Program: “Tu Salud y La Nueva Ley: Conversación con el Presidente” (Your Health and the New Law: A Conversation with the President)
Content: Interview with Barack Obama, President of the United States
Air Date: Thursday, March 6, 2014
POTUS: Barack Obama, President of the United States
EA: Enrique Acevedo
JDB: Jose Diaz-Balart
JDB: Mr. President, it is a pleasure to have you.
POTUS: Muchas gracias.
EA: Your Spanish is perfect. Thank you, sir. Mr. President, we are just three weeks away from a key date, March 31. That is what the deadline for registration on the program. However, millions of people are eligible for insurance under the new law but have not yet signed up. Why is this happening? And would you call this a crisis?
POTUS: Well, first of all, I want to thank Telemundo and Univision for coming together to help inform the community. And the whole purpose here is to have the information so they can make their own decisions. The Affordable Care Act, also known as ObamaCare these days, the whole purpose is to deal with the fact that we have 41 million people in this country who don’t have health insurance. I was looking at the video that introduced the subject, and one of the things that they pointed out was people I think don’t always understand that if you get in an accident, if you get sick, then the costs of health care without health insurance are so high that either you may not be able to get the treatment you need, or it could end up bankrupting you. You could lose your home, you could lose everything you have, all your savings, just to pay for the cost of a few days in the hospital or the kinds of treatments that are necessary if you have a serious accident or illness.
So what we’ve done is we’ve set up a system where through a website, CuidadoDeSalud.gov, or for English speakers, Healthcare.gov, that allows you to compare various plans that are available to you, and you get a subsidy potentially that can bring your costs down so that you can afford health insurance at a much cheaper rate than you ever could if you were trying to buy it on your own. Now most people in America get their health insurance through their employers. And that’s good. And if you do, then you shouldn’t have to worry about this. But if you don’t have health insurance right now, then it is very important for you to at least look on the website or call up the phone number or go to a community clinic and find out whether you are eligible and how much it will cost. The average cost could be much lower than people expect. In many circumstances, you may end up paying $100 or less a month to have really good health insurance. So for less than it costs you for your cell phone bill or your cable bill, you may be able to have the security, the peace of mind of getting health insurance.
And part of the reason that it’s so important for us to reach out to the Latino community is the Latino community is the most likely to be uninsured. One out of four of the uninsured are Latino. Most of those people work very hard, but because maybe there’s a low-wage job, they’re in a job that doesn’t provide health insurance, their families don’t have any protection. So we want to make sure that everybody has the information, and you have to sign up by March 31 if, in fact, you’re going to be able to get covered for this year.
JDB: Mr. President, we know that undocumented people are not covered. That was clear from the very beginning. But many of the family members are covered. This is the case, for example, of Guadalupe Stallone from California, she is undocumented. However, her sons are citizens.
“I have four sons, one daughter, three boys, actually, my youngest is a special case. I have been told that I have to register him so that they get benefits. Insurance, now I’m afraid that I have to sign him up and fill in all these documents, I’m afraid that they will be taken from me. From the moment we start providing your personal information, you start to feel the fear, that’s the fear, that they’re going to share it with immigration. Many people are in the same situation. They don’t know that Obama is not going to hand them over to immigration, and they fear that the next day, they’re going to hear someone knocking on their door, and it’s going to be immigration to take them away.
“I would tell Mr. Obama I want to believe in you. I have kids. My kids are U.S. citizens. We are human.”
And, like Guadalupe’s family, we have hundreds of thousands more with a mixed migration status. Fear and lack of trust have become one of the main obstacles for Latinos to register. Mr. President, from the time that you took office, there have been over 1,000 deportations per day in this country. You’re looking at 2 million, in fact, this week, the leader of the Latino organization, the largest one, the National Council of La Raza, called your administration and you, sir, as Deporter-in-Chief. So while the question is can our people hear from you a pledge, a personal promise that the information provided in the registration process will not be used for deportation purposes?
POTUS: Absolutely. Let me break that question up because there are a bunch of different issues in there.
