Feb 2, 2008

AdWatch: Pressure insurance & drug companies to change

Obama TV ad in Iowa:
Announcer: While Iowans struggle with health costs, outside groups are spending millions to stop change, including false attacks on Barack Obama’s health plan. But experts say Obama’s plan is “the best.” It “guarantees coverage for all Americans.” Putting “pressure on insurance and drug companies,” his plan cuts costs more than any other--saving $2,500 for the typical family. The same old Washington politics won’t fix health care. But we can.
Source: FactCheck's AdWatch of 2008 campaign ad, “Interest” , Jan 3, 2008

Being poor in this country is hazardous to your health

Q: Both Latinos and Blacks receive significantly worse medical care than whites in the US, when they get care. What can the president do to address this, and can we afford it?

A: The president can do everything to address this and can afford it if we are able to bring people together to get it done. And this is something that I am committed to doing as president. But it is indisputable that if you are poor in this country that is hazardous to your health, if you are black or brown, too, and poor, it can be downright deadly. Right now, even when blacks or Latinos have the same health insurance as whites, they are not receiving the same quality of care. And that means that we’ve got to have more black and brown doctors and nurses; we’ve got to have studies in terms of making sure that we are eliminating these disparities; we’ve got to make sure that we are doing outreach in these communities ahead of time to prevent disease.

Source: 2007 Iowa Brown & Black Presidential Forum , Dec 1, 2007

Added 20,000 children to Illinois healthcare

Obama also has a record of success on health care in Illinois. He sponsored the legislation expanding Kid Care and Family Care that added 20,000 children to the state health insurance program. Obama was a cosponsor of the Senior Citizen Prescription Drug Discount Program Act, which enabled senior citizens and the disabled to obtain prescription drugs at discount rates. Obama also cosponsored smaller reforms such as SB989, which allowed Medicaid money to care for mentally or emotionally disturbed children as outpatients rather than the far more expensive option of institutionalizing them, and SB1417, which required all insurance companies operating in Illinois to pay for screenings of colorectal cancer.
Source: The Improbable Quest, by John K. Wilson, p.148 , Oct 30, 2007

National insurance pool & catastrophic insurance

Let me tell you what [my health care plan] would do. Number one, we should have a national pool that people can buy into if they don’t have health insurance, similar to the ones that most of us who are in Congress enjoy right now. It doesn’t make sense to me that my bosses, the taxpayers, may not have health insurance that I enjoy. And we can provide subsidies for those who can’t afford the group rates that are available. The second thing is to make sure that we control costs. We spend $2 trillion on health care in this country every year, 50% more than other industrialized nations. And yet, we don’t have, necessarily, better outcomes. If we make sure that we provide preventive care and medical technology that can eliminate bureaucracy and paperwork, that makes a big difference. The third thing is catastrophic insurance to help businesses and families avoid the bankruptcies that we’re experiencing all across the country and reduced premiums for families.
Source: 2007 South Carolina Democratic primary debate, on MSNBC , Apr 26, 2007

Healthcare system is broken without lifetime employment

Our health-care system is broken: expensive, inefficient, and poorly adapted to an economy no longer built on lifetime employment, a system that exposes Americans to insecurity and possible destitution. But year after year, ideology and political gamesmanship result in inaction, except for 2003, when we got a prescription drug bill that managed to combine the worst aspects of the public and private sectors--price gouging and confusion, gaps in coverage and an eye-popping bill for taxpayers.
Source: The Audacity of Hope, by Barack Obama, p. 22-23 , Oct 1, 2006

Focus on the affordability of a broad healthcare plan

Our medical care costs twice as much per capita as any other advanced nation. Given that half of the people are getting, already, employer-based health care, that it would be impractical for us to do so, which is why my plan says anybody can get health care that is the same as the health care that I have as a member of Congress. The problem is, they can’t afford it. As a consequence, we focus on reducing costs. This is a legitimate argument for us to have, but it’s not true that I leave them out
Source: 2008 Facebook/WMUR-NH Democratic primary debate , Jan 6, 2006

Crises happen in our lives and healthcare is necessary

The use of generics is important, as the chairman of the Health and Human Services Committee I’ve continually encouraged the use of generic drugs at the state level. Part of the problem and the reason we’re not using generic drugs as much as we should is because we have a convoluted set of patent laws that allow drug companies to change the shape or color of the tablet, and as a consequence, renew their patents and block generic drugs from coming onto the market. It does make sense for us to encourage preventative care and improve our health and lifestyles. A father in Galesburg that I met who had just lost his job, just got his pink slip, and whose son had just had a liver transplant, and he’s trying to figure out how does he pay $4,200 a month in immunosuppressant drugs in order to keep his son alive. A liver transplant is not solvable by better health. Crises happen in our lives. To the extent possible, we should control costs when we can and expand affordability and accessibility of healthcare.
Source: IL Senate Debate, Illinois Radio Network , Oct 12, 2004

Barack Obama on Voting Record

No need to mandate coverage; just let people afford it

Q: [to Obama]: Sen. Edwards says your plan doesn’t really provide universal coverage. Does it?

OBAMA: Absolutely it does. John and I have a disagreement. John thinks that the only way we get universal coverage is to mandate coverage. I think that the problem is not that people are trying to avoid getting health care coverage. It is folks like that who are desperately in desire of it, but they can can’t afford it.

Q: [to Edwards]: Does Sen. Obama provide universal coverage

EDWARDS: No, because the only way to provide universal coverage is to mandate that everyone be covered. Sen. Obama’s made a very serious proposal, and I’m not casting aspersions on his plan. It just doesn’t cover everybody. The only way to cover everybody is to mandate it. We have talked about it too long. We have got to stand up to the insurance companies and the drug companies. It is the only way we’re ever going to bring about real change. We should be outraged by these stories.

Source: 2007 YouTube Democratic Primary debate, Charleston SC , Jul 23, 2007

Voted NO on means-testing to determine Medicare Part D premium.

CONGRESSIONAL SUMMARY: To require wealthy Medicare beneficiaries to pay a greater share of their Medicare Part D premiums.

SUPPORTER'S ARGUMENT FOR VOTING YES: Sen. ENSIGN: This amendment is to means test Medicare Part D the same way we means test Medicare Part B. An individual senior making over $82,000 a year, or a senior couple making over $164,000, would be expected to pay a little over $10 a month extra. That is all we are doing. This amendment saves a couple billion dollars over the next 5 years. It is very reasonable. There is nothing else in this budget that does anything on entitlement reform, and we all know entitlements are heading for a train wreck in this country. We ought to at least do this little bit for our children for deficit reduction.

OPPONENT'S ARGUMENT FOR VOTING NO: Sen. BAUCUS: The problem with this amendment is exactly what the sponsor said: It is exactly like Part B. Medicare Part B is a premium that is paid with respect to doctors' examinations and Medicare reimbursement. Part D is the drug benefit. Part D premiums vary significantly nationwide according to geography and according to the plans offered. It is nothing like Part B.

Second, any change in Part D is required to be in any Medicare bill if it comes up. We may want to make other Medicare changes. We don't want to be restricted to means testing.

Third, this should be considered broad health care reform, at least Medicare reform, and not be isolated in this case. LEGISLATIVE OUTCOME:Amendment rejected, 42-56

Reference: Bill S.Amdt.4240 to S.Con.Res.70 ; vote number 08-S063 on Mar 13, 2008

Voted YES on requiring negotiated Rx prices for Medicare part D.

Would require negotiating with pharmaceutical manufacturers the prices that may be charged to prescription drug plan sponsors for covered Medicare part D drugs.

Proponents support voting YES because:

This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.

It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.

Opponents support voting NO because:

Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.

Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.
Status: Cloture rejected Cloture vote rejected, 55-42 (3/5ths required)

Reference: Medicare Prescription Drug Price Negotiation Act; Bill S.3 & H.R.4 ; vote number 2007-132 on Apr 18, 2007

Voted YES on expanding enrollment period for Medicare Part D.

To provide for necessary beneficiary protections in order to ensure access to coverage under the Medicare part D prescription drug program. Voting YES would extend the 6-month enrollment period for the Prescription Drug Benefit Program to the entire year of 2006 and allows beneficiaries to change plans once in that year, without penalty, after enrollment. Also would fully reimburse pharmacies, states and individuals for cost in 2006 for covered Medicare Part D drugs.
Reference: Medicare Part D Amendment; Bill S Amdt 2730 to HR 4297 ; vote number 2006-005 on Feb 2, 2006

Voted YES on increasing Medicaid rebate for producing generics.

