Press Briefing by Press Secretary Jay Carney, 11/15/2013
James S. Brady Press Briefing Room
1:00 P.M. EST
MR. CARNEY: Good afternoon, ladies and gentlemen. Happy Friday. Thanks for being here. Did I hear a yay for Friday? Let's hear it for Friday.
Q A little premature for a yay. It's only 1:00 p.m.
MR. CARNEY: It is Friday. Wait, are you -- (laughter) -- are you questioning the premise of the assertion that it's Friday? (Laughter.)
Q It is Friday.
Q He’s still bitter he went to Cleveland, and the President had a press conference.
MR. CARNEY: You're bitter the President had a press conference?
Q Knoller was in Cleveland.
Q He was in Cleveland.
MR. CARNEY: Oh, Mark, I'm sorry.
Q He got a free roll of steel.
MR. CARNEY: Can we make sure that doesn’t happen again?
Q Thank you. (Laughter.)
Q Cleveland feels the same way.
MR. CARNEY: Cleveland was fantastic. That factory is unbelievable. Those rolls of steel --
Q Rolls of steel. Quite amazing.
MR. CARNEY: Quite amazing.
Q They gave us souvenir rolls. They're about 50 tons.
MR. CARNEY: They probably didn’t weigh -- yes. Didn’t the -- I think somebody told me, I'm not sure it's accurate, that one of those rolls was 40,000 pounds. Is that -- that’s a lot of --
Q Yes, 40 tons, something like that.
Q I think our hour is up. Good visit.
Q We missed all that. We were busy here.
MR. CARNEY: Oh, sorry about that. So my only topper here is that I do have a hard stop at 1:50 so we'll get right to your questions. At the end of questions, I do have a week ahead for you. Jim.
Q Thanks, Jay. The President is meeting with insurance company CEOs this afternoon. It seems that the announcement yesterday is getting some pushback and second-guessing from the industry, from actuaries, from even some insurance commissioners who say that it could result in higher premiums. And I'm wondering whether this meeting is something that should have taken place ahead of time, rather than after the fact. And does the White House accept or disagree with this possibility that premiums could increase because of this decision?
MR. CARNEY: Well, there's a couple of issues here. We do disagree with the assertion that this is not something that cannot be dealt with. In fact, part of the fix that the President announced was instructions to -- included instructions to HHS to adjust the risk corridor -- what's called the risk corridor, the policy that allows for adjustments if, for example, the pool is less healthy than expected or more healthy than expected, and there are cost changes accordingly.
So we believe -- I mean, there’s a lot of data here about the portion of the population that’s affected here. The fact that there’s a myth about -- while there are healthy people, generally, healthier people generally in the individual market -- because insurance companies could discriminate against those who weren’t healthy -- the fact is that it’s a myth that they’re particularly young in the individual market. In fact, there’s data that shows that the disproportionate number of people in the insurance market are older Americans, are 40 and up.
So having said that, as this policy rolls out, and allowing those with plans in the individual market to renew those plans for a more extended period of time, HHS has the capacity to adjust the risk corridor accordingly, if necessary.
Q But you still -- I mean, you have actuaries saying -- I mean, is it because they’re not taking into account what HHS will be able to do? Is that what you’re saying?
MR. CARNEY: Well, I haven’t seen the actuaries’ reports. What I’m saying is that HHS has the capacity, because of the provision within the ACA, to make adjustments in this risk corridor to deal with changes in costs, swings in costs associated with either more or less risk within the pool of people insured. So, I mean, the way it works is if the costs are higher, then HHS can mitigate those costs with insurers. If costs come in significantly lower, then the insurers replenish the fund by passing back some of those profits back.
So we believe there’s a mechanism here to deal with any swings associated with this provision -- which, remember, again, the size of the population we’re talking about here: 5 percent of the country is in the individual insurance market; a portion of that 5 percent is affected by the cancellation notices. And what the fix the President announced allows is for -- it basically removes the prohibition from the ACA that said those policies could not be renewed from 2014 into 2015.
This is something we haven’t talked a lot about, but even under the law, prior to the President’s announcement yesterday, insurers were able to offer renewals of these policies, early renewals of these policies to their policyholders. And so this extends that possibility so that if you had a plan that was effective through September of next year, you could renew it so that it could go all the way through August 31st, say, of 2015.
So it’s a way of smoothing the transition. It’s a way of making an adjustment in response to the problems we saw with the cancellation notices and with that segment of the 5 percent that was put in this position where they did not feel that they had the opportunity to take advantage of marketplace plans that would reduce their costs or keep costs the same. And the President made clear that he feels like a fix was necessary. So he looks forward to the implementation of this, looks forward to working with Congress on any sincere effort, good-faith effort, to make improvements to the Affordable Care Act as we implement it.
Q And having announced the fix yesterday and having this meeting today, didn’t that put the cart before the horse?