The first thing that everybody needs to know with respect to health care is if you are a U.S. citizen or you have a legal presence in this country, then you are eligible for this health care program. It’s true that the undocumented are not eligible. That’s how the law was written, but if you are a U.S. citizen or you have a legal presence in this country, you are eligible. And none of the information that is provided in order for you to obtain health insurance is in any way transferred to immigration services. So that’s something that we’ve been very clear about if you live in a mixed status family, then the son, who could potentially be eligible for the children’s health insurance program or some other mechanism to get health insurance, he needs to be signed up. And the mother should not be fearful that in any way that’s going to affect…
So that’s point number one. Point number two. Since I ran for President, I’ve been pushing for comprehensive immigration reform and continue to push for comprehensive immigration reform. I am the Champion-in-Chief of comprehensive immigration reform.
But what I’ve said in the past remains true, which is until Congress passes a new law, then I am constrained in terms of what I am able to do. What I’ve done is to use my prosecutorial discretion, because you can’t enforce the laws across the board for 11 or 12 million people, there aren’t the resources there. What we’ve said is focus on folks who are engaged in criminal activity, focus on people who are engaged in gang activity. Do not focus on young people, who we’re calling dreamers, who are studying, grow up here, who through no fault of their own find themselves suddenly under the threat of deportation. That already stretched my administrative capacity very far. But I was confident that that was the right thing to do. But at a certain point the reason that these deportations are taking place is, Congress said, you have to enforce these laws. They fund the hiring of officials at the department that’s charged with enforcing. And I cannot ignore those laws anymore than I could ignore, you know, any of the other laws that are on the books. That’s why it’s so important for us to get comprehensive immigration reform done this year. We already have seen bipartisan support in the Senate. Now we have the opportunity to get bipartisan in the House. I’ve spoken to the Speaker John Boehner, about this. I think he’s sincere about this. I think he’s sincere about wanting to do it. But until it’s done, there’s still going to be challenges. And so there are going to be families that may be concerned when they sign up. What I can tell you though, is while we’re waiting to get comprehensive immigration reform done, I don’t want a young person out there to get sick, could have had health insurance, and suddenly they are in a position where they may lose everything they have. Or not get the good treatment that they need, or not get preventive care that would allow them to find out whether or not they can be treated.
So, for everybody out there that’s in a mixed family, there’s no sharing of the data from the healthcare plan into immigration services. You should feel confident that if somebody in your family is eligible, you should sign them up.
EA: Well, that’s a particularly important point you touched on at the end, Mr. President. Because your administration doesn’t have the best record with keeping your citizen’s personal information and sharing among agencies. I could think of a few cases in the past. So you are entirely committed to refrain from sharing information of anybody who signs on to the insurance.
POTUS: That’s the commitment.
EA: Very well then, let’s move on to the cost now. We have a great number of questions from the many social media platforms. We have been getting many questions about cost. This question here comes from a gentleman who says that he asked, he wanted Obamacare for his family. He wanted Obamacare for a family of three. And he says, I make about $36,000 per year, and the minimum amount here is $315 per month. I think that’s too much for me. That’s a question from this gentleman here, as I was saying, a lot has been said about the cost.
JDB: And for families that live from paycheck to paycheck, $316 might be a lot. Well yes, for example, Mr. President, the study from the California government shows that our people want medical insurance. They need insurance. They tried to register but when they go to register they can’t cover it. So the question is, is the Affordable Care Act really affordable?
POTUS: I think it’s very important to understand a couple of things. Number one, that many people when they go on the website or they make a call or they go to the clinic, they may be eligible for Medicaid, they just don’t know it. In which case, they may be able to get health insurance coverage for free or very low costs. The child who was in the video previously may qualify for the Children’s Health Insurance Program. That’s a no cost program. He should be signed up. When it comes to somebody who’s not qualified for Medicaid, we already have in place what’s called a hardship exemption. So that you are not required to get health insurance if you genuinely cannot afford it. And frankly, there are a few states like Texas or Florida, that have not expanded Medicaid the way the law allows. Those people should qualify for Medicaid under the federal rules, but the states have refused to expand it for political reasons. And so they may find themselves in a situation where they really can’t afford to pay more. They should be able to get health insurance. That’s why we got to put pressure on those governors to expand Medicaid.
But, for the majority of people when you sign up on this website, you will discover that because of the tax credits and subsidies that are available, that the vast majority of people will find a good option that is affordable for them. And as I said before, a large portion of people will be able to find health insurance for $100 or less. Now there may be some circumstances where somebody is making $40,000, $50,000 a year. They’ve got a health insurance option that, you know, cost $300 a month for their family. And they may say, you know, with all the bills that I’ve got that’s too tight. I guess I would say is if you looked at that person’s budget and you looked at their cable bill, their telephone, their cell phone bill, other things that they’re spending on, it may turn out that it’s just they haven’t prioritized to healthcare because right now everybody’s healthy. Nobody actually wants to spend money on health insurance until they get sick. And then once they’re sick, the costs of not having health insurance are a lot worse than the cost of having health insurance. I guarantee you if that gentleman who just wrote you that letter, and I don’t know his particular circumstance and whether he actually has gotten all the information about the subsidies that might be available.
But I guarantee you that even at $300 a month, if heaven forbid something happened to him or a family member where they got sick and really needed, let’s say a week’s worth of hospitalization, he will wish that he had paid that $300 a month. Because he stands potentially to get bills of hundreds of thousands of dollars for treatment and you cannot pay that without health insurance. You know, I get a pretty good salary as President of United States. But if I didn’t have health insurance and something happened to me, I’m not sure I could pay out of pocket for the kinds of cost of care that are necessary.
JDB: Your government, once again, extended the deadline for the policies that do not qualify to the new law. Now, these extensions you have granted, are they not a tacit recognition, in fact that this portion of the law is a mistake.
POTUS: No, no. Here’s what happened. Is that some people buy health insurance on the individual market. Yeah, they don’t get health insurance for the job, but they know they should get health insurance and so they’ve gone out and they’ve purchased it on their own. Sometimes because they’re healthy, they don’t have a pre-existing condition, they’re young, they can get a good deal. Because insurers are very good at figuring out, you know what, we bet we won’t have to pay much on this person. And so we’ll offer them a good deal. And then there’re some people who actually get very bad insurance, but they don’t know it, because they haven’t seen the fine print. And so what we’ve said was, look, if you have health insurance you should be able to keep it. The way the law was drafted it didn’t cover everybody under that provision. Some people got cancellations, they didn’t want to see their insurance cancelled. They said, I thought you said, that we’d be able to keep it. And we said, you know what, you’re right. You should be able to keep the health insurance that you have, even if it’s not very good. Even if you could actually get better health insurance.
JDB: Even if you’re happy with it.
POTUS: Even if you could get better health insurance on healthcare.gov. You should be able to keep it. And that’s the law that we have extended. And on a program like this that has so many people involved. And millions of people who are trying to find health insurance, or get better health insurance they’re always going to be some smoothing out of the process that has to take place. But keep in mind that for the majority of people even if they have health insurance on the individual market, they should go to the website because they may qualify for tax credits. They may qualify for subsidies that give them better health insurance for less money. And keep in mind that we’ve already seen over 4 million people sign up. And I get letters everyday from people who signed up, they say, you know, I didn’t agree with you on Obamacare, and I thought it was a terrible law. But then my cousin told me I should look on the website. And I’m now saving $200 a month on my premiums for better health insurance. So the main message I have for everybody who’s listening or watching is, look to see if in fact you can get a better deal.
Even if you’ve got health insurance on the individual market you should see if in fact you’re getting the best health insurance you can. I saw, I met a woman yesterday, I was in Connecticut. She drove up from Rhode Island to thank me, because even though she had health insurance, it turned out that she hadn’t read the fine print and she had not been covered when she got leukemia. It wasn’t going to cover all the costs. And she literally said to me, you saved my life, because we could not have afforded to get treatment. Fortunately, we were able to sign up for the Affordable Care Act and now the treatments that I have is covered. And I’ve been in remission now for a year. So as I said before, the problem with health insurance is, people don’t necessarily want to pay for it until something goes wrong. And what we’re trying to do is provide affordable options for all people. And if you go on the website, CuidadoDeSalud.gov , or make a phone call to the call centers that we’ve setup. Or visit some of the 8,000 clinics, community clinics that exist within the Latino community all across the country. You can get information and make your own decisions about whether in fact this is a good decision for you.
