WASHINGTON ― Former President Bill Clinton caused a bit of stir Monday when he was quoted describing Obamacare as “the craziest thing in the world” ― an opinion that would put him sharply at odds with Democratic presidential nominee, Hillary Clinton.
It would be quite a turn in this campaign if the last Democratic president slammed the signature policy achievement of the current Democratic president while campaigning for his wife, who hopes to be the next Democratic president. It also would be a remarkable turn for Bill Clinton, who championed health care reform from the White House and has been a vocal supporter of the Affordable Care Act.
But those ideas seem far-fetched, and they should. A spokesman for the ex-president denies that that’s what Bill Clinton actually said. And a review of Clinton’s full remarks appears to support this claim.
During a speech in Flint, Michigan, that ran nearly 40 minutes, Bill Clinton addressed the health care system and Hillary Clinton’s plans for further reforming it. He also discussed the progress made under President Barack Obama, and the calls from Republicans to repeal the Affordable Care Act.
A CNN report published Tuesday begins this way:
Bill Clinton criticized President Barack Obama’s signature policy reform while on the stump for his wife, Democratic presidential nominee Hillary Clinton, calling Obamacare “the craziest thing in the world.”
That quotation, while accurate, doesn’t fully portray Bill Clinton’s argument for keeping the Affordable Care Act ― which has extended health coverage to 20 million people and cut the uninsured rate to a historic low ― and enhancing it with policies proposed by Hillary Clinton’s campaign.
Bill Clinton accurately described the status quo as one where people who get health coverage from government programs like Medicare and Medicaid, and people who are eligible for subsidies under the Affordable Care Act, are well-covered ― but where people who earn too much for financial assistance can face high premiums:
The current system works fine if you’re eligible for Medicaid, if you’re a lower-income working person, if you’re already on Medicare, or if you get enough subsidies on a modest income that you can afford your health care.
But the people that are getting killed in this deal are small businesspeople and individuals who make just a little too much to get any of these subsidies.
So you’ve got this crazy system where all of a sudden, 25 million more people have health care and then the people that are out there busting it ― sometimes 60 hours a week ― wind up with their premiums doubled and their coverage cut in half. It’s the craziest thing in the world.
Plus, prior to the Affordable Care Act, millions fewer people qualified for Medicaid, and no one received subsidies for private insurance.
Hillary Clinton’s campaign proposals would help close the remaining gap and make health insurance more affordable for people who don’t currently qualify for financial help, Bill said Monday.
“Hillary believes we should simply let people who are above the line for getting these subsidies have access to affordable entry into the Medicare and Medicaid programs. They’ll all be covered,” he said. (Hillary Clinton hasn’t actually called for people to be able to purchase Medicaid coverage, but she does support working with states that haven’t expanded the program under Obamacare to do so.)
During a speech later Monday in Pontiac, Michigan, the former president offered direct praise of Obamacare.
“I think [Obama’s] health care bill has been a remarkable success for 25 million people, and for getting rid of pre-existing conditions, and the problems with it show why the president was right to recommend a public option in the first place,” Bill Clinton said, according to a transcript his spokesman, Angel Urena, supplied.
Hillary Clinton campaign’s platform calls for several enhancements to the Affordable Care Act, like creating a government-run “public option” that would compete with private insurers and allowing near-retirees to buy into Medicare instead of purchasing private coverage. Clinton would also provide tax credits to families who face extraordinarily high health care costs, among other things.
“I think [Obama's] health care bill has been a remarkable success.”
Despite its characterization in the CNN report, Bill Clinton’s assessment of the health care system and the Affordable Care Act mirrors Hillary Clinton’s and Obama’s own.
Urena acknowledged that the former president’s remarks in Flint could lend themselves to misinterpretation.
“President Clinton spoke about the importance of the Affordable Care Act and the good it has done to expand coverage for millions of Americans,” Urena wrote in an email. “And while he was slightly short-handed, it’s clear to everyone, including President Obama, that improvements are needed.”
The third year of annual open enrollment on the health law’s exchanges begins Nov. 1, one week before the election. Despite the expansion of coverage to millions of previously uninsured people, these marketplaces enter the new sign-up period facing real headwinds.
