the WHITE HOUSEPresident Barack Obama

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The White House
Office of the Press Secretary
For Immediate Release

Daily Briefing by the Press Secretary, 4/1/14

James S. Brady Press Briefing Room

1:48 P.M. EDT

MR. CARNEY:  Oh, it is a good, good day here at the White House.

Q    Aren’t they 0 and 1?

MR. CARNEY:  It's a long season, my friend.  Although I was a little stressed out, I have to say.  It's amazing when the season starts, all your biorhythms change.  But what a wonderful thing for Red Sox fans here at the White House today, and I hope for the Red Sox themselves.  I know the President enjoyed the event and those of us who attended sure did enjoy it.  So hats off to the Boston Red Sox -- World Champions.  Let me toss this to my trusty companion. 

It’s a good day for another reason.  I've been at the White House from the very beginning and have seen people say that meaningful health care reform could not be done more times than I can count.  From before the law passed when such a transformation of the health care system was thought to be politically impossible to the day that it reached the Supreme Court, throughout an election year when it was the principal subject of debate, and from October, when critics said the website could not recover, much less reach independent experts’ predictions on how many people would sign up -- even those independent experts lowered their estimates. 

But with the remarkable surge in enrollment, 7,041,000 people signed up for health insurance before the midnight deadline yesterday.  And that doesn’t count the last-day surge in signups in more than a dozen states that run their own marketplaces.  We surpassed the 7 million mark with the over 200,000 people who enrolled yesterday in states run by the federal government alone.  When we get numbers in from the rest of the states and people who were trying to sign up by the deadline and are finishing now, even more people will be covered. 

But what makes the law a success is not just that hardworking families will have good, affordable coverage that will be there when they need it and does what it is supposed to do, it's that millions more will have coverage through the Medicaid expansion; that discrimination against preexisting conditions is a thing of the past; that women will no longer be discriminated against in health coverage; and that entrepreneurs and the self-employed will finally have good, attainable coverage for themselves and their families.  And since the law passed the growth in health care costs has slowed to its lowest level on record.

Now, I could go on -- and I have a feeling I will -- but I hope the fact that this 7 million number has been reached allows us all to step back and look at the sweeping, positive change that the law has ushered in to strengthen health security for every American as they go through life.

Republicans have spent millions on false, negative ads.  They blocked Medicaid expansion in dozens of states.  They shut down the government and voted over 50 times to repeal the Affordable Care Act.  But that effort could not stop this law from working, and it could not stop middle-class families from getting the health care security that they deserve.

Amazingly, just this week, the Speaker recommitted Republicans to their strategy of repealing the law.  I hope you’ll ask the Speaker this:  How will that effort to repeal the law ensure that Americans have access to the same quality health care that members of Congress have?  I'd love to hear the answer.


Q    Thanks, Jay.  Do you have any sort of breakdown -- how many of those 7,041,000 were previously uninsured, or any demographic data?

MR. CARNEY:  We have none of the breakdown data at this point.  The experts over at CMS and HHS will be working on that, both the demographics and the issue of the percentage that paid.

But on both issues, let’s step back for a moment.  When you buy health insurance from a private provider, you enter into a contract.  And long before the Affordable Care Act was even contemplated and certainly before it became law, a lot of people bought health insurance and the overwhelming majority of them paid for their health insurance on time.  There will be nothing different about this.  There is nothing different about the kind of contract that you have with a private insurer through the marketplaces than existed in the past, save for the minimum level of benefits that are required by the Affordable Care Act, save for all the protections that the Affordable Care Act puts into place. 

But we expect that -- and issuers have anecdotally suggested that they are seeing this -- folks who get health insurance through the marketplaces will pay their premiums in the manner that they have in the past.  So there’s that.

On the issue of demographics, again, I point you to what the insurers themselves have said and the statements that they have made about the increase in the enrollment of young adults as we’ve come closer to the deadline, as we approached the deadline -- that was something fully anticipated -- and statements that issuers have made that they feel good about the breakdown, the demographic breakdown that they're seeing already. 

There has been the red herring put forward many times about the so-called 40 percent figure, which is simply the percentage of the uninsured who are young adults.  It is not the percentage that is required to make the marketplaces work.  That percent has already been cleared.  What we will see when the demographic breakdown comes in, we suspect, based on what we’ve seen from different states and anecdotally, is that there was a surge in enrollment among young adults. 

But we already know that that breakdown is sufficient to ensure that the marketplaces will effectively function, that issuers will feel comfortable with the demographics.  And as you also know, and as I mentioned yesterday, there are provisions within the law itself that ensure that the kind of spike in premiums that people might be concerned about, the fluctuations in prices because of the demographic breakdown of the risk pool are contained should they come about -- as was the case in Medicare Part D, by the way.

So we’ll see obviously what those percentages are.  We’ll see what the breakdown is.  But today we can say definitively that at midnight last night, I think fair to say we surpassed everyone’s expectations, at least everyone in this room.  And there’s a reason for that -- there are two reasons.  One, the extraordinarily dedicated service of a lot of folks who worked hard on the effort to get the website functioning effectively, and that includes people in this building, beginning with the President, the Chief of Staff and others.  It includes folks at CMS; Jeff Zients who led a tech team. 

It includes the efforts that everybody engaged in to, beginning in January, really, to conduct outreach to those populations in America who needed the information about the Affordable Care Act, and we got pretty creative in how we reached out to young Americans and others, different communities to make sure they got the information they needed.

But most of all, it’s because the American people -- despite everything they’d heard, despite all the negative advertising, despite the obstacles that we put in their way with the crummy rollout of -- made it clear that they wanted this product.  And that's important because the whole purpose of the law was to provide security through the benefits contained within the plans on offer all around the country.

Q    Obviously, the early problems with enrollment hurt some Democrats.  Are you advising them now that you’ve reached this milestone to embrace the law?  What are you telling them?

MR. CARNEY:  I’m not here to give political advice.  I’m saying that despite the obstacles we saw, despite the lowered expectations that experts and others created, something important happened here, which is that the systems we put in place worked; the demand for the product was there; and most importantly, millions of Americans and their families are getting health care coverage.

For those who voted to support that bill, that's something they should be proud of.  It’s something they can tell their constituents that they did for them.  And they paid -- they took a lot of political heat in some cases and at some times over the past several years because of it, but they did the right thing.

How every candidate runs his or her race is obviously up to each individual.  But what matters here is the policy, the law, the benefits that the American people, American families have -- the security of knowing that you have a preexisting condition or your child has asthma or any other condition that before the Affordable Care Act might have been the reason insurers wouldn’t give you coverage, that that can never happen again.  And that creates an enormous amount of comfort and security for American families across the country and that is a good thing.

And this is just the first enrollment period.  There are going to be many more for years to come.

Q    On Jonathan Pollard, since the briefing yesterday, U.S. officials have confirmed that there are talks underