Hello, Minneapolis! It is so good to be back in the great state of Minnesota. I hear the Gophers have their home opener in their brand new stadium a little later today. I’d wish them luck, but they’re playing Air Force, and I have to fly home on one of their planes in a few hours.
I don’t know if any of you caught it on television, but the other night I gave a speech to Congress about health care. I can already see that this crowd’s a lot more fun.
But I didn’t just go to Congress to speak to Senators and Representatives. I went to speak on behalf of the American people. You see, I ran for this office because I believed it was time for a government that once again made possible the dreams of middle-class Americans — a government that understands the quiet struggles you wrestle with at the kitchen table or when you’re lying awake at the end of a long day.
Health care is one of those struggles.
If you are one of the tens of millions of Americans who have no health insurance, you live every day just one accident or illness away from bankruptcy. And these are not primarily people on welfare. These are middle-class Americans. Maybe your employer doesn’t offer coverage. Maybe you’re self-employed and can’t afford it. Or maybe you’re one of the millions of Americans who have been denied coverage due to a previous illness or condition that insurance companies decide is too risky or expensive to cover.
In the last twelve months alone, six million more Americans lost their health insurance. And today, we received more disturbing news. A new report from the Treasury Department found that nearly half of all Americans under 65 will lose their health coverage at some point over the next ten years. More than one-third will go without coverage for longer than one year. In other words, it can happen to anyone. There but for the grace of God go I.
But I don’t need to tell you that our health care problems don’t stop with the uninsured. How many of you who have health insurance have ever worried that you might lose it if you lose your job, or change jobs, or move? How many stories have you heard about folks whose insurance company decided to drop their coverage or water it down when they got sick and needed it most? How many of you know someone who paid their premiums every month only to find out that their insurance company wouldn’t cover the full cost of their care?
We’ve all heard these stories. There’s the father I met in Colorado whose child was diagnosed with severe hemophilia the day after he was born. They had insurance, but there was a cap on their coverage. So once the child’s medical bills piled up, he was left to frantically search for another option, or face tens of thousands of dollars in medical bills. Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne. By the time she had her insurance reinstated, her breast cancer more than doubled in size. These stories are heart-breaking, they are wrong, and no one should be treated that way in the United States of America.
It has now been nearly a century since Teddy Roosevelt first called for health care reform. It has been attempted by nearly every President and Congress ever since. And our failure to get it done — year after year, decade after decade — has placed a burden on families, on businesses, and on taxpayers that we can no longer sustain.
If we do nothing, your premiums will continue to rise faster than your wages. If we do nothing, more businesses will close down and fewer will open in the first place. If we do nothing, we will eventually spend more on Medicare and Medicaid than every other government program combined. That is not an option for the United States of America. So Minnesota, I may not be the first President to take up the cause of health care reform, but I am determined to be the last.
The good news is, we are now closer to reform than we have ever been. After debating this issue for the better part of the year, there is now agreement in Congress on about eighty percent of what needs to be done. That has never happened before. And our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors’ groups and even drug companies — many of whom opposed reform in the past.
Of course, what we’ve also seen in these last few months is the same partisan spectacle that has left so many of you disappointed in Washington for so long. Too many have engaged in scare tactics instead of honest debate. Too many have used this as an opportunity to score short-term political points instead of working together to solve a long-term challenge.
Well the time for bickering is over. The time for games has passed. Now is the season for action. Now is the time to deliver on health care.
So here’s what you need to know about the plan I announced on Wednesday night. It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. And it will slow the growth of health care costs for our families, our businesses, and our government.
First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.
What this plan will do is to make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. When I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies — because there’s no reason we shouldn’t be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.
Now, if you’re one of the tens of millions of Americans who don’t currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange — a marketplace where individuals and small businesses will be able to shop for an affordable health insurance plan that works for them. As one big group, these uninsured Americans will have the leverage to get a much better deal than they do now. This is how large companies and government employees get affordable insurance. It’s how everyone in this Congress gets affordable insurance. And it’s time to give every American the same opportunity that we’ve given ourselves.
Now, if you still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits so that you can. And in the few years it takes us to set up the exchange, we will immediately offer Americans with pre-existing conditions low-cost coverage that will protect you from financial ruin if you become seriously ill.
I have also said that one of the options in the insurance exchange should be a public insurance option. Let me be clear — it would only be an option. No one would be forced to choose it, and no one with insurance would be affected by it. What it would do is provide more choice and more competition. It would keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting private colleges and universities.
I have said that I’m open to different ideas on how to set this up. But I will not back down on the basic principle that if Americans can’t find affordable coverage, we will provide you with a choice. And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the coverage that you need.
Now, a lot of you might think this plan sounds pretty good, but you’re wondering, “How do we pay for it?” So here’s what you need to know:
First, I will not sign a plan that adds one dime to our deficits — either now or in the future. Period. Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for — from the Iraq War to tax breaks for the wealthy. I will not make that same mistake with health care.
Second, we’ve estimated that most of this plan can be paid for by finding savings within the existing health care system — a system that is full of waste and abuse. Right now, too much of the hard-earned savings and tax dollars we spend on health care doesn’t make us healthier. That’s not my judgment — it’s the judgment of medical professionals across this country. This is also true when it comes to Medicare and Medicaid. And since Medicare is another issue that’s been subjected to distortion during this debate, I’d like to speak directly to the senior citizens out there.
More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years. That is how Medicare was born. And it remains a sacred trust that must be passed down from one generation to the next. That is why not a dollar of the Medicare trust fund will be used to pay for this plan. Not one dollar.
The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies — subsidies that do everything to pad their profits and nothing to improve your care. And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.
We will ensure that you — America’s seniors — get the benefits you’ve been promised. We will ensure that Medicare is there for future generations. And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pocket for prescription drugs. That’s what this plan will do for you. So don’t pay attention to those scary stories about how your benefits will be cut. That will never happen on my watch. I will protect Medicare.
And because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody. We have long known that some places, like the Intermountain Healthcare in Utah or the Mayo Clinic right here Minnesota, offer high-quality care at costs below average. The commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system — everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.
This is the plan I’m proposing. It’s a plan that incorporates ideas from Democrats and Republicans. And I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open.
But know this: I will not waste time with those who have made the calculation that it’s better politics to kill this plan than improve it. I will not stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what’s in the plan, we will call you out. And I will not accept the status quo as a solution. Not this time. Not now.
We are closer to reform than we have ever been. But this is the hard part. This is when the special interests and the insurance companies and the folks who want to kill reform fight back with everything they’ve got. This is when they spread all kinds of rumors to scare and intimidate the American people. This is what they always do.
That’s why I need your help. I never said that change would be easy. Change is hard. It always has been. And ever since I was a community organizer on the South Side of Chicago, I have always believed that change doesn’t start in Washington, DC. It begins in places like Minneapolis. It begins in places like St. Paul. It begins with people who have the courage to share their stories and then fight for something better. It begins with you.
That’s how change happens. And that’s what has to happen right now. If you want a health care system where insurance companies can’t drop your coverage or deny you care, I need you to knock on a few doors and talk to your neighbors. If you want to make sure that you can keep your health care if you lose your job or change your job, I need you to make a few phone calls. If you believe, as our friend Ted Kennedy always said, that health care is not a privilege, but a fundamental right for every American, then I need you to make your voice heard in Washington.
Tell them that this is not about politics. This is about people’s lives. This is about America’s future, and whether we will be able to look back years from now and say that this was the moment when we met our responsibilities to our children. This was the moment when we met history’s test. And this was the moment when the United States of America renewed our capacity to do great things. Thank you, God Bless You, and may God Bless America.