Barack Obama on The Affordable Care Act (2013)

“When we passed the Affordable Care Act, there were a number of components to it. A big part of it was essentially providing a Patients’ Bill of Rights that Americans and advocates have been fighting for for decades. What we wanted to do was make sure that if you already had health insurance, that you’d get a fair deal, that you were being treated well by your insurers. So we eliminated – prohibited – insurance companies from imposing lifetime limits, which oftentimes if a family member really got sick, they thought they were covered until suddenly they hit that limit, at which point they were out hundreds of thousands of dollars with no way of paying.

We said to insurance companies, ‘You’ve got to use at least 80% of your premiums that you’re receiving on actual healthcare – not on administrative costs and CEO bonuses. And if you don’t, you’ve got to rebate anything you spent back to the consumer.’ So there are millions of Americans who have received rebates. They may not know that they got it because of the Affordable Care Act or ‘Obamacare’, but they were pretty happy to get those rebates back because it made sure that the insurance companies were
treating folks fairly.

We said that any young person who doesn’t have health insurance can stay on their parents’ health insurance until they’re 26 years old. As a consequence what we’ve seen is the rate of uninsured for young people steadily dropping over the last three years since the bill’s been passed, obviously providing a lot of relief to a lot of parents out there because a lot of young people, as they’ve been entering into the job market at a time when jobs are tough to get and oftentimes benefits are slim, this is providing an enormous security until they get more firmly established in the labor market.

We’ve provided additional discounts for prescription drugs for seniors under the Medical Care Program. And so seniors have saved billions of dollars when it comes to their prescription drugs. So there have been – over the last three years – a whole array of consumer protections and savings for consumers that result directly from the law that we passed. And for those who say that they want to repeal [The Affordable Care Act], typically when you ask them about all these various benefits they say, ‘Well, that one’s good, and that one’s pretty good, and we’d keep that,’ and you pretty much go down the list and there’s not too much people object to. 

You will recall – at the time – that part of the way we paid for the Healthcare Bill was that we said, ‘Medicare’s wasting a lot of money without making seniors healthier.’ And there was a lot of hue and cry about how we were taking money out of Medicare. Well, it turns out we were right, that we could change how doctors and hospitals and providers were operating, rewarding them for outcomes as opposed to just how many procedures they did. You started seeing practices change among millions of providers across the country, Medicare rates have actually slowed in terms of inflation, seniors have saved money, folks are healthier. And some of those savings we’ve been able to use to make sure the people who don’t have health insurance can get health insurance.

Now, this brings me to October 1st.

The one part of the Affordable Care Act that required several years to set up was, ‘How do we provide health insurance for individuals who don’t get health insurance through the job?’ It’s a historical accident that in this country healthcare is attached to employers. And part of the problem is if you’re out there shopping for health insurance on your own – you’re not part of a major pool – there’s no aggregation to risk for the insurers. So they’re basically going to say, ‘Let’s see. You’re 50 years old, you’ve got high blood pressure, and we’ll just look at the actuary tables and we figure you’re going to get sick, so we’re going to charge you $1,500 a month for health insurance,’ which the average person has no way of affording. There’s no pooling of risk. So what we said is, ‘We need to set up a mechanism to pool people who currently don’t have health insurance, so they have the same purchasing power, the same leverage that a big company does when they’re negotiating with the insurance company.’ And essentially what we’ve done is we’ve created what we’re calling marketplaces in every state across the country where consumers are now able to be part of a big pool. Insurers have to bid – essentially compete – for the business of that pool. And what we now have set up are these marketplaces that provide high-quality healthcare at affordable prices, giving people choices so they can get the health insurance that they need and they want, and the premiums are significantly lower than what they were able to previously get.”