MR. CARNEY: Well, Jim, I think it is absolutely the case that we have been in consultation with and have had numerous meetings with insurance companies over the course of the last several years with the drafting and passing and implementation of the Affordable Care Act. And those consultations continue. The President looks forward to the meeting he’s having later this afternoon with insurers and will talk about ways we can work together to help people enroll through the marketplace and efforts we can make to minimize disruption for consumers as they transition to new coverage.
Q And last, given the numbers, the enrollment numbers, has the White House given any consideration or have you set aside any thought of extending a waiver period for the mandatory -- the individual mandate so that it doesn’t kick in on March 31st as it’s scheduled to do?
MR. CARNEY: Jim, as we’ve said all along, the individual responsibility provision is essential to the Affordable Care Act because it is what ensures that individuals with preexisting conditions cannot be denied insurance. It allows for the rest of the Affordable Care Act to be implemented effectively so that the benefits that the American people deserve are able to be distributed.
So we are obviously working on a tighter time frame because of the problems with the website and the slowness associated with the rollout and the enrollment period. But we do have a six-month enrollment period; we are a month-and-a-half into that. So we're working assiduously to make improvements to the website so that that experience continues to get better for consumers, and more and more Americans are able to enroll.
Q So under no circumstance would there be a consideration to extend?
MR. CARNEY: Well, I’m not going to speculate about the future. What I’m going to tell you is that right now we are focused on making the changes and fixes necessary to the website, to improve that experience for consumers, and also to work in a variety of ways to make it easier for Americans to enroll.
One of the things that remains true is that there's enormous interest in the quality, affordable coverage available on the marketplaces. And where we were unsuccessful is in making that access to that coverage easy from day one, October 1st. And as the President, I think, made clear to you here yesterday, he takes responsibility for that, we take responsibility for that, and we're about the business of making the fixes necessary to ensure that those benefits are available to the American people who so clearly want them.
Q Jay, Henry Chao was raising red flags back in July about the website, saying the plane could crash on takeoff. Was the White House aware of these concerns at the time?
MR. CARNEY: Steve, we've said all along -- I know that there's these selective leaks going on out of various House committees, as they conduct oversight into this. But we've said all along that there were, in the testing of this, instances where there were problems that were identified, and fixes that were undertaken to the website.
What we did not expect was that we would have the size problem that we had, come October 1st. And if we had expected that, we wouldn't have been promoting the launch of the website and the run-up to it in the way that we were. The President was very candid about that. I mean, it does not stand the test of logic to suggest that we somehow knew that this website would perform as poorly as it did, and a week before, or four days before, were encouraging people to go to it and talking about how it would be fairly functional and effective.
So there's no question -- if the point of these selective leaks is to get everybody to recognize that the website performed terribly on October 1st, I don't think that's a point that anybody here is denying. So what we're focused on is making the fixes necessary so that the website works in the way that it was intended to.
Q And a budget question. You would like to extend unemployment benefits. What offsets in the budget are you willing to consider to make that happen?
MR. CARNEY: I appreciate the question. I think that while we have made substantial progress in bringing the economy back from the brink, there is no question that there are still too many Americans out of work. And as a nation, we have always taken the approach that in addition to the basic unemployment benefits available to those who lose their jobs and are looking for work, emergency unemployment compensation should be available in times when the labor market is not at full strength. And while the labor market has been improving, it is not, clearly, at full strength.
At the end of the year, emergency unemployment compensation is set to expire, and that means that 1.3 million unemployed Americans will lose unemployment insurance benefits. These benefits are crucial for maintaining incomes of the unemployed and their families, and have been shown to reduce poverty and increase the chances of returning the unemployed worker to a good job.
Independent studies have also shown that in terms of economic impact, these benefits have a big bang for the buck -- because as you know, and anybody who covers these kinds of issues knows, those benefits flow right back into the economy because, almost by definition, those who are strapped and need unemployment benefits are using the benefits that they've received right away, and spending them and injecting that money into the economy, which helps spur growth and create jobs.
So as Gene Sperling mentioned yesterday -- I think that's why I'm getting the question you mentioned yesterday -- that the President believes we should extend this provision through the end of 2014, and we are confident that Congress will join us in this effort. And we're confident of that, because if you look back, unemployment compensation, emergency unemployment compensation, has always been extended when the unemployment rate is near current levels. That was the case under President George W. Bush and it's been the case in the aftermath or in the recovery from the Great Recession.
So we'll work with Congress for how to make that happen. But we're confident that Congress will join us in extending these benefits.
Let me move around. Victoria.
Q The question is, the whistleblowers yesterday at a committee hearing were talking about the Secret Service's apparent sexcapades in 17 countries and visiting bordellos, hiring prostitutes, having one-night stands as well as longer-term relationships with foreign nationals who have not been cleared. Given this level of what seems to be inappropriate sexual activity going on with the Secret Service, what is the President's level of confidence in them at this point?
THE PRESIDENT: The President believes deeply that the vast majority of the men and women who work for the U.S. Secret Service exemplify the highest standards of service, and that they work day and night professionally to protect the President and presidents before him, and presidents -- and they will after him, as well his family and presidential families as well as other protectees.
Issues that have arisen, including the visit to Colombia and other issues that arise, the President is confident that they will be fully investigated and that action where appropriate will be taken. And he believes that the leadership at the Secret Service, including the new director, will address matters as they arise appropriately.
But it is important to note that the President believes very strongly that these men and women are professionals and that they put their lives on the line to protect the Commander-in-Chief, protect the President, protect his or her family. And that's a very weighty responsibility, and he greatly appreciates it.
Q Does he think that the new director has taken swift action to act on the kinds of allegations that have been in place before she came in?
MR. CARNEY: I know that the President believes very strongly that Director Pierson is the right person for the job and has great confidence in her leadership. I don’t have a specific reaction to any investigation that might be ongoing or accusations that might be leveled currently, except to say that the President has absolute confidence in the leadership at the Secret Service.
Q Question about this insurance fix the President announced yesterday. It does introduce a little bit of uncertainty here. So what advice would you guys give, if any, to these people who have gotten these cancellation letters? Do they call their insurance company back? Do they call the state insurance commissioners? Do they keep trying to log on? What should they do sort of in the meantime, trying to figure out whether their companies are going to offer this to them?
MR. CARNEY: Well, a couple of things. One, what the President did and can do -- and the Secretary has the authority to do -- is essentially waive the provision within the Affordable Care Act that would make plans beyond the current early enrollment phase become compliant with minimum standards. And, obviously, because we have a system where state insurance commissioners have great authority over the markets in their states, this is something that insurance companies and insurance commissioners will make the ultimate decision on, in terms of offering to extend the renewal period or to offer to renew policies in the individual market where cancellation notices might have gone out.
What is also required in the fix that the President announced yesterday is that if that offer is made, insurers need to make clear to their customers what benefits are available to them or the fact that benefits are available to them through the marketplace, and also what benefits that might come to them under the new standards are missing in the plans that they might be renewing. So it's basically eyes wide open is the way -- so that the consumers have the most amount of information possible as they make this decision.
And the whole goal here is to address the problem that has arisen and to give consumers more options as they begin this transition into an insurance marketplace where, over the long run, costs will be contained, minimum benefits will be offered, and you won't be in a situation which has existed up to this very moment where if you're in the individual market you tend to be doing okay as long as you're healthy -- because, A, you'll be offered insurance if you're healthy and you might be thrown off insurance once you get sick; but you’ll also, in this current environment, you might pay more if you're a woman, you might pay double, even, for the same coverage, and you might find that you do not have caps on out-of-pocket expenses, so you could be confronted with a $40,000 or $50,000 bill that’s not covered.
These are the kinds of things that the Affordable Care Act was designed to fix. And what the President announced yesterday was a solution to a problem that helps the transition into those marketplaces occur more smoothly.
Q But it sounds like people who are affected here won't necessarily know for some time whether it's going to be fixed for them.
MR. CARNEY: We believe that insurers certainly can generate letters, just like they did already, to their customers that advise them of this new opportunity if they choose to make that opportunity available to them, and if there is time to do that.
So we're obviously going to be working with insurers and working with states on this matter. But we believe there is time, and we believe it's a solution to a problem that has clearly arisen that the President wants addressed.
Q One more larger one. We know that the Affordable Care Act has been under fire from the very beginning -- the problems with the website, this issue of people getting these cancellation letters that have only made matters worse. So the question is, what do you say to the folks who are wondering if the President is going to be able to get back on track and be able to have a productive second term, get his agenda through legislatively? So how's he going to do that? What do you say to those folks?
MR. CARNEY: Look, I think he's going to do it by waking up every day and focusing on addressing the concerns that the American people have, that they want their elected leaders here in Washington to focus on. And that means, in this case, making the Affordable Care Act deliver on its promise, deliver the benefits that it will provide, when implemented, to millions and millions of Americans.
There's no question that this has been a problem in its rolling out of the policy, as the President I think pretty amply acknowledged yesterday. But this is an issue that goes to whether or not we are successfully delivering benefits to the American people, delivering on a policy that promises to continue to rein in health care spending over the long term, that provides minimum benefits to Americans that prohibits insurance companies from denying you coverage because you have even a minor preexisting condition.
This is obviously a challenge and we’re facing the challenge and we’re up to the challenge, but when it comes to what it means more broadly, I think it just goes right to the heart of the fact that the American people want their elected leaders working for them. And this President wakes up every day focused on what he can do to work for the hardworking Americans and make their lives a little easier, a little better, and a little more secure. That’s what he’s going to do every day that he is in office.
