President Barack Obama today attacked the Republican 2013 budget as a “Trojan horse” and “thinly veiled social Darwinism.” Speaking in Washington to an association of newspaper editors, Obama not only attacked Republican budget proposals, but in response to a question, he also laid out a defense of the 2010 health law and why he thinks the Supreme Court will uphold the law as constitutional.
These video excerpts, and the transcript below, include Obama’s critique of Republican plans for Medicare and Medicaid, plus his remarks on the health law and its constitutionality.
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PRESIDENT OBAMA: We’re told that Medicaid would simply be handed over to the states. That’s the pitch. You know, let’s get it out of the central bureaucracy. The states can experiment. They’ll be able to run the programs a lot better.
But here’s deal the states would be getting: They would have to be running these programs in the face of the largest cut to Medicaid that has ever been proposed, a cut that, according to one nonpartisan group, would take away health care for about 19 million Americans — 19 million.
Who are these Americans? Many are someone’s grandparents who, without Medicaid, won’t be able to afford nursing home care without Medicaid. Many are poor children. Some are middle-class families who have children with autism or Down syndrome. Some are kids with disabilities so severe that they require 24-hour care. These are people who count on Medicaid.
And then there’s Medicare. Because health care costs keep rising and the baby boom generation is retiring, Medicare, we all know, is one of the biggest drivers of our long-term deficit. That’s a challenge we have to meet by bringing down the costs of health care overall, so that seniors and taxpayers can share in the savings.
But here’s the solution proposed by the Republicans in Washington and embraced by most of their candidates for president. Instead of being enrolled in Medicare when they turn 65, seniors who retire a decade from now would get a voucher that equals the cost of the second-cheapest health care plan in their area. If Medicare is more expensive than that private plan, they’ll have to pay more if they want to enroll in traditional Medicare. If health care costs rise faster than the amount of the voucher, as, by the way, they’ve been doing for decades, that’s too bad. Seniors bear the risk. If the voucher isn’t enough to buy a private plan with the specific doctors and care that you need, that’s too bad.
So most experts will tell you the way this voucher plan encourages savings is not through better care or cheaper cost. The way these private insurance companies save money is by designing and marketing plans to attract the youngest and healthiest seniors, cherry-picking, leaving the older and sicker seniors in traditional Medicare, where they have access to a wide range of doctors and guaranteed care. But that, of course, makes the traditional Medicare program even more expensive and raise premiums even further. The net result is that our country will end up spending more on health care, and the only reason the government will save any money — it won’t be on our books — is because we’ve shifted it to seniors. They’ll bear more of the costs themselves.
It’s a bad idea. And it will ultimately end Medicare as we know it.
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QUESTION: Mr. President, you said yesterday that it would unprecedented for a Supreme Court to overturn laws passed by an elected Congress. Yet that is exactly what the court’s done during its entire existence. If the court were to overturn individual mandate, what would you do or propose to do for the 30 million people who wouldn’t have health care after that ruling?
PRESIDENT OBAMA: Well, first of all, let me be very specific. We have not seen a court overturn a law that was passed by Congress on a economic issue, like health care, that I think most people would clearly consider commerce — a law like that has not been overturned at least since Lochner, right? So we’re going to back to the ’30s, pre-New Deal.
And the point I was making is that the Supreme Court is the final say on our Constitution and our laws, and all of us have to respect it, but it’s precisely because of that extraordinary power that the court has traditionally exercised significant restraint and deference to our duly elected legislature, our Congress. And so the burden is on those who would overturn a law like this.
Now as I said, I expect the Supreme Court actually to recognize that and to abide by well-established precedents out there.
I have enormous confidence that in looking at this law, not only is it constitutional, but that the court is going to exercise its jurisprudence carefully because of the profound power that our Supreme Court has. As a consequence, we’re not spending a whole lot of time planning for contingencies.
What I did emphasize yesterday is there is a human element to this that everybody has to remember. It’s not an — this is not an abstract exercise.
I get letters every day from people who are affected by the health care law right now even though it’s not fully implemented, young people who are 24, 25, who say: You know what? I just got diagnosed with a tumor. First of all, I would have not gone to get a checkup if I hadn’t had health insurance. Second of all, I wouldn’t have been able to afford to get it treated had I not been on my parents’ plan. Thank you and thank Congress for getting this done.
I get letters from folks who have just lost their job, their COBRA is running out, they’re in the middle of treatment for colon cancer or breast cancer and they’re worried, when their COBRA runs out if they’re still sick, what are they going to do, because they’re not going to be able to get health insurance.
And the point I think that was made very ably before the Supreme Court, but I think most health care economists who have looked at this have acknowledged, is there are basically two ways to cover people with pre-existing conditions or assure that people can always get coverage even when they have bad illnesses.
One way is a single-payer plan. Everybody is a under a single system, like Medicare. The other way is to set up a system in which you don’t have people who are healthy but don’t bother to get health insurance, and then we all have to pay for them in the emergency room. That doesn’t work, and so as a consequence, we’ve got to make sure that those folks are taking their responsibility seriously, which is what the individual mandate does.
So I don’t anticipate the court striking this down. I think they take their responsibilities very seriously.
But I think what’s more important is for all of us, Democrats and Republicans, to recognize that in a country like ours, the wealthiest, most powerful country on earth, we shouldn’t have a system in which millions of people are at risk of bankruptcy because they get sick or end up waiting until they do get sick and then go to the emergency room, which involves all of us paying for it.