EA: Mr. President, the reason we’re here, and we said this at the beginning is that the Latino community is key for the success of this healthcare reform. Now we have the very same deadline of March 31, we said this at the beginning. But now we have had access to information, different tools, and different platforms that did not operate the same way in English as they did in Spanish. Now taking this into account, why not consider extending the deadline that we’re looking at?
POTUS: Well, first of all the website works really well now. So anybody who’s watching, you still have a month to sign up. And it doesn’t take that long. I was watching the introductory video and somebody was saying, oh it took me so long to get on. Or I kept on going back and forth. That was in the first month, or the first month and a-half. If you call now, if you get on the website now it works, it provides you the information. You can potentially sign up very quickly to get coverage. And so there’s really no reason why over the next four weeks, it’s not as if the deadline is tomorrow. You guys are doing us a service by making sure that people know. Well, you have time now to sign up. And the reason that we don’t want to extend the deadline forever, the way insurance works is, at some point the insurance companies have to make a decision about what’s the pool? How many people are in this insurance pool that they’ve got to cover? They’ve got to start making decisions about prices for next year. They can’t make those decisions last minute, they have to be able to see who it is that they’re insuring.
And so there has to be a cutoff date, March 31 is the cutoff date. That gives people enough time to be able to sign up.
JDB: Mr. President, on the website in Spanish, it still has problems that were already solved in the English language. For example, the language issue itself. On the web page and when somebody calls on the phone, sometimes they have to go through two steps in English in order to get to Spanish. We still see problems that my friend, my colleague Enrique had mentioned. But if we cannot prolong that deadline March 31, would you not at least consider not penalizing those who cannot meet the deadline?
POTUS: Well, keep in mind that what’s going to happen is that again, if you cannot afford health insurance, you’re going to be exempted. You’re not going to be paying a penalty. And if in fact you want health insurance, then I am very confident that between now and March 31 you can get on the website, make a phone call. And we make sure that you get health insurance. And I would say Jose, that for people who let’s say started to sign up in October, the website was terrible in October. It was, and it still wasn’t very good in November. And so if you got discouraged initially, please go back and take a look, and see in fact is it working? And can you get the information that you need? Here’s part of the concern that I have. Is that if everybody waits until the last minute, everybody waits until March 27 or 28, then in some ways it’s a self fulfilling prophecy. Because if you have 5 million people all going on the website at the same time, even if it’s a great website that’s working well now, then yes, there are going to be delays. Because there are only so many people that any website can absorb at a single time. What we’re trying to see is, the people to spread out their interests, start now, start today. You know, go to the website, get the information. If in fact there is a problem, call the call center number which will be on the screen, if that’s a problem go to a community clinic and find out whether or not you can sign up. I would say that for the Spanish speaking website, CuidadoDeSalud.gov that 95 percent of the issues have been resolved.
For the English speaking website I’d say 99 percent of the problems have been resolved. Some of the issues that were specific to the Spanish speaking website had to do with if somebody has a change in immigration status or you know, a very complex problem in terms of their family and then sometimes it takes a little bit longer. It’s not as routine. For if you’re a young person, you know, you’re 28, 29 years old you don’t have a serious history of illness of any sort, or what have you, I promise if you go on the website you can sign up in pretty quick time.
EA: So just to make sure, you will enforce the deadline and penalties will be enforced?
POTUS: We are going to enforce the deadline. But we are confident that anybody out there who is interested in getting health insurance for their families they’re going to be able to get that done before March 31.
JDB: And penalties will be enforced after that time?