Q Jay, we’ve already heard from three state insurance commissioners that say the President’s plan simply is not workable. I mean, what is that going to do for people in those states? Washington State, Arkansas, Vermont -- all those insurance commissioners said this just won’t work, they’re not going to do it.
MR. CARNEY: Well, Jon, I can also cite Kentucky, Florida, and California, I think collectively even a higher population -- states that have said they will -- they’ve announced that they will allow insurers to renew these plans under this policy. And the fact is --
Q So states that do it are okay? States that don’t, those people are out of luck?
MR. CARNEY: Well, Jon, what you are identifying is the insurance world that we live in, in the United States, where state insurance commissions obviously have a great deal of authority about how insurance is marketed and sold in their state. So we are going to work with states. It has always been the case, even up to -- as I noted earlier and this is rarely acknowledged or discussed -- but that the Affordable Care Act has within it the provision that allows insurance companies in those states where the state insurance commissions allow it, to renew existing policies already. And that was true prior to the problems that we’ve seen in the last several weeks with cancellation notices.
What the President’s fix does is extend that renewal period. But it has always been the case -- because, as the President said yesterday, we were trying to build on the existing system to cause the least amount of disruption -- state insurance commissions have authority in their states to govern how policies are marketed and sold, and to set standards for those policies.
Q So what do you say to Bill Fullner, he’s the guy in Washington State, cancelled -- his insurance policy was cancelled, he was out of luck, took great hope in what the President had said, and then a few hours later finds out that it’s not going to apply to him because his insurance commissioner says the plan is not workable?
MR. CARNEY: Jon, I would say that what the President said yesterday is that he wants to continue to work with lawmakers of both parties who are engaged in a good-faith effort to make improvements to the Affordable Care Act and even to address this particular issue. The fact of --
Q But he’s losing his insurance at the end of the year and is faced now with paying a premium twice as expensive.
MR. CARNEY: Well, as has always been the case, I don’t know any -- when you throw out an individual to me, I can’t -- I don’t have a capacity --
Q This would apply to anybody who had a cancellation notice in Washington State.
MR. CARNEY: Well, no, it wouldn’t apply -- what you just cited about the premium wouldn’t necessarily apply to every individual. What the fact of the matter is -- and these cases aren’t usually brought into the briefing room here -- that more than half of people who get --
Q These are real people. I mean, it’s --
MR. CARNEY: Oh, absolutely. And I think you heard the President here at length talk about his concern for those people, and that’s why he’s making this fix, and why he is going to work every day to do what he can and then to work with Congress so that they can do what they can to make the Affordable Care Act implementation go more smoothly and work effectively for the American people.
What is absolutely the case, Jon, is that the Affordable Care Act, when implemented, will allow Americans across the country, millions of Americans, to purchase affordable, quality health insurance for many of whom that was something that was not possible before. And even as we deal with the problems that are arising with the implementation of the Affordable Care Act, it is absolutely essential that we remember what the alternative here is. And the President talked about this a little bit yesterday. When critics point out -- and they justifiably point out the problems with implementation -- and then they say, well, we should then do away with Obamacare, we should do away with the Affordable Care Act, they are saying that they want to go back to the status quo ante -- which in this market, I don’t know about this individual, but anybody in the individual market was subjected to extreme increases annually in their premiums, to a situation where insurance companies regularly either dropped or abruptly changed the policies that were offered to them, downgrading the coverage that was offered to individuals.
And that's why -- and to some degree, one of the reasons why we’re seeing this problem is because there has been and is so much churn in that market -- so that the number of people who got cancellation notices was as high as it was because so few policies are maintained for very long, because individuals come in and out of that market because it’s the worst place to be. It has traditionally been the worst place to be.
So if you’re somebody who buys an individual policy because you have to, because you’re in between jobs, or you have a job where your employer doesn't offer it, and then you get a job with an employer who does, you’re going to go with the employer-provided insurance because the benefits currently available on the insurance market are often substandard, and that is something that the Affordable Care Act was specifically designed to address.
Q So one more. Can I just ask you -- the President said yesterday, “I was not informed directly that the website would not be working the way it was supposed to.” I mean, we’ve heard the latest is the project manager on healthcare.gov warned -- was worried this thing could crash at takeoff. I’m just wondering, did the President at any point ask the question, has this thing been tested; are we ready to go? And what was the answer he got?
MR. CARNEY: Jon, the President was regularly briefed on the implementation of the Affordable Care Act in the run-up to the launch. What he and others have said is that at no time did we anticipate that the problems that we ended up seeing on October 1st would occur. And if we had --
Q I get it. But the people working on this knew that there were problems and were worried this could happen.
MR. CARNEY: No, I get it.
Q And I’m just asking, did the President ask the question, has it been tested?
MR. CARNEY: Absolutely, the President constantly asked where we were and what was the progress on --
Q So who misled him if they knew of these problems and didn't disclose it to him?
