Below is the full text of the prepared remarks President Obama delivered during his press conference last night, along with updates from the subsequent Q&A. The full transcript can be read here. Scroll to the bottom to watch the full press conference.
President Barack Obama, who has spent weeks urging lawmakers to embrace his health care agenda at White House meetings, is focusing now on a broader and more distant audience: the American people, whose qualms about his plan seem to be growing.
In his comments Wednesday and at scheduled events Thursday in Cleveland, the president is speaking directly to families about their pocketbook and medical concerns, urging them to ignore political opportunists and naysayers in order to achieve sweeping changes, which previous administrations could not attain.
"If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket," Obama said Wednesday night, looking past the dozens of reporters assembled for his White House news conference and peering straight into the TV cameras. "If we do not act, 14,000 Americans will continue to lose their health insurance every single day."
On Thursday in Ohio, the president will undertake two more events focused on health care, the issue dominating his administration even as the economy still suffers and wars continue in Iraq and Afghanistan. For his supporters, Obama's stepped-up pace is coming not a second too soon.
For now, Obama keeps insisting on all the major elements of his far-reaching proposal and warning of dire consequences if they are not enacted. Turning the focus away from Capitol Hill -- even as he tries to build pressure on wavering lawmakers -- Obama said Wednesday that the debate "is about every family, every business and every taxpayer who continues to shoulder the burden of a problem that Washington has failed to solve for decades."
He zeroed in on perhaps the least popular segment of the health care world: insurance companies, alluding often to "health insurance reform" instead of "health care reform."
He cited a Colorado woman with cancer that her insurance company would not cover. He referred to a "middle-class college graduate from Maryland whose health insurance expired when he changed jobs." He used the word "families" 22 times in 55 minutes.
"Reform is about every American who has ever feared that they may lose their coverage if they become too sick, or lose their job or change their job," the president said. "It's about every small business that has been forced to lay off employees or cut back on their coverage because it became too expensive."
Obama praised the work of the Cleveland Clinic, which he was visiting Thursday before holding a town-hall forum on health care at the nearby Shaker Heights High School. The clinic pays doctors a salary, which does not depend on how many procedures or tests they perform.
"They've set up a system where patient care is the No. 1 concern, not bureaucracy, what forms have to be filled out, 'What do we get reimbursed for?'" Obama said. "Those are changes that I think the American people want to see."
It's a theme that lawmakers back in Washington can expect to hear repeatedly.
-- Obama on his interactions with Congress on health care. Obama's first question: Have you told House and Senate leaders which health care ideas are acceptable to you? If so, will you share them publicly? And if not, why haven't you stepped in to get a deal done because you are the one pushing a deadline?
Obama began by addressing the worsening health care crisis, with premiums and the number of uninsured rising. He emphasizes his pledge not to keep his health care plan deficit-neutral, and explains that only a third of the proposed spending still needs to a plan to be funded. He says he's open to a variety of ideas for paying for that final third, but of course will reject any plan that places the burden for that funding on the back of middle class Americans.
After several minutes discussing policy details, he addressed the skepticism about major health care legislation felt by many Americans:
Now, I understand that people are feeling uncertain about this. They feel anxious, partly because we've just become so cynical about what government can accomplish. People's attitudes are, you know, even though I don't like this devil, at least I know it. And I like that more than the devil I don't know. So folks are skeptical. And that is entirely legitimate because they haven't seen a lot of laws coming out of Washington lately that helped them. But my hope is, and I'm confident that when people look at the cost of doing nothing, they're going to say, we can make this happen. We've made big changes before that end up resulting in a better life for the American people.
-- Obama asked, why the rush? Question two: "You've been pushing Congress to pass health care reform by August. Why the rush? Are you worried that if you don't, there's a delay until the fall and that it will collapse?"
Obama said there are two reasons -- first, because of the letters he gets "every day from families that are being clobbered by health care costs. And they ask me, can you help?" People are suffering and he feels it's critical to act, he said.
Obama's second reason: "If you don't set deadlines in this town, things don't happen... because doing something always creates some people who are unhappy. There's always going to be some interest out there that decides, you know what, the status quo is working for me a little bit better. And the fact that we have made so much progress, where we've got doctors, nurses, hospitals, even the pharmaceutical industry, aarp, saying that this makes sense to do, I think means that the stars are aligned, and we need to take advantage of that."
-- Health care politics. NBC's Chuck Todd asks, "The politics of it -- you mentioned two Republicans in your opening statement, but you have 60 Democratic seats [in the Senate], a healthy majority in the House. If you don't get this, isn't this a fight inside the Democratic Party? and Republicans aren't really playing a -- you can't really blame the Republicans for this one?"
Obama responded by noting that he hasn't been blaming the Republicans -- but he did admit that he's "been a little frustrated by some of the misinformation that's been coming out of the Republicans, but that has to do with, as you pointed out, politics."