Health insurance companies are raising premiums, sometimes by a lot, to compensate for losses incurred because enrollees have proved sicker and costlier to cover than expected. Insurers included UnitedHealth Group and Aetna are scaling back their participation in these exchanges, contributing to diminished choices for consumers.
Congressional Republicans have steadfastly refused to consider amending the Affordable Care Act, and instead maintain that the six-year-old law should be repealed completely and replaced by a set of vague policies that would cover significantly fewer people.
Republican presidential nominee Donald Trump also supports repeal, and although his statements about health policy are incoherent, he also would prefer to take away coverage from about 20 million people.
Urena, Bill Clinton’s spokesman, provided a transcript of the former president’s remarks in Flint on Monday:
Now the next thing is, we got to figure out now what to do on health care. Her opponent said, ‘Oh, just repeal it all. The market will take care of it.’ That didn’t work out very well for us, did it? We wound up with the most expensive system in the world and we insured the smallest percentage of people. On the other hand, the current system works fine if you’re eligible for Medicaid, if you’re a lower income working person, if you’re already on Medicare, or if you get enough subsidies on a modest income that you can afford your health care.
But the people that are getting killed in this deal are small businesspeople and individuals who make just a little too much to get any of these subsidies. Why? Because they’re not organized, they don’t have any bargaining power with insurance companies, and they’re getting whacked. So you’ve got this crazy system where all of a sudden, 25 million more people have health care and then the people that are out there busting it ― sometimes 60 hours a week ― wind up with their premiums doubled and their coverage cut in half. It’s the craziest thing in the world so here’s the simplest thing ― you raise your hands, you think about it ― here’s the simplest thing: figure out an affordable rate and let people use that ― something that won’t undermine your quality of life, won’t interfere with your ability to make expenses, won’t interfere with your ability to save money for your kid’s college education. And let people buy in to Medicare or Medicaid.
Here’s why: you can let people buy in for just a little bit because unlike where you are now, if you were on the other side of this, if you were an insurer, you’d say, ‘Gosh, I only got 2,000 people in this little pool. Eighty percent of insurance costs every year come from 20 percent of the people. If I get unlucky in the pool, I’ll lose money.’ So they overcharge you just to make sure, and on good years, they just make a whopping profit from the people who are least able to pay it.
It doesn’t make any sense. The insurance model doesn’t work here; it’s not like life insurance, it’s not like casualties, it’s not like predicting flooding. It doesn’t work. So Hillary believes we should simply let people who are above the line for getting these subsidies have access to affordable entry into the Medicare and Medicaid programs. They’ll all be covered, it will not hurt the program, we will not lose a lot of money. And we ought to do it.
Urena also gave The Huffington Post a transcript of Bill Clinton’s comments in Pontiac on Monday:
I think his health care bill has been a remarkable success for 25 million people, and for getting rid of pre-existing conditions, and the problems with it show why the president was right to recommend a public option in the first place because the only real problems I can see with it are small businesspeople and individual working people just above the subsidy line are having. Why is that? Because they’re small, they’re independent, they do have any market power vis a vis the insurance companies, and that’s why Hillary said, “The change we need is not to wreck this thing and repeal it. It’s done too much good. The change we need is to create an affordable option for the small business people and the working people who are not covered ― that’s what the public opinion is about.
Keep in mind, when the other side complains about that, if they just pay these people something they can afford, it will cover well over 90 percent of the costs of the expansion of Medicare or Medicaid or both. Why? Because there’s a huge pool. This is one place where his adjective works. This is really important ― there’s a ‘huge’ pool, and the economics of health care are as follows: in any given year, more than 80 percent of the costs are claimed by 20 percent of the people. It’s just a shifting 20 percent. That means if you have a small pool, it’s impossible to price right. It doesn’t work, it’s not like life or casualty or property or other insurance, which is why there should be a public opinion, and it will either be available to people, or the private insurance companies will figure out how to reorganize themselves and put people into huge pools to compete.
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Editor’s note: Donald Trump regularly incites political violence and is a serial liar, rampant xenophobe, racist, misogynist and birther who has repeatedly pledged to ban all Muslims — 1.6 billion members of an entire religion — from entering the U.S.