MR. CARNEY: Again, there’s a jump in your logic there. The fact is, as we acknowledged and have said since October 1st and even before that, we anticipated glitches. We were told there might be some problems. And as is the case when any site --
Q The project manager was worried this could crash at takeoff.
MR. CARNEY: Could I finish? Hey, Jon, I know we’re creating an exchange here. But if I could just exchange -- finish for one second, that the fact is when a site like this is being developed and it’s tested and problems arise, checklists are developed and problems are addressed. And we believed that the problems were being addressed, and that while there would be some glitches upon launch on October 1st, that, obviously, we never anticipated that we would have the kind of severe problems that we had -- that the site would function as poorly as it did.
And I really ask for everyone to take a step back and look at the logic here of suggesting that somehow we or anybody responsible for it knew that we would have the problems that we had on October 1st.
Q But the project manager is saying that he was worried that it could crash on takeoff.
MR. CARNEY: I addressed this when Steve asked it already a few minutes ago.
Q This isn't about glitches, this is crashing. I mean, this is -- he seemed worried about something bigger than that.
MR. CARNEY: Again, I think that -- I think it would be -- I would advise everyone who is susceptible to taking these partial transcript leaks from committee staff -- and I think again and again we've seen when the full story is revealed that committee staff hasn’t really been completely transparent with you and others -- that it would be wise to look at the whole story. And that would be the case in this instance, and I think almost invariably the case when committee staff is trying to make a political point.
There is no question that this goes to -- the fundamental issue is: Has the website functioned effectively? Absolutely not. And nobody is more aware of that or frustrated by it than the President and the people who work for him on this issue. That’s why we're focused on fixing it and not focused on dribbling out information to score political points. We're focused on getting it right, because this is about a policy that will deliver benefits to millions of American people who deserve them and have earned them.
Q As you know, Senator Lindsey Graham has threatened to put a hold on all confirmations presented by the President, including that of Janet Yellen, the new Chair of the Federal Reserve, until he receives information he's requested on Benghazi. What steps is the administration taking to resolve this issue and ensure the confirmation of Ms. Yellen, and continuity at the Federal Reserve, which in fact could affect world markets?
MR. CARNEY: We're very confident that Janet Yellen is absolutely the right candidate for the job. Her hearing yesterday, we felt, went very well, and it offered an opportunity for her to take questions from committee members of both parties.
When it comes to Benghazi, we have -- and I will spare everyone here the recitation of the amount of cooperation that we have shown oversight committees with reams of documents and numerous interviews and testimony in hearings. And that continues. So we are working with Congress on this as we always do. And we absolutely believe that the President's highly qualified nominees should not be held, they should be given the votes that they deserve. And we look forward to their confirmation.
Q Yes, do you have either a firm number or a pretty good estimate of the number of cancellation letters that have actually gone out nationwide?
MR. CARNEY: I meant to mention it -- I think it's this afternoon -- CMS is doing its regular briefing, and I would encourage you to participate in those briefings. They're going to have more detailed information. I don’t know if they have a number on that. The reports in the press vary widely. I think that one -- I think it's important to note that when you look at the number of people who, for example, get benefits in the marketplaces, tax credits and the like, it’s 17 million. And I think the largest number I've seen, in terms of cancellation letters, is 3.5 million, and I don't even know if that's accurate. So I would refer you to CMS.
Q You implied a second ago that there's a fuller story about Mr. Chao's testimony, that Jonathan referred to. Would you like to try to --
MR. CARNEY: No, I'm simply saying that it has been the case again and again and again, with certain committees, that partial information is produced or leaked to reporters or put out in press releases that, upon further scrutiny, is not quite what they say it was. What I --
Q Do you have any reason to dispute what that represents him thinking and fearing before the launch of the website?
MR. CARNEY: What I can tell you is that there is certainly -- it is certainly the case that in the period leading up to the launch, that individuals involved in it saw problems that needed fixing, and those problems were identified and addressed. We believed they were addressed sufficiently so that the site would launch with some glitches, but effectively, on October 1st. And that did not happen.
So again, the logic around this is to suggest that somehow inside the administration, we all knew, or somebody knew, that the thing was not going to work effectively October 1st, and yet we were out there talking about the importance of the launch on October 1st and how everybody should go to the website and take advantage of it. I don't think if you follow that logic to its conclusion that it makes any sense at all.
The fact is we did not anticipate that the problems that occurred on October 1st and in the aftermath were going to happen. We thought there were would be some glitches, as there are with the launches of major websites, but not on the scale that we ended up seeing.
Q Would you acknowledge that what the President announced yesterday will be difficult for insurance companies to deal with? They've already raised some just practical issues. They'll have to contact their consumers -- their customers, rather. They'll have to recalculate their premiums. And they'll have to --
MR. CARNEY: Premiums are locked in for 2014. They are locked in and set. That is a fact.
Q They don't have to recalculate them by re-issuing policies that have been canceled? Won't that affect some of those calculations?
