The White House
Office of the Press Secretary
Press Gaggle by Press Secretary Jay Carney Aboard Air Force One En Route Dallas, Texas
Aboard Air Force One
En Route Dallas, Texas
4:04 P.M. EST
MR. CARNEY: Good afternoon, ladies and gentlemen. Thank you for joining us as we make our way to the great state of Texas, to Dallas. As you know, the President will have an event in Dallas where he will focus on the efforts underway there to educate citizens about their options when it comes to enrolling in the marketplaces associated with the Affordable Care Act.
Dallas is important because Dallas is one of the 10 cities with the highest number of uninsured residents in the country. There are 1.1 million uninsured individuals in the Dallas-Fort Worth metropolitan area who may be eligible for insurance through the new health insurance marketplace. Of these 1.1 million eligible uninsured in the greater Dallas area, 40 percent -- or nearly half a million -- are Latino; 41 percent -- also nearly half a million -- are between the ages of 18 and 35; 80 percent
-- about 900,000 -- have at least one full-time worker in the family. And 550,000 have family incomes below 138 percent of the federal poverty level and may be eligible for Medicaid if the state expanded Medicaid.
The President's visit to Dallas is both a part of that effort and an opportunity to highlight the outreach work being done on the ground. According to the Kaiser Family Foundation, if Texas decided to expand Medicaid, the state's uninsured population would be reduced by over 50 percent by 2016, meaning an additional 1.2 million Texans would gain coverage. In addition, Kaiser estimates that expanding Medicaid could save Texans $1.7 billion in costs incurred as a result of uncompensated care over the next 10 years.
Now, imagine that -- expanding Medicaid would both significantly cut the ranks of uninsured individuals in Texas. That would be a positive I would think for a lawmaker of any party or a governor of any party in that state. It would also -- according to Kaiser, could potentially save the state $1.7 billion in costs incurred as a result of uncompensated care over the next 10 years. So that sounds like a pretty good deal to me. It certainly sounds like a pretty good deal to the President. So he looks forward to discussing that when we get to Texas.
I would note that there's an interesting University of Texas-Texas Tribune poll that was released today that while it notes that Obamacare -- or the Affordable Care Act -- is not particularly popular in that state, which may not come as a surprise given its status as a red state, in fact, many of the components of the Affordable Care Act are quite popular. Two-thirds of voters support giving states the option to expand Medicaid programs for low-income, uninsured adults. Three-quarters of Texans -- Texas voters, rather -- like the idea of tax credits for small businesses that offer health insurance to their employees. Nearly as many, 73 percent, support the creation of health care marketplaces where small businesses and people without health coverage can shop for it.
Prohibiting insurance companies from denying coverage because of preexisting conditions has the support of 76 percent of registered Texas voters, and 61 percent, led by Democratic and independent voters, said they would support increasing the Medicare payroll tax on upper-income Americans.
A slight majority of Republicans support allowing children to stay on their parents’ health insurance until age 26, but independents are more strongly in favor and Democrats overwhelmingly support that provision. So, again, many of the components of the Affordable Care Act enjoy considerable support according to that poll, University of Texas-Texas Tribune.
With that, I will take your questions.
Q The President met with about 16 Senate Democrats today for about two hours -- concerns over the implementation. Is the President prepared to take any steps to address their concerns, including perhaps extending the deadline for signoff, or dealing with these terminations that have become such an anecdotal headache for you guys?
MR. CARNEY: Thank you for the question. The President did meet with a group of Senate Democrats, had a very good meeting. They discussed all the things that are happening with the implementation of the Affordable Care Act as it relates to the marketplaces, the efforts underway to make improvements to healthcare.gov. And the President listened to the senators and heard from them what they’re hearing from their constituents about it, and talked about with them the need to make sure that their constituents are getting the information they need so that they can, if they’re interested, they can enroll to get covered in the health insurance marketplaces.
The President believes and made the point that we need to work together to ensure that everyone who wants insurance through the marketplaces is able to effectively sign up and enroll in time to get insurance by January 1st, if they want it by then, or in time to get it before the open enrollment period ends on March 31st.
I would remind you we’re barely a month into a six-month enrollment period, and while there have been considerable troubles with the website, we are addressing those challenges daily in a 24/7 effort and we expect that the website will function effectively for the vast majority of users by the end of this month.
So we’re committed to working towards making sure that everyone who is interested in -- and obviously many millions of people have demonstrated an interest in enrolling for coverage in the marketplaces -- is able to do that in time for being insured by January 1st.
Q So no extension of the deadline --
MR. CARNEY: -- that there's six-month enrollment period; that’s a lengthy enrollment period. I know that at least under the program I have, I believe it's four weeks. It's probably very similar to the programs you have -- your annual open enrollment period is usually one or two months at most. This is a six-month enrollment period, which reflects the decision to give an expanded period of time to allow people to educate themselves about the options available to them, to shop around and make decisions in these new marketplaces.
So we still believe that there is time available to make the necessary improvements to the website and to use all the other means that we can to get the information to the American people who wants to enroll that they need in time for them to do it either so they'd be insured by January 1st or before the end of the enrollment period.
Q Who asked for the meeting, Jay? Who asked for the meeting? Was it the senators or the White House?
MR. CARNEY: I'm not sure. The President meets with members all the time. I believe we initiated the meeting, but this is the kind of thing that reflects the interactions the President has had with lawmakers on this issue in an ongoing way. So the President was very interested in hearing from the senators who participated and in giving them an update on what's happening with the implementations of the marketplaces and the updates to the -- and improvements to the website.
Q Did he tell them he opposes the legislation?
MR. CARNEY: I don't have a further readout than what I've just given and what was provided and I think sent out from the Press Office.
Q -- whether he thinks -- whether the President told them he opposes the legislation?
MR. CARNEY: I mean, again, I don't have -- you shouldn't take it verbatim, but it's the President's position that we are able to continue work, as I've just said, on the website, make the improvements necessary and then, take advantage of the fact that we do have a six-month open enrollment period.
And we're always confronting a likely evolution of enrollment that would show low numbers initially and higher numbers at the time -- that was certainly what we saw in Massachusetts. As Secretary Sebelius and others have said, and I have said, we expect the first month numbers to be even lower than they might otherwise have been, because of the troubles we've had with the website. But, again, as I know I said before the launch date and others did, we certainly knew that the numbers would be low early on, because it's only natural, as we saw in Massachusetts, that when a new program like this is instituted and there's a deadline that's fairly far off in the distance, that people take their time to educate themselves, shop around before making a final decision.
Q Jay, I know you're pushing for this Medicaid expansion and trying to put some pressure on Governor Perry, but given the problems with the website and also the apparently broken promises about you can keep your insurance if you like it, the level of mistrust from the Republican leadership in Texas is enormous and they think that the cost of the Medicaid expansion would be tremendously higher than you think it would be. How do you overcome that?
MR. CARNEY: Have you got your chronology wrong? Are you suggesting that prior to the launch date they were considering expanding Medicaid, but now, their level of mistrust because of the troubles with the website --
Q I'm simply suggesting --
MR. CARNEY: Well, that's the way you phrased it, which is interesting. But we have seen Republican governors in a variety of states make the decision on behalf of their constituents to make expanded Medicaid available, and what that has resulted in is the prospect for a significant reduction in the numbers of uninsured in their states, because those governors are focused on their constituents. And that's the good thing and that's the right thing.
And we're obviously in discussion with governors and legislators from states around the country that have not yet decided to expand their program, because we firmly believe that those Americans in those states who fall in that area in terms of income levels where they would qualify for coverage under Medicaid if that program were expanded deserve that coverage.
And there are benefits to doing that for the states, as the Kaiser Family Foundation -- if you don’t -- if the trust perhaps extends to these independent groups -- the Kaiser Family Foundation has cited the potential savings to Texas if it were to take that step.
Q I don't understand what you're trying to do, though. Are you trying to publicly shame Rick Perry into changing his mind? Or are having some parallel, actual negotiations with Texans to change their mind?