He offered praise for some GOP Senators by name -- "I am very appreciative that people like Chuck Grassley on the Finance committee in the Senate, people like Mike Enzi, people like Olympia Snowe have been serious in engaging Democrats in trying to figure out how do we actually get a system that works. And even in those committees where you didn't see Republican votes, we've seen Republican ideas. So for example in the Health committee in the Senate, 160 Republican amendments were adopted into that bill, because they've got good ideas to contribute. So the politics may dictate that they don't vote for health care reform because they think, you know, it'll make Obama more vulnerable. But if they've got a good idea we'll still take it."
He also acknowledged that there have been differences among Democrats, but mostly explained those away to people having "a lot of different ideas" of how to help, and to some "regional disparities" producing divides on things like Medicare reimbursement rates.
-- Will health care reform require sacrifices? ABC's Jake Tapper asked a leading question, first stating that health care reform will require sacrifices in "tests, referrals, choice, end of life care," then asking whether Obama accepted that Americans will have to give something up to get better health care.
Obama basically rejected the question's premise. "They're going to have to give up paying for things that don't make them healthier," he said. "And I, speaking as an American, I think that's the kind of change you want." He cited unnecessary duplication of tests that would be reduced with reform.
Obama also had a long riff emphasizing his concerns about federal spending, the debt and the deficit -- and why health care was an important part of addressing those problems. Here's a portion:
The debt and the deficit are deep concerns of mine. I am very worried about federal spending. And the steps that we've taken so far have reduced federal spending over the next ten years by $2.2 trillion. It's not enough but in order for us to do more we're not only going to have to eliminate waste in the system -- and by the way we had a big victory yesterday by eliminating a weapons program, the F-22, that the Pentagon had repeatedly said we didn't need.
We're going to have to eliminate waste there, no big contracts, do all kinds of reforms in our budgeting, but we're also going to have to change health care. Otherwise we can't close that $7.1 trillion gap in the way the American people want it to change. So to all -- everybody who's out there who has been on this idea the Obama administration wants to spend and spend and spend, the fact of the matter is that we inherited an enormous deficit, enormous long-term debt projections. We have not reduced it as much as we need to and as I'd like to, but health care reform is not going to add to that deficit. It's designed to lower it. That's part of the reason why it's so important to do and to do now.
-- Obama pressed on transparency. Here's the question: "You promised that health care negotiations would take place on C-span and that hasn't happened, and your administration recently turned down a request from a watchdog group seeking a list of health care executives who visited the White House to talk about health care reform. Also, the TARP inspector general recently said your White House is withholding too much information on the bank bailout. My question for you is, are you fulfilling your promise of transparency in the White House?"
Well, on the list of health care executives who visited us, most of the time you guys have been in there taking pictures. So it hasn't been a secret. My understanding is we just sent a letter out providing a full list of all the executives, but frankly these have mostly been at least photo sprays where you could see who was participating.
With respect to all the negotiations not being on C-SPAN, you will recall in this very room that our kick-off event was here on C-SPAN. And at a certain point, you know, you start getting into all kinds of different meetings. The Senate Finance committee is having a meeting. The House is having a meeting. If they want those to be on C-span, then I would welcome it. I don't think there are a lot of secrets going on in there. And the last question with respect to TARP, I -- let me take a look at what exactly they say we have not provided. I think that we've provided much greater transparency than existed prior to our administration coming in. It is a big program. I don't know exactly what's been requested.
-- On the arrest of Harvard Professor Henry Louis Gates. The Chicago Sun-Times' famously pugnacious reporter Lynn Sweet asked about the only question of the night that didn't somehow touch on health care, probing Obama for his thoughts on the controversial arrest of Harvard University's Skip Gates. After noting that Gates was a friend of his, Obama said:
Now, I don't know, not having been there and not seeing all the facts what role race played in that, but I think it's fair to say, number one, any of us would be pretty angry. Number two, that the Cambridge police acted stupidly in arresting somebody when there was already proof that they were in their own home and, number three, what I think we know separate and apart from this incident is that there is a long history in this country of African-Americans and Latinos being stopped by law enforcement disproportionately. And that's just a fact.
As you know, Lynn, when I was in the state legislature in Illinois we worked on a racial profiling bill because there was indisputable evidence that blacks and Hispanics were being stopped disproportionately. And that is a sign, an example of how, you know, race remains a factor in this society. That doesn't lessen the incredible progress that has been made. I am standing here as testimony to the progress that's been made. And yet, the fact of the matter is that, you know, this still haunts us.
* * * *
Obama's prepared remarks prior to the Q&A:
Good evening. Before I take your questions, I want to talk for a few minutes about the progress we're making on health insurance reform and where it fits into our broader economic strategy.
Six months ago, I took office amid the worst recession in half a century. We were losing an average of 700,000 jobs per month and our financial system was on the verge of collapse.
As a result of the action we took in those first weeks, we have been able to pull our economy back from the brink. We took steps to stabilize our financial institutions and our housing market. And we passed a Recovery Act that has already saved jobs and created new ones; delivered billions in tax relief to families and small businesses; and extended unemployment insurance and health insurance to those who have been laid off.