MR. CARNEY: The fact of the matter is that any of the existing -- I mean, this is one of the things that consumers need to be aware of -- that as was the case always in the individual market, which was the least regulated portion of the insurance market, these policies were subject to substantial premium increases. It happened all the time. The average was 15 percent. And they were also subject to downgrading on a regular basis, or where individuals had a policy for a year, but if they got sick that year, then they could be dropped.
None of that exists now. In the Affordable Care Act and in the marketplaces, there are protections in place for those individuals. If you choose to renew that existing policy, you need to do so, understanding -- and this is where we're asking the insurance companies to make it clear to their consumers these facts -- that you do not get obviously the tax credits that might be available to you, but also some of the other protections that would come with policies that fit the minimum standards under the Affordable Care Act.
Q Do you have any idea or estimate of how many people actually fall into this particular category? Because it's a broader -- it's a smaller category than the individual market itself.
MR. CARNEY: No, I think this is what Cheryl was asking. And I don't -- I've seen a lot of reports. I would encourage you to participate in the CMS briefings that they have. They may have more detail about this. I think the reports have varied. It is a portion of the 5 percent of the population that participates in the individual market. What we know is that of that 5 percent, a million -- what's going on here?
Q No, I was saying it was simulcast. It's underway now.
MR. CARNEY: Well, if anybody wants to go get on that call, you can. You might get answers to the specific question for numbers. But, in any case, of the 5 percent, a million, roughly, would be eligible for Medicaid in those states that have expanded it.
And when we talk about -- I mean, here's, again, context. These individuals are of great concern to the President, the ones who have been adversely affected by this. And he feels a responsibility for taking steps to fix the problem for those individuals, to make that transition smoother; to allow insurance companies and state insurance commissioners to ensure that they can renew their policies, if they so desire, making sure that they're aware of what their alternative are and aware of the fact that their alternatives might be significantly better for them, both in the benefits they receive and the costs that they incur.
One thing that is absolutely the case when we talk about this, again, more globally, is that all those states out there that have refused, for ideological reasons, to expand Medicaid are depriving millions of Americans of insurance coverage. Millions. More than are affected by these cancellation policies. That's a fact, and it's a problematic fact, because a lot of those individuals are veterans who could be getting Medicaid insurance under the expansion of Medicaid, created by the Affordable Care Act, but for ideological reasons, governors have in some states declined to do that. Not all Republican governors. As we know, in Ohio, where the President was yesterday; Arizona, Florida, other states with Republican governors, they have made the decision to do right by their constituents and expand Medicaid and make quality insurance available to millions of low-income Americans who need it.
So we have a problem that we’re trying to fix specific to the section, the subsection of that 5 percent of the population. But there are other issues here that we need to work together to fix, and that’s why we continue to urge governors in states that haven’t expanded Medicaid to do so for their constituents, not because of their -- they may be ideologically opposed to this President or to a health care reform that has his name on it, but the bottom line is they have the opportunity to help their citizens and they ought to.
Q It’s no secret to you that House Democrats and Senate Democrats were urging the President to make public whatever fix he was going to have for this problem before the House vote today on the Upton bill, and to give them a place or a position to take, or a policy response to point to, so they wouldn’t be exposed to this vote on the Upton bill or possibly something else in the Senate. Does the President and the White House believe this fix settles the issue, at least for now, and does not require legislative intervention of the kind that Mary Landrieu and other Senate Democrats are continuing to explore?
MR. CARNEY: The President said in his remarks, in his prepared remarks yesterday, that he wants to work with lawmakers of both parties who are engaged in good-faith efforts to make improvements to the Affordable Care Act so that it --
Q No, but on this particular issue.
MR. CARNEY: That would include on this particular issue. We absolutely do not support and oppose the Upton bill, because whatever the intentions -- and I think House Republican intentions towards the Affordable Care Act have been pretty clear -- but whatever the intentions of that particular bill, it certainly -- while maybe fixing the problem potentially of those who receive cancellation letters -- it also, by allowing insurers to sell new policies to new customers that don’t meet the standards, is deliberately or not designed to undermine the Affordable Care Act in the long run.
And I think you would find if you talked to insurers that they would have serious problems with something like that, because it would undercut the marketplace and it would create a situation that would be very hard to sustain.
Q Since the President can’t compel insurers to renew these policies, what’s he going to say to them to convince them to go along, to persuade them, which I gather is what today’s meeting is about?
MR. CARNEY: Well, look, there are a lot of issues that the President looks forward to discussing with insurers today, when it comes to the implementation of the Affordable Care Act. This is one of them. I think that he will certainly raise with them what this fix does and why he thinks it’s the right thing to do, and encourage them to offer renewals to those customers who might want to avail themselves of that choice.