MR. CARNEY: We're trying to highlight the efforts underway in Texas to reach out to and provide information to the large number of uninsured in the Dallas area. It's one of the top 10 cities in terms of uninsured Americans around the country. And so the President will meet with people who are working on that effort to make sure that those citizens have the information they need to avail themselves of the coverage they can get through the marketplaces.
I was simply making the point that in addition to this, Texas is one of those states that has declined to take advantage of the expanded Medicaid option and that there is a cost to that, both in terms of coverage for Texans and potential savings down the road.
Q So if they hold that position, there's not really anything that the administration can do to force them to expand Medicaid, right?
MR. CARNEY: We can't force them to expand -- the Supreme Court ruled on this -- but as I noted when I cited the University of Texas-Texas Tribune poll, citizens of Texas seem to, based on the results of that poll, endorse the idea. And while it's perhaps the case that Texas Republicans may not be responsive to the views of a Democratic President or a Democratic administration, they may at least take into account to some degree the views of their constituents.
Q Is it the case that this is an effort to distract attention -- going to Texas, where you have such resistance, is an effort to distract attention from all of the various problems with the rollout? Because there is a lot of suspicion out there to that effect.
MR. CARNEY: I can promise you that whether or not the website works, we would be going to places like Dallas, where the education effort and outreach effort is underway to reach these pockets of dense -- these dense pockets of uninsured Americans. And Dallas is high up on that list. So this is part of an overall outreach and education effort that’s very important.
Q Jay, back to the meeting today. These are Democrats who are facing reelection. Does the President concede that this could be a political liability, given the concerns that these senators have, for them next year?
MR. CARNEY: The President believes that it's essential for all those who support the Affordable Care Act that we fix the website, and that we get the implementation and rollout through this six-month period right. And there's no question that the launch has not been anything close to as smooth as the President wanted. His frustration is real, and he has made clear to those who are responsible for it and the teams that have been brought in to help work on it that he expects an intensive effort to bring it up to the standards that they need to meet in order to make it function effectively for the vast majority of the American people.
So the fact is that he's focused on delivering the access to quality and affordable health insurance to the American people that the Affordable Care Act promises. He's not concerned about the politics of that. He obviously campaigned on it in 2008. He fought hard to get the legislation passed in 2010. He defended it, his solicitor general defended it in front of the Supreme Court successfully, and he made clear that he was campaigning on it against the candidate who called for its repeal in 2012 and he won.
So the President believes that it is the delivering of the access to affordable and quality health care that is the policy that makes for good politics. And that’s why he's focused on -- well, he's focused on the good policy and he believes that from that supporters can take heart that the benefit here is in the delivering to their constituents of the promises of the Affordable Care Act.
Q But the election in 2012 may have been a referendum on health care more in the abstract. In 2014, it will be more in the reality. So does he worry that it could cost him control of the Senate, which would have repercussions --
MR. CARNEY: It's November 6th of 2013, and we had an election yesterday. And I think it’s instructive because of the I think interesting analysis about what that election meant. I grew up in Virginia; my father’s family, Virginians for generations. I know Virginia politics. For the first time in 40 years, the candidate from the incumbent President’s party won that office. First time in 40 years -- since 1973. The Republican candidate in that race made his name as an opponent of Obamacare, campaigned on the repeal of Obamacare, and lost. The Democratic candidate embraced the Affordable Care Act, campaigned on the Affordable Care Act, and won -- again, for the first time in 40 years that a candidate from the incumbent President’s party has done that.
And I think if you look at the data -- and I would refer you to Geoff Garin, who is the Governor-Elect's pollster, he can show it to you. I mean, he says that, if anything, health care worked in Governor-Elect McAuliffe’s favor and to the disadvantage as an issue of his opponent.
Q Do you believe that the Virginia governor's race election result was a mandate for Obamacare?
MR CARNEY: I couldn't tell you. I said that it was certainly not what some pundits have suggested because there’s no data that suggests that it was, which is that -- I mean, here’s what we know. In a race where history was tilted against the Democrat, 40 years of history tilted against the Democrat, one candidate ran as a fierce opponent of the Affordable Care Act, made it the central issue of his platform; another candidate ran embracing the Affordable Care Act. One of them won, and one of them lost.
