1. “Another 396,000 have the ability to gain access to Medicaid under the Affordable Care Act. That’s been less reported on, but it shouldn’t be.”
Much of the coverage of the release of data Wednesday on the new health care law focused on the approximately 106,000 Americans who have enrolled in health insurance plans in which they must pay for premiums. In part because of the failures of HealthCare.gov, that number fell far short of an internal administration estimate that 500,000 would enroll in the month of October.
But expanding Medicaid is a major part of the new law as well, targeting individuals who earn less than $16,000 each year and families with incomes below $32,000. The law was designed in part to address the challenge of getting health insurance for low-income adults without children who were often not covered under state Medicaid programs before the ACA.
Obama was prodding the media to cover the Medicaid expansion as much as the challenges from HealthCare.gov and for people who have lost their insurance coverage because of the ACA.
2 “My intention in terms of winning back the confidence of the American people is just to work as hard as I can, identify the problems that we’ve got, make sure that we’re fixing them, whether it’s a website, whether it is making sure that folks who got these cancellation notices get help, we’re just going to keep on chipping away at this until the job is done.”
Obama, in his answer, conceded what had been in a question from one of the journalists: Some Americans have lost confidence in his leadership because of the health care rollout, and he must earn that back. This was an important moment. In the past, Obama has often dismissed questions about his poll numbers sliding down or media commentary criticizing some aspects of his presidency.
Not in this case. Obama is admitting a policy failure (the website and the inability of people to keep their current insurance plans) and a communications failure (his confident remarks that people would be able to keep their insurance) and pledging to fix both.
“Am I going to have to do some work to rebuild confidence around some of our initiatives? Yeah,” he said later in the press conference. “But part of — part of this job is, the things that go right, you guys aren’t going to write about. The things that go wrong get prominent attention; that’s how it’s always been. That’s not unique to me as president, and I’m up to the challenge. We’re going to get this done.”
3. “That’s on me.”
In explaining why his original pledge that people would be able to keep their insurance had not turned out to be true, Obama was apologetic and frank. And throughout the press conference, he admitted mistakes.
“I make no apologies for us taking this on because somebody, sooner or later, had to do it,” Obama said, referring to the broader health care reform effort. “I do make apologies for not having executed better over the last several months.”
4. “Our failure to roll out the ACA smoothly has put a burden on Democrats, whether they’re running or not, because they stood up and supported this effort through thick and thin, and, you know, I feel deeply responsible for making it harder for them rather than easier for them.”
‘Fellow Democrats — particularly in Congress — the president is sorry,’ was the obvious message here. Obama twice made reference to those in his party who had backed him in the past and believed and often repeated his assurances that people who had health care plans already would be able to keep them under the ACA.
The press conference was designed in part to get Democrats in Congress and outside (like Bill Clinton) to stop criticizing the White House or publicly suggesting changes to the ACA and simply give the president’s team more time. A public apology to Democratic members of Congress from the president could soften their anger and get them to keep more of their concerns in private.
5. “In terms of what happens on November 30th or December 1st, I think it’s fair to say that the improvement will be marked and noticeable. You know, the website will work much better on November 30th, December 1st, than it worked certainly on October 1st. That’s a pretty low bar. It’ll be working a lot better than it is — it was last week and will be working better than it was this week, which means that the majority of people who go to the website will see a website that is working the way it’s supposed to.”
Earlier this month, administration officials were speaking in very confident terms about the website HealthCare.gov operating efficiently by Nov. 30. They have stopped, as it becomes more clear the website struggles may remain for a long time. Some Obama administration officials have pledged the website will work well for the “vast majority” of users by Nov. 30, but the president himself just said “majority.”
His comments were careful and measured on the website progress, without the comparisons with Kayak.com and other popular, easy-to-use consumer websites that he used to make.
“Buying health insurance is never going to be like buying a song on iTunes,” he said.