Barack Obama on Health Care

Last Updated : Oct 24, 2012

Summary

Single Payer and Health Care as a Right

In 2003, while a State Senator from Illinois, Barack Obama stated that he supported a single-payer government run health care system. He also asserted that the US would not be accepting of such positions given that an employer based system was already in place and that a change from the current system to a government system would take decades. In the 2008 debates, Senator Clinton used these statements against him. In responding to these attacks, Senator Obama asserted that what he really meant was that while he preferred a single-payer system, it was not feasible given the system which was already present. He stated that what he meant was that if he was starting from scratch, then he would imlement a single-payer system.

During the 2008 debates, Senator Obama also asserted that health care is not a service or commodity to be purchased, but rather a right that all people are entitled to. He also stated that we have a moral obligation to provide health care and that there was something fundamentally wrong with a country that allowed people to go bankrupt due to health issues.

Since assuming office, President Obama has appointed Donald Berwick to be the head of Medicare and Medicaid, a position otherwise known as the health care czar. Mr Berwick has shown a great deal of support for single-payer systems and the redistribution of wealth through health care.

Mandates and Taxes

While campaigning for office, Senator Obama was an strong opponent of individual mandates which  would require each person to purchase health insurance as a matter of law. He once mocked the idea of a mandate, by stating that if a mandate was a solution then we could simply mandate that everyone purchase a house and solve homelessness. He also noted in debates that mandates sometimes cause people who could not afford insurance to pay a fine in addition to not having insurance.

The 2009 health care reform legislation contained a mandate for individuals to purchase insurance with a penalty for those who do not comply. President Obama has asserted that such a fee is not a tax. When questioned on this statement and read the definition of a tax in comparison to the mandate fee, President Obama reiterated that the fine was not a tax even though the definitions matched.

The Public Option

President Obama has always been a strong supporter of a public option as a means to provide health insurance and decrease costs by providing competition for insurance companies.  He was often critical of any reform bill that did not contain such a program and pledged not to sign any reform legislation that did not include a public option.

2008 Campaign Plan

During the 2008 Presidential Campaign, Senator Obama outlined a plan that consisted of methods to lower health care costs and extend coverage to everyone. The plan consisted of preventing companies from using pre-existing conditions to turn away customers, coverage for all "essential services", and subsidies to those who could not afford insurance. 

  • Coverage options for all Americansrn
    • Nobody turned away for pre-existing conditions
    • Everyone able to buy plan similar to all federal employees
    • Covers all essential medical services
    • subsidy provided to those who can't afford
    • Portable coverage
    • No longer lines
    • Private plan options available
  • Lower Costsrn
    • Help to small business
    • Tax credits to cover up to 50% of employee insurance
    • Take on big drug companies blocking reform
    • Cut costs for small businesses and workers by:rn
      • Picking up part of tab on most expensive illnesses
      • Allow insurance purchase in low risk pool
    • Lower family health care costs byrn
      • investing in prevention
      • Investing in paperless system to cut admin costs

 

Cadillac Health Care Plans

In speeches and debates during the election, Senator Obama openly mocked Senator McCain's proposal to tax "cadillac" health care plans. He stated that Senator McCain could not make a pledge not to raise taxes since he was proposing this tax. President Obama has supported such a tax while in office and stated that cadillac plans just take more money from people without making them more healthy.

Negotiations on CSPAN

One of the more notable promises made by Senator and President Obama was that all negotiations would take place on CSPAN. He stated that health care companies would still have a seat at the table, but would not be able to buy all the seats. He made these promises before and after the election but most of these discussions were never disclosed.

The Affordable Care Act

After assuming office, President Obama asserted that he was asking Congress to pass a reform plan that consisted of three components: bringing down the rising cost of health care, allowing Americans to keep their doctor and health care plan if they chose to do so, and all Americans must have quality, affordable health care.

Throughout the health care reform process, President Obama was adamant that the end product would reduce the overall cost of health care, and be budget neutral for the first ten years of the program. Part of his campaign literature states that the reform will be paid for through ending the Bush tax cuts for those making over $250,000 and retaining the estate tax at 2009 levels. As the legislation passed, President Obama stated that it would reduce the federal deficit by $1.3 trillion over the next two decades, making it the greatest deficit reduction tool since the balanced budgets of the 1990's.

There were a number of issues that arose surrounding the Affordable Care Act that were controversial. First, President Obama continues to insist that the plan does not amount to government funding for abortion. However, the legislation provides government subsidies to those incapable of paying for insurance and those insurance plans are allowed to cover abortion. The Affordable Care Act does allow states to pass legislation barring private insurance plans that cover elective abortion from their state exchanges. So far, 15 states have passed such laws.

