Obama Q+A at the 2010 House Republican retreat: on Health Care

Barack Obama: High-risk pool for uninsured, now in plan, was GOP idea

Creating a high-risk pool for uninsured folks with preexisting conditions, that wasn't my idea, it was Senator McCain's. And I supported it, and it got incorporated into our approach. Allowing insurance companies to sell coverage across state lines to add choice and competition--that's a [GOP] idea that was incorporated into our package. And I support it, provided that we do it hand in hand with broader reforms. So when you say I ought to be willing to accept Republican ideas on health care, let's be clear: I have.

Barack Obama: Healthcare debate mostly televised, but could have had more

Pres. OBAMA: If you look at the health care process--overwhelmingly the majority of it actually was on C-SPAN, because it was taking place in congressional hearings in which you guys were participating. Now, I kicked it off, by the way, with a meeting with many of you, including your key leadership. I take responsibility for not having structured it in a way where it was all taking place in one place that could be filmed. How to do that logistically would not have been as easy as it sounds, because you're shuttling back and forth between the House, different offices, different legislators. But I think it's a legitimate criticism. So on that one, I take responsibility.

Barack Obama: Cross-state-line insurance leads to cherry-picking

Pres. OBAMA: Actually, I've gotten many of your ideas. Some of the ideas we have embraced in our package Some of them are embraced with caveats. So let me give you an example. One of the proposals that has been focused on by the Republicans as a way to reduce costs is allowing insurance companies to sell across state lines. We actually include that as part of our approach. But the caveat is, we've got to do so with some minimum standards, because otherwise what happens is that you could have insurance companies circumvent a whole bunch of state regulations--mammograms as part of preventive care, for example. Part of what could happen is insurance companies could go into states and cherry-pick and just get those who are healthiest and leave behind those who are least healthy, which would raise everybody's premiums who weren't healthy.

Barack Obama: Ideas and solutions must pass some test of realism

Pres. OBAMA: I don't think I said that. What I said was, within the context of health care, I welcome ideas that you might provide. I didn't say that you haven't provided ideas.

Rep. PRICE: Mr. President, multiple times, from your administration, there have come statements that Republicans have no ideas and no solutions. In spite of the fact that we've offered positive solutions to all of the challenges we face.

Pres. OBAMA: If you say, "We can offer coverage for all Americans, and it won't cost a penny," that's just not true. So I am absolutely committed to working with you on these issues, but it can't just be political assertions that aren't substantiated when it comes to the actual details of policy. So there's got to be some test of realism in any of these proposals, mine included.

Barack Obama: Tort reform only saves $5B per year; not enough to matter

Pres. OBAMA: I am willing to work with you tort reform, but the CBO says, at best, this could reduce health care costs relative to where they're growing by a couple of percent, or save $5 billion a year, and it will not bend the cost curve long term or reduce premiums significantly. If we're going to do multi-state insurance so that people can go across state lines, I've got to be able to go to an independent health care expert, who can tell me that this won't result in cherry-picking and the least healthy being worse off. I've read your legislation, and the good ideas we take.

Barack Obama: Medicare is major driver of our long-term liabilities

Rep. RYAN: No.

Pres. OBAMA: No?

Rep. RYAN: People 55 and above are grandfathered in.

Pres. OBAMA: But just for future beneficiaries, the basic idea would be that at some point we hold Medicare cost per recipient constant as a way of making sure that that doesn't go way out of whack, right?

Rep. RYAN: We drew it as a blend of inflation and health inflation. Medicare is a $38 trillion unfunded liability-- it has to be reformed for younger generations because it's going bankrupt. And the premise of our idea is, why not give people the same kind of health care plan we here have in Congress?

Jason Chaffetz: Healthcare debate should all be televised, as promised

Pres. OBAMA: If you look at the health care process--overwhelmingly the majority of it actually was on C-SPAN, because it was taking place in congressional hearings in which you guys were participating. Now, I kicked it off, by the way, with a meeting with many of you, including your key leadership. I take responsibility for not having structured it in a way where it was all taking place in one place that could be filmed. How to do that logistically would not have been as easy as it sounds, because you're shuttling back and forth between the House, different offices, different legislators. But I think it's a legitimate criticism. So on that one, I take responsibility.

Marsha Blackburn: Reform by reducing bureaucracy and reducing costs

Pres. OBAMA: Actually, I've gotten many of your ideas. One of the proposals is allowing insurance companies to sell across state lines. We actually include that a part of our approach. But we've got to do so with some minimum standards, because otherwise insurance companies cherry-pick and just get those who are healthiest and leave behind those who are least healthy.

Paul Ryan: Medicare is a $38 trillion unfunded liability--add vouchers

Rep. RYAN: No.

Pres. OBAMA: No?

Rep. RYAN: People 55 and above are grandfathered in.

Pres. OBAMA: But just for future beneficiaries, the basic idea would be that at some point we hold Medicare cost per recipient constant as a way of making sure that that doesn't go way out of whack, right?

Rep. RYAN: We drew it as a blend of inflation and health inflation. Medicare is a $38 trillion unfunded liability-- it has to be reformed for younger generations because it's going bankrupt. And the premise of our idea is, why not give people the same kind of health care plan we here have in Congress?

Tom Price: Republicans have offered ideas and solutions on healthcare

Pres. OBAMA: I don't think I said that. What I said was, within the context of health care, I welcome ideas that you might provide. I didn't say that you haven't provided ideas.

Rep. PRICE: Mr. President, multiple times, from your administration, there have come statements that Republicans have no ideas and no solutions. In spite of the fact that we've offered positive solutions to all of the challenges we face.

Pres. OBAMA: If you say, "We can offer coverage for all Americans, and it won't cost a penny," that's just not true. So I am absolutely committed to working with you on these issues, but it can't just be political assertions that aren't substantiated when it comes to the actual details of policy. So there's got to be some test of realism in any of these proposals, mine included.

Tom Price: Address lawsuit abuse; it doesn't raise taxes by a penny

Pres. OBAMA: I am willing to work with you tort reform, but the CBO says, at best, this could reduce health care costs relative to where they're growing by a couple of percent, or save $5 billion a year, and it will not bend the cost curve long term or reduce premiums significantly. If we're going to do multi-state insurance so that people can go across state lines, I've got to be able to go to an independent health care expert, who can tell me that this won't result in cherry-picking and the least healthy being worse off. I've read your legislation, and the good ideas we take.