I mean, the purpose here is to provide a choice, it’s not to compel people to renew or to compel people to choose any particular plan within the marketplace. It’s to make them -- to give them this option, and when you give them this option, to also make them aware of what’s available to them in the marketplace and also make them aware of what they do not get in terms of protections and benefits if they choose to stick with an individual market plan that does not meet the minimum standards of the Affordable Care Act.
Q But it requires insurance companies to act rather swiftly over the next 32 days or so. What will he say to persuade them to make that effort?
MR. CARNEY: Well, I think he will talk about -- and I think there was a very lengthy briefing yesterday in which officials more steeped in the minutiae of the policy tried to explain how it works to reporters. But I think he would explain how he envisioned this working, how we are confident that it would not, for example, on the questions I got at the top of the briefing, create adverse problems for the Affordable Care Act when it came to the risk pools because of the flexibility the Secretary has to make adjustments. And I’m sure those issues will be discussed.
The goal here is to make this transition as smooth as possible for those Americans who have been affected by cancellation notices and may be in a position of finding their best option in their view, the renewal of an existing policy, even if it doesn’t meet minimum standards and doesn’t give the protections that new plans would offer. And this extends that possibility.
It’s important to remember, again, when we talk about the world as it existed before the announcement yesterday, that every insurer in the states where this is allowed could have and could offer renewals of those plans already. What the President announced yesterday would simply extend the period for renewal.
Q What’s his authority for doing this? I ask that in the same way that people ask whether he had the authority to basically waive the mandate for larger businesses. What’s his authority for doing this today?
MR. CARNEY: I know I -- well, the Secretary has the authority under the law to -- here it is. The Secretary’s authority can be used in narrow circumstances to ease implementation, short of legislative changes, and this is one of those instances. There are individuals for whom the implementation of new consumer protections without a transition would result in a loss of an existing plan, even though the law includes a section on the preservation of the right to maintain existing coverage -- what I talked to you about earlier.
So this type of action was used for last year in the administration’s policy on deferred action for childhood arrivals pending immigration reform, for example. That was something that DHS did.
So this is authority that exists for the Secretary to use to help smooth the implementation of this policy.
Peter and then Chris.
Q While we were speaking, the House just passed the Keep Your Health Plan Act, 261 to 157. In simple language, the message from the White House about why that’s bad is what?
MR. CARNEY: This is the Upton bill.
Q Yes, correct.
MR. CARNEY: Because whatever its intentions, the plan would, by allowing insurers to sell substandard policies to new customers -- not simply to renew -- allow those individuals who had those policies and received cancellations to renew them, but to sell those policies to new customers, unlimited number of new customers would undermine the central premise of the Affordable Care Act, which is that there should be minimum standards for everyone and that insurance companies should not be able to in the new marketplaces sell plans that charge Athena twice what they charge you; that put annual caps on what benefits you can receive; that give you doctors’ visits, but not hospitalizations; that give you coverage, but not your child because your child has asthma.
So this is -- the problem with the Upton bill and why we will -- the President will veto it if it ever gets to his desk, is because it would basically -- again, whether this is the intention of the author or not -- it would basically go back to in that market the world that existed before, which I think it's important to remember: Even as we have these legitimate discussions about the problems with the rollout of the Affordable Care Act, it's not a world that most people want us to remain living in for those who have to suffer the vagaries of the insurance market as individuals. So that's why it won't work.
Q Since the President made the “if you like your plan, you can keep your plan” promise, and now already we've heard from at least three states that say they are not going to allow the change from yesterday -- the idea presented by the White House to go forward -- will, A, the President reach out to those states and push them to do that? And then what does he say directly to those individuals in those states who say, Mr. President, you've made those promises to me and now they don't apply to me?
MR. CARNEY: What the President will do and his team will do is work with every state to try to discuss the benefits of this fix --
Q So what do you say to Washington State?
MR. CARNEY: Well, I think I had this question earlier. But the answer is that the President will continue to work -- he is doing -- he did yesterday --
Q Is he disappointed maybe is a better way to put it. I know you answered -- perhaps his thoughts.
MR. CARNEY: He did yesterday what he can do administratively to address this problem. He will work with Congress to do -- so that Congress can do what it can do legislatively in a good-faith effort to address problems, to improve the implementation of the Affordable Care Act. What he won't do is support policies that essentially are designed to sabotage, repeal, undermine the Affordable Care Act.
Q So if people are upset, who should they be upset with? Who should the blame be directed to? Should it be directed to the President, to the state commissioner, or to the insurance company? The insurance companies say you're making people direct the blame toward them.
MR. CARNEY: Two things. One, the President I think accepted an ample amount of responsibility before you yesterday. No question.
Q But it doesn’t fix it for a lot of people even still.
MR. CARNEY: Let's also be clear, and it is absolutely incumbent on anyone who reports on this to be clear about the reality of the individual market -- which is that the things that happen to consumers in that market every year can continue to happen, unless individuals end up in the marketplaces where they have the protections under the Affordable Care Act.