Second, the issue of what portions of the law would apply to illegal aliens was controversial in that nothing in the plan prevents illegal aliens from continuing to receive free health care in emergency rooms across the US. There also appears to be no mechanism to prevent illegal aliens from purchasing a plan from the government exchanges. This led to Congressman WIlson's famous declartion of "you lie" on the House floor.

Third, President Obama has repeatedly asserted that there are no "death panels" created within the legislation and that such an idea is insulting. What the legislation did create were Individual Payment Advisory Boards (IPABS) that advise on ways to save costs through care to seniors. 

Finally, the assertion that the reform will reduce costs has been challenged by a number of people. When repeatedly asked what mechanism within the legislation actually lowers costs, there has been no substantive answer. The fact that the plan raises the number of people receiving health care adds to concerns that the real cost savings measures are those that will be implemented by the IPABs in the form of reduced care for the elderly.

 

AFL-CIO Event - Universal Health Care

Early in his career, State Senator Obama and US Senator Obama supported a universal health care plan for the US.  At a 2003 AFL-CIO speech, (State Senator) Obama firmly asserted that he supported a single payer system.

 

CNN Debate

This video of Senator Obama supporting a single payer system was used by the Clinton campaign to accuse Senator Obama of being misleading when he made later attempts to claim that he was not supportive of such a plan.  When asked about the situation in a CNN primary debate, Senator Obama stated the following:

 

The Today Show

Senator Obama was pressed again on the matter of single payer just days after the CNN debate on the Today show.  When he was played the audio from 2003, he claimed not be able to hear it and that the statement may have been taken out of context. He stated that his opinion has always been that if we did not already have a legacy of employer based health care then he would start with a single payer system.

 

Albuquerque Campaign Event

Several other times after the debate, Senator Obama was asked again about why he changed his position and he re-iterated that a single-payer system was preferable when there was no other system in place, but there was a need to act quickly and build on the system in place.

 

Health Care is a Right

As part of the general election debates, Senators Obama and McCain were asked if health care was a right or a privilege. Senator Obama responded that health care is a right and that no one should go broke because they had to pay their health care bills. He noted his mother's battle with her insurance provider and stated that there was something fundamentally wrong about people going bankrupt because of health care.

 

Primary Debate - Mandates

At one of the earlier primary debates with Senator Clinton, Senator Obama noted his oppositon to mandates and how this contrasted with Senator Clinton. He noted that this oppositon was based upon the possibility that people would not be able to afford health insurance and would then have to pay a fine, leaving them in a worse financial position and still with no insurance.

 

CNN Debate - Mandates

In a CNN debate, Senator Obama again drew this distinction between himself and Senator Clinton. He noted that Senator Clinton had a mandate on people to purchase insurance. He noted that this was dangerous in that there were people who could not afford insurance and were then penalized - leading to them being in a worse situation.

 

CNN Debate - Health Care Plan

In the same CNN Presidential debate, Senator Obama described his plan. He reiterated that anyone who likes their health care can keep it. He also claimed that health care was a moral and economic imperative. He was critical of Senator McCain's plan to tax health care as a commodity.

 

CNN Interview - Mandates

In a later interview on CNN, Senator Obama stated that mandates were not the solution and if they were, we could simply mandate that all the homeless purchase a house.

 

Stephanopoulis Interview

President Obama mirrored this language once in office.  After if became clear that a mandate to purchase insurance would be part of the health care reform bill, questions were raised about whether or not this violated not only President Obama's opposition to a mandate, but also his promise not to raise taxes.  Was a mandate to purchase health insurance under threat of punishment equivalent to a tax increase?  This lead to the following conversation in an interview with George Stephanopoulos.

 

The Public Option

A public option is little more than an insurance company that is run by the federal government.  The idea is that such a system operates just at the break even point and forces private insurance companies to lower their costs to compete. Throughout the campaign, and even after the election in 2008, President Obama was an ardent supporter of the public option.  Several times in the campaign, and even after the election, President Obama stated that any health care reform must include a public option.  When the health care reform plan that was signed into law did not have a public option, proponents of the system on the left were very critical of President Obama.  The commercial below was made in an attempt to get the President to reconsider the public option and show his pledge after becoming president to include the system.

 

Campaign Website Plan

The plan that President Obama put forth during the 2008 campaign and after the election, included subsidies for those who could not afford the insurance, a law making it illegal for an insurance company to refuse someone due to a pre-existing condition, and the ability to take the coverage from job to job.  These items are covered in the President's "blueprint" for health care and in statements made on his campaign website. 