Vote on an amendment that removes an increase in the Medicaid deduction rebate for generic drugs from 11% to 17%. The effect of the amendment, according to its sponsor, is as follows: "This bill eliminates the ability of generic drugs to be sold using Medicaid. Over half the prescription drugs used in Medicaid are generic. Because we have raised the fees so dramatically on what a generic drug company must pay a pharmacy to handle the drug, pharmacies are not going to use the generic. In the long run, that will cost the Medicaid Program billions of dollars. My amendment corrects that situation." A Senator opposing the amendment said: "This bill has in it already very significant incentives for generic utilization through the way we reimburse generics. Brand drugs account for 67% of Medicaid prescriptions, but they also account for 81% of the Medicaid rebates. This is reasonable policy for us, then, to create parity between brand and generic rebates. This amendment would upset that parity."
Reference: Amendment for Medicaid rebates for generic drugs; Bill S Amdt 2348 to S 1932 ; vote number 2005-299 on Nov 3, 2005

Voted YES on negotiating bulk purchases for Medicare prescription drug.

Vote to adopt an amendment that would allow federal government negotiations with prescription drug manufactures for the best possible prescription drug prices. Amendment details: To ensure that any savings associated with legislation that provides the Secretary of Health and Human Services with the authority to participate in the negotiation of contracts with manufacturers of covered part D drugs to achieve the best possible prices for such drugs under Medicare Part D of the Social Security Act, that requires the Secretary to negotiate contracts with manufacturers of such drugs for each fallback prescription drug plan, and that requires the Secretary to participate in the negotiation for a contract for any such drug upon the request of a prescription drug plan or an MA-PD plan, is reserved for reducing expenditures under such part.
Reference: Prescription Drug Amendment; Bill S.Amdt. 214 to S.Con.Res. 18 ; vote number 2005-60 on Mar 17, 2005

Increase funding for AIDS treatment & prevention.

Obama adopted the CBC principles:

HIV/AIDS Initiatives
The CBC’s Minority HIV/AIDS Initiative will focus on those areas hardest hit by the epidemic, many of which are in districts that we represent. The initiative will focus on prevention and treatment and we will also seek to re-direct and/or increase funding levels based on a detailed review of the implementation of the initiative. In addition, the CBC recognizes the devastating impact of HIV/AIDS on the global workforce, specifically in Africa, and on the allocation of resources of developing countries. Therefore, the CBC will continue its efforts to support a comprehensive global policy aimed at ending the scourge of HIV/AIDS around the globe.

Source: Congressional Black Caucus press release 01-CBC5 on Jan 6, 2001

More funding for Rx benefits, community health, CHIPs.

Obama adopted the CBC principles:

Source: Congressional Black Caucus press release 01-CBC6 on Jan 6, 2001

Improve services for people with autism & their families.

Obama co-sponsored improving services for people with autism & their families

Amends the Public Health Service Act to require the Secretary of Health and Human Services to:

  1. convene, on behalf of the Interagency Autism Coordinating Committee, a Treatments, Interventions, and Services Evaluation Task Force to evaluate evidence-based biomedical and behavioral treatments and services for individuals with autism;
  2. establish a multi-year demonstration grant program for states to provide evidence-based autism treatments, interventions, and services.
  3. establish planning and demonstration grant programs for adults with autism;
  4. award grants to states for access to autism services following diagnosis;
  5. award grants to University Centers of Excellence for Developmental Disabilities to provide services and address the unmet needs of individuals with autism and their families;
  6. make grants to protection and advocacy systems to address the needs of individuals with autism and other emerging populations of individuals with disabilities; and
  7. award a grant to a national nonprofit organization for the establishment and maintenance of a national technical assistance center for autism services and information dissemination.
  8. Directs the Comptroller General to issue a report on the financing of autism services and treatments.
Source: Promise for Individuals With Autism Act (S.937 & HR.1881) 07-HR1881 on Apr 17, 2007

Establish a national childhood cancer database.

Obama co-sponsored establishing a national childhood cancer database

Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.

    Authorizes the Secretary to award grants to childhood cancer professional and direct service organizations for the expansion and widespread implementation of:
  1. activities that provide information on treatment protocols to ensure early access to the best available therapies and clinical trials for pediatric cancers;
  2. activities that provide available information on the late effects of pediatric cancer treatment to ensure access to necessary long-term medical and psychological care; and
  3. direct resource services such as educational outreach for parents, information on school reentry and postsecondary education, and resource directories or referral services for financial assistance, psychological counseling, and other support services.
Legislative Outcome: House version H.R.1553; became Public Law 110-285 on 7/29/2008.
Source: Conquer Childhood Cancer Act (S911/HR1553) 07-S911 on Mar 19, 2007

Preserve access to Medicaid & SCHIP during economic downturn.

Obama co-sponsored preserving access to Medicaid & SCHIP in economic downturn

A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn.

Source: Economic Recovery in Health Care Act (S.2819) 2008-S2819 on Apr 7, 2008

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