POTUS: If in fact you can afford health insurance and you have not purchased it, that’s what the law says. And I want to be clear as to the reason for that. The reason is, remember I said earlier, you never know what might happen. You know, you may get in an accident. You may get sick. If you don’t have health insurance you then go to the emergency room. And we’re going to provide you treatment, that’s law, that somebody has to provide you initial treatment. But then if you can’t pay somebody else ends up having to pay. And so it’s not fair for others to essentially provide insurance for you. You need to take some responsibility if you can afford it. There’s some people who cannot, in which case you’ll be exempted.
EA: Well, now that we talked about penalties, people that get sick or have an accident and cannot pay, will they continue to be covered? Because they can’t keep on paying.
POTUS: Well, basically they’ll end up being in the same situation they are now, which is they used the emergency room. The problem and this is true in the Latino community, is a lot of people use the emergency room as their doctor. But what that means is that first of all, you very rarely get regular checkups or preventive care. And oftentimes people wait until they’re really sick before they go to the doctor. That means already, not only have they been going through pain, but they may have seen a disease advance. If caught earlier would have been much easier to solve and much healthier for them. And they could have prevented many diseases. One of the things about getting health insurance and this is something that young people should know is, it means that, you know, you can get a regular mammogram. Or you can get, you know, other checkups that can monitor your health. And that’s part of making sure that you’re living a healthy lifestyle.
JDB: Mr. President, this year if immigration is approved would you include the, but would you act unilaterally in that case so that the, now people on the path to citizenship would benefit from the healthcare reform.
POTUS: Well, we will have to see what the law looks like. My first and foremost goal is getting comprehensive immigration reform done. And my suspicion is if we get that passed, then initially at least, the Republicans will insist that people are not eligible for various benefits, even if they have a legal status. I think that’s a principle they’ve generally expressed. But the good news is once somebody has a legal status, first of all, they’re more likely to be able to get a job that provides health insurance. So they may not need the subsidies through the Affordable Care Act. Second of all, over time I think it becomes less of a political issue. You’ll recall that when I came into office the law on the Children’s Health Insurance Program did not allow children who were legal permanent residents from taking advantage of the law. Well, that’s something I reversed. It didn’t make any sense if they’re here legally then we should be able to make sure that those children have the healthcare that they need. But that’s a discussion for a future date. I think the important thing for now is there are millions of people are definitely eligible who right now are not taking advantage of it.
And what I need everybody to do is to talk to your friends, your neighbors, your family, your coworkers and just ask them, take a look. Does this make sense for you? Does it make sense for your family? Do you need the financial security? Do you want a healthier lifestyle? And if you can obtain that at a relatively modest cost. In some cases as I said, for a lot of people it’s going to be less than $100 a month, which people can afford. In some cases for young people it might be as little as $50, or $40 or $30 a month, if that makes sense to you, then take advantage of this now. Because if you don’t take advantage of it by March 31st, then the next chance you may have won’t be until November. And you know, I’ve seen too many stories of people who did not have health insurance and tragedy struck and they were unprepared. To know that this is something really worthwhile. And you know, I remember being young and never thinking I was going to get sick. And part of what happens I think is when you have children, then you become much more aware of how you want to provide security for yourself and your family.
EA: I know you’re often asked this. But do you believe that this will be the legacy of your administration? And do you feel comfortable with that legacy, if so?
POTUS: You know, I am very proud of this law. It’s already helping millions of people. Keep in mind in addition to the over 4 million people who’ve signed up for the private health insurance, 3 million young people are staying on their parents’ plan ‘till the age of 26 because of the law. You have millions who are on Medicaid in the states that have expanded it because of the law. You’ve got seniors who are getting discounts on their prescription drugs and Medicare because of the law. You’ve got a patient’s bill of rights for those who have health insurance through their jobs because of the law. So I’m very proud of this. And I believe that once we get through the initial startup phases, which are always difficult. It was true for Social Security, and it was true for Medicare. Some of the same arguments were made against those programs when they first started off. That 5 years, 10 years from now people will look back and say, that this was the right thing to do. And at that point the Republicans won’t call it Obamacare anymore.
JDB: Well, that’s interesting. Because one of the things the Republicans say is and this week they tried to do this 50 times, the lower house, they tried to change the law in its current form. Now this law is up and running since 2010. Now what changes, what specific changes would you make to this law from here on out?