Q Is Senator Bennet on board to talk about senate races and the politics of the Affordable Care Act?
MR. CARNEY: Well, you know we have a DSCC event in Dallas, so I think that’s why he’s on board. He was part of the meeting at the White House.
Q Are they going to be talking about 2014 races on the trip?
MR. CARNEY: Well, again, there’s a -- the President and Senator talk a lot and are talking now, I believe, but I don’t know the content of the conversation. But it is true that one of the events we have tonight is a DSCC event.
Q Is the President aware of the early retirements that were announced at CMS today? And do you know whether those will be the last of the departures of people who have had a role in the rollout?
MR. CARNEY: I’m not aware of that, so I would have to refer you to CMS.
Q Back on the enrollment deadline, the health insurer Humana states that it expects that the deadline will be pushed back. Was that at all something that was discussed in McDonough's meeting yesterday with health insurers? Did it come up at all?
MR. CARNEY: I don’t have more of a readout than what I gave. And I don’t have more on that. I've seen the report. I would simply say our expectation is that the website will function effectively for the vast majority of users by the end of the month; that coupled with all the other efforts that we have underway to make sure that people have the information they need
to make choices about enrolling, and then enrolling, that we'll be able to do that within the six-month enrollment period that we've talked about.
Q We're two weeks out from the 50th anniversary of the assassination of John F. Kennedy. And I'm wondering why the President is not going to do anything in Dallas to commemorate that. Or what can you tell me about what he is going to do?
MR. CARNEY: I don't have any updates on the President's schedule for that solemn anniversary at this time.
Q Jay, a two-parter on foreign policy. Is everybody done with health care? Mideast -- Secretary Kerry is trying to broker negotiations between the Palestinians and the Israelis. Those talks appear to be deadlocked right now. And today, we have an additional element with a Swiss investigation concluding that Yasser Arafat was probably murdered by poisoning. And I'm wondering whether the President, one, is aware of that. Two, does he think that should be explored further? And does it inject yet another element into the discussions of peace talks that complicates things?
MR. CARNEY: I have nothing on the report about Yasser Arafat for you with regards to the President.
I think that the President's position, as Secretary Kerry has so ably articulated, remains what it always has been. And making progress on the Middle East peace process is never easy, but it's essential for the long-term future of the region and for the security of Israel and the future of the Palestinians. So we remain focused on working together with both sides to try to bring about progress on this very difficult issue, because we think it's in the interest -- we know it's in the interest of the Israelis and the Palestinians.
Q Will it ultimately require the administration to provide its own blueprint for peace rather than -- if it doesn’t look like anything is emerging from the talks?
MR. CARNEY: I'm not going to speculate about the future. Right now, we're trying to help a process move forward that involves direct negotiations between the two sides.
Didn't you say you had two?
Q There were calls at the hearing today for Sebelius directly to resign. If she were to -- were she to resign, would the President accept that resignation?
MR. CARNEY: The President has full confidence in Secretary Sebelius.
Q Did the President call the governors?
MR. CARNEY: He did call Governor Christie to congratulate him on his re-election before we took off, before we left the White House.
MR. CARNEY: The day after the election, which is what he did four years ago, he congratulated him on his re-election.
Q Did they phone-embrace?
MR. CARNEY: Obviously, he and the Governor have spent a lot of time together in person and on the phone because of, in particular, Hurricane Sandy -- Super Storm Sandy, and the terrible impact that storm had on New Jersey and the efforts that FEMA and the state have engaged in together to help the people of New Jersey recover from that storm. So the President was glad to congratulate him on his victory.
Q Did he call de Blasio or McAuliffe, do you know?
MR. CARNEY: He did last night, yes.
Q Any other calls to winners? Or issues?
MR. CARNEY: Those, the three we read out last night, and today to Governor Christie -- those are the only I'm aware of.
4:29 P.M. EST