Of course, we still have a long way to go. And the Recovery Act will continue to save and create more jobs over the next two years - just like it was designed to do. I realize this is little comfort to those Americans who are currently out of work, and I'll be honest with you - new hiring is always one of the last things to bounce back after a recession.
And the fact is, even before this crisis hit, we had an economy that was creating a good deal of wealth for folks at the very top, but not a lot of good-paying jobs for the rest of America. It's an economy that simply wasn't ready to compete in the 21st century - one where we've been slow to invest in the clean energy technologies that have created new jobs and industries in other countries; where we've watched our graduation rates lag behind too much of the world; and where we spend much more on health care than any other nation but aren't any healthier for it.
That is why I've said that even as we rescue this economy from a full-blown crisis, we must rebuild it stronger than before. And health insurance reform is central to that effort.
This is not just about the 47 million Americans who have no health insurance. Reform is about every American who has ever feared that they may lose their coverage if they become too sick, or lose their job, or change their job. It's about every small business that has been forced to lay off employees or cut back on their coverage because it became too expensive. And it's about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid.
So let me be clear: if we do not control these costs, we will not be able to control our deficit. If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket. If we do not act, 14,000 Americans will continue to lose their health insurance every single day. These are the consequences of inaction. These are the stakes of the debate we're having right now.
I realize that with all the charges and criticisms being thrown around in Washington, many Americans may be wondering, "What's in this for me? How does my family stand to benefit from health insurance reform?"
Tonight I want to answer those questions. Because even though Congress is still working through a few key issues, we already have agreement on the following areas:
If you already have health insurance, the reform we're proposing will provide you with more security and more stability. It will keep government out of health care decisions, giving you the option to keep your insurance if you're happy with it. It will prevent insurance companies from dropping your coverage if you get too sick. It will give you the security of knowing that if you lose your job, move, or change your job, you will still be able to have coverage. It will limit the amount your insurance company can force you to pay for your medical costs out of your own pocket. And it will cover preventive care like check-ups and mammograms that save lives and money.
If you don't have health insurance, or are a small business looking to cover your employees, you'll be able to choose a quality, affordable health plan through a health insurance exchange - a marketplace that promotes choice and competition Finally, no insurance company will be allowed to deny you coverage because of a pre-existing medical condition.
I have also pledged that health insurance reform will not add to our deficit over the next decade - and I mean it. In the past eight years, we saw the enactment of two tax cuts, primarily for the wealthiest Americans, and a Medicare prescription program, none of which were paid for. This is partly why I inherited a $1.3 trillion deficit.
That will not happen with health insurance reform. It will be paid for. Already, we have estimated that two-thirds of the cost of reform can be paid for by reallocating money that is simply being wasted in federal health care programs. This includes over one hundred billion dollars in unwarranted subsidies that go to insurance companies as part of Medicare - subsidies that do nothing to improve care for our seniors. And I'm pleased that Congress has already embraced these proposals. While they are currently working through proposals to finance the remaining costs, I continue to insist that health reform not be paid for on the backs of middle-class families.
In addition to making sure that this plan doesn't add to the deficit in the short-term, the bill I sign must also slow the growth of health care costs in the long run. Our proposals would change incentives so that doctors and nurses are free to give patients the best care, not just the most expensive care. That's why the nation's largest organizations representing doctors and nurses have embraced our plan.
We also want to create an independent group of doctors and medical experts who are empowered to eliminate waste and inefficiency in Medicare on an annual basis - a proposal that could save even more money and ensure the long-term financial health of Medicare. Overall, our proposals will improve the quality of care for our seniors and save them thousands of dollars on prescription drugs, which is why the AARP has endorsed our reform efforts.
Not all of the cost savings measures I just mentioned were contained in Congress's draft legislation, but we are now seeing broad agreement thanks to the work that was done over the last few days. So even though we still have a few issues to work out, what's remarkable at this point is not how far we have left to go - it's how far we have already come.
I understand how easy it is for this town to become consumed in the game of politics - to turn every issue into running tally of who's up and who's down. I've heard that one Republican strategist told his party that even though they may want to compromise, it's better politics to "go for the kill." Another Republican Senator said that defeating health reform is about "breaking" me.
So let me be clear: This isn't about me. I have great health insurance, and so does every Member of Congress. This debate is about the letters I read when I sit in the Oval Office every day, and the stories I hear at town hall meetings. This is about the woman in Colorado who paid $700 a month to her insurance company only to find out that they wouldn't pay a dime for her cancer treatment - who had to use up her retirement funds to save her own life. This is about the middle-class college graduate from Maryland whose health insurance expired when he changed jobs, and woke up from emergency surgery with $10,000 in debt. This is about every family, every business, and every taxpayer who continues to shoulder the burden of a problem that Washington has failed to solve for decades.
This debate is not a game for these Americans, and they cannot afford to wait for reform any longer. They are counting on us to get this done. They are looking to us for leadership. And we must not let them down. We will pass reform that lowers cost, promotes choice, and provides coverage that every American can count on. And we will do it this year. And with that, I'll take your questions.