POTUS: Well, you know, on a complicated program like this, and this is true of every social program. There are always improvements and modifications that can be made. And what I’ve said to the Republicans is if they have something specific that makes sense for families, makes healthcare more affordable, drives down costs, covers more people, we’re happy to look at it. But there’s a reason why they’ve never actually put forward a serious alternative. Did you notice for the last 5 years they’ve been saying, this is terrible, we’ve got a better way of doing it. And then we keep on waiting for their plan of a better way of doing it, and they don’t produce it. Well, the reason is, is because actually we have taken the best ideas, conservative ideas, liberal ideas, and we’ve put them together and we’re now implementing them. And what I can say is that if in fact people sign up and take advantage, if they go to the website, if they make the calls, they go to the community clinic, and they get the information, I am absolutely confident that you will see millions of people benefitting from this law. It doesn’t mean that at some point there won’t be some additional problems or improvements that we can make. It doesn’t…
JDB: Do you have anything in mind in the near future? Do you know…
POTUS: At this point I think actually it is working the way it should. But I, what we need to do is after the first year we’ll evaluate what the pool looks like. Can we make sure that we’re keeping the premiums low? Are there more people that we could potentially cover through other mechanisms, reaching those who are still uninsured? The biggest improvement I’d like to see right now is for the Governors in states like Texas and Florida to expand Medicaid. ‘Cause we know that would work. And that’s a decision they could make right now. And I think it’s very important for the Latino community to understand. Because a state like Texas has the highest uninsured rate in the nation. Keep in mind, the state of Texas would not have to pay itself more money to cover these people. This is money that the federal law and the federal government would provide, all they have to do is to agree to accept these dollars to help their citizens, their residents to do the right thing.
And the idea that you wouldn’t do that for political reasons I think is, that’s something I’d like to see improved. But that doesn’t have to do with making a change in the law. It means changing the attitudes of some of the politicians who’ve been blocking it.
EA: But Mr. President, without a doubt I guess you agree that your credibility has been somewhat tarnished with the Latino community, because of the immigration reform and deportations. Now how can you ask the Latino community once again to trust and to sign on to this program and to follow your example.
POTUS: Well, I would challenge the premise of my credibility. Keep in mind that, you know, when you’re President of the United States somebody’s always going to be frustrated or unhappy about something you have done or haven’t done, or haven’t done fast enough. But if you look at my track record in terms of expanding, access to college for Latino students. If you look at my track record in terms of the number of Latino families we kept out of poverty during the Great Recession. If you look at my track record in terms of the number of Latino families who I helped make sure that they stayed in their homes through our various programs when the housing market crashed. If you look at the track record that I have had in expanding health insurance for legal residents’ children. If you look at the track record that I have with respect to making sure that the Dreamers were not subject to deportation, despite the fact that, that required me to make some very difficult changes administratively in existing law. I think the community understands that I’ve got their back and I’m fighting for them. Does that mean that there aren’t going to be frustrations when changes don’t happen as fast as they should?
Of course, but that’s true for pretty much everybody in the population. If something’s wrong then they’re saying, why hasn’t Obama done something about this. That doesn’t, that’s not just true of here in the United States. That’s around the world. You know, you got people in Africa and Asia and Europe and China saying, why didn’t Obama do something about this, this is a terrible problem. And I understand that, that’s part of the job. The main message I have for the community right now is, and Latin America. The main question that I have, or the main point that I have for everybody watching right now is you don’t punish me by not signing up for healthcare. You’re punishing yourself or your family if in fact there’s affordable healthcare there to be had and subsidies and tax credits that allow you to have the peace of mind and security and regular checkups and preventive care that would keep you healthier. That’s not a matter of trusting me, that’s a matter of looking for yourself and seeing if you can get services.
JDB: We’ll be back in just a moment. But Mr. President, we wanted to thank you for being here with us today. Thank you for broaching these very important topics for our community with us.
POTUS: I enjoyed that very much. Thank you. Good. I enjoyed it.