Blueprint for Healthcare

During the 2008 presidential election, Senator Obama made a series of videos called blueprints for a variety of subject.  The blueprint for healthcare is shown here.

  • Coverage options for all Americansrn
    • Nobody turned away for pre-existing conditions
    • Everyone able to buy plan similar to all federal employees
    • Covers all essential medical services
    • subsidy provided to those who can't afford
    • Portable coverage
    • No longer lines
    • Private plan options available
  • Lower Costsrn
    • Help to small business
    • Tax credits to cover up to 50% of employee insurance
    • Take on big drug companies blocking reform
    • Cut costs for small businesses and workers by:rn
      • Picking up part of tab on most expensive illnesses
      • Allow insurance purchase in low risk pool
    • Lower family health care costs byrn
      • investing in prevention
      • Investing in paperless system to cut admin costs

 

 

2008 Campaign Website Statements

 

Three Principles for Health Care Reform

In the 2008 election cycle, after the election, and during the 2009 to 2010 reform debate, President Obama responded repeatedly to fears that any health care reform would force those who like their coverage to switch to another plan by stating that if you like you health care, then nothing will change. He stated that "if you like your health care coverage, keep it." This was seen in the CNN debate with Senator McCain when Senator Obama asserted that premiums would be lowered by $2,500 a year and people would be able to buy into a plan similar to the one that Senator McCain and him have. After assuming office, President Obama held to the same three principles discussed in the debate. 

  • the rising cost of health care must be brought down
  • Americans must have the freedom to keep their doctor and health care plan if they chose to do so
  • all Americans must have quality, affordable health care

 

Costs of Health Care Reform

In June of 2009, President Obama used his weekly address to discuss the costs of health care reform. He stated that any reform must be budget neutral over the next ten years. He noted that in addition to other measures, there would be an addition $313 Billion dollar cut to Medicare and Medicaid programs.

 

Myths and Morality

On August 21, 2009 President Obama used his weekly address to address the myths and morality of health care reform. In this address, President Obama stated that the reform packaged in Congress did not constitute a government takeover of health care, that there were no "death panels", and that anyone who liked their health care would be able to keep it. He also stated that coverage for abortions would not be provided, and that illegal aliens would not be covered under the plan. He also reiterated the core promises of his campaign that prices would be lowered and coverage extended to all.

 

Cadillac Health Care Plans

The term "cadillac" is used to describe health care plans that cover a large number of procedures at a high reimbursement rate. In other words, plans that may cost a lot but provide a great deal of coverage. During the 2008 Presidential campaign, Senator Obama was critical of Senator McCain's plans to tax those plans to help pay for the costs of health care for others. In Newport News, Virginia on October 4, 2008, Senator Obama said the following at a campaign rally.

These statements reenforced some made on September 12, 2008 in Dover, New Hampshire. In these statements, Senator Obama noted a pledge he had made not to increase taxes on anyone making less than $250,000. He stated that Senator McCain could not make this pledge as he would tax cadillac plans.

These pledges directly contradict statements made by President Obama since taking office, and the contents of the 2009-2010 health care reform legislation that contains these provisions. On December 23, 2009 President Obama was interviewed by NPR and stated that he was "on record" as supporting the taxing of cadillac health care plans.

    

Reform Reduces the Deficit

In March of 2010, as the final vote on the reconciliation bill was approaching, President Obama announced that an analysis from the CBO would reduce the deficit by $1.3 trillion over the next two decades. He stated that it was the most significant effort to reduce deficits since the balanced budget amendment of the 1990s.

 

On the Passage of Health Care Reform

In March of 2010, after the passage of the health care reform legislation in Congress, President Obama gave an address noting the historic moment and his support for the legislation.

 

Voting Record

Amendment - Drug Reimportation

In July of 2006, a an amendment was voted on to prohibit the United States Customs and Border Protection from preventing an individual not in the business of importing a prescription drug from importing an FDA-approved prescription drug. Barack Obama voted in favor of the amendment to prevent border patrol agents from taking prescription drugs from citizens crossing the border.

Barack Obama voted in favor of the amendment to prevent border patrol agents from taking prescription drugs from citizens crossing the border.

 

Sponsored and Cosponsored Legislation

Session-110; Bill Number-S 242; Pharmaceutical Market Access and Drug Safety Act of 2007 - Cosponsor

A bill to amend the Federal Food, Drug, and Cosmetic Act with respect to the importation of prescription drugs, and for other purposes.

Session-110; Bill Number-S 316; Preserve Access to Affordable Generics Act - Cosponsor

A bill to prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market.

Session-109; Bill Number-S 1580; Healthcare Equality and Accountability Act - Cosponsor

A bill to improve the health of minority individuals.

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