So one of the reasons why we got where we are is because insurers have been able to in that market to sell you a plan because you're healthy. And then, when you get sick during the year that that plan and that contract was in effect, refuse to renew your policy the next year, because you now have a preexisting condition. They again, as I said, could sell you a plan and take the same plan and market it to a woman of the exact same age and the exact same health, and charge her up to twice as much.
So again, this is not about blame. But I think it is important to understand what individuals in that market have been dealing with for a long, long time, and problems in that market that have been real and have nothing to do with the Affordable Care Act, except in the fact that the Affordable Care Act was designed in part to prevent those problems from traveling with us into the future.
Q The President said yesterday there will be an intense evaluation already. He is asking a lot of tough questions of his team to figure out how we got to this point. Has the President done anything, communicated anything to his team to go forward now with some form of after-action report, given the fact that the October 1 deadline has already passed? What is he doing right now for that study to take place?
Q Peter, I think that the answer to that is no, because the President right now has tasked his team -- and everyone involved in this effort -- to the work needed to improve the website and to improve the implementation of the Affordable Care Act and the delivery of the benefits of the Affordable Care Act.
I think there are obviously already efforts underway in Congress to engage in oversight. And what the President is focused on and what his team is focused on is doing the work necessary to make sure that the Affordable Care Act works for the American people.
Q Does he believe that people should be accountable -- even if that process doesn’t happen yet?
MR. CARNEY: I think the President stood up in front of you yesterday, as he did in an interview on your network last week, and took responsibility for the problems that have arisen with the rollout of the Affordable Care Act. He is accountable and his team is accountable. And, no, his team -- and that’s why he has assigned them to work overtime to make these fixes and get it right.
Q Thanks, Jay. Yesterday, Speaker Boehner said that he sees no basis or no need for the Employment Non-Discrimination Act when I asked him at a news conference if he would be open to bringing it up for a vote. Given the repeated statements of opposition from that bill from Republican leadership, is there any reconsideration at the White House to an executive order --MR. CARNEY: Chris, I appreciate the question and the Speaker’s comments of course are disappointing. And I think that those who oppose this legislation are taking the wrong position. And they are taking a position that I think history will prove to be wrong, as has been the case in seminal civil rights legislation throughout our history in this country.
Basic equality is fundamental to who we are as a nation. And our history is, in part, a story of efforts and struggles to reach that ideal where equality is not only an aspiration but a fact. The Employment Non-Discrimination Act is a piece of that story, and it ought to be passed by Congress, passed by the House as it was by the Senate, because this President will sign it into law.
And we believe that we have come a long way -- and I know you and I have had this conversation over the course of the last several years -- and I think that it is fair to say that maybe some close observers of this debate did not believe we would get to where we are now, where the Senate has passed this legislation with bipartisan support. So we are not at all ready to believe that the fight is over in the House, because it is the President’s strong conviction that this is the right thing to do and that the arguments against it do not hold up to scrutiny or the test of history.
So we’re going to keep fighting for the House to take it up and urging the House to take it up. We believe that if it were given a vote on the floor, that it would pass and that Democrats and Republicans would vote yes, and the President would sign it into law. And we believe, as we've discussed, you and I, over the past many months and years, that that is the best solution here. And we're going to continue to fight for it.
Q If the intransigence continues, would the President be open to the idea of threatening to issue the executive order --
MR. CARNEY: Look, I think that we're focused on getting this legislation passed right now, Chris. And for the reasons I just discussed, we believe that resistance to it will eventually fall away, because the rightness of it will prevail.
Let me give you a week ahead, please.
On Sunday, the First Family will attend the Oregon State versus University of Maryland basketball game in College Park, Maryland.
On Monday, the President will attend meetings here at the White House.
On Tuesday, the press will deliver remarks at the White House Journal's CEO Council's annual meeting.
On Wednesday, the President will award the Presidential Medal of Freedom. The First Lady will also attend. The Medal of Freedom is our nation's highest civilian honor, presented to individuals who have made especially meritorious contributions to the security or national interests of the United States, to world peace, or to cultural or other significant public or private endeavors. The medals will be presented at the White House in a morning ceremony.
On Thursday, the President will attend meetings here at the White House.
And on Friday, the press will host King Mohammed VI of Morocco at the White House. The visit will highlight the longstanding friendship between the United States and Morocco, and strengthen our strategic partnership. The President looks forward to discussing a range of issues of mutual interest with the King, including support for Morocco's democratic and economic reforms.
This visit is also an opportunity to increase our cooperation on addressing regional challenges, including countering violent extremism, supporting democratic transitions, and promoting economic development in the Middle East and Africa.
That is your week ahead. Thank you all very much. Have a great weekend.
Q Will you send out a reading --
Q The insurance meeting?
Q Yes, will you send out something after the meeting?
MR. CARNEY: A readout? We'll see.
1:55 P.M. EST
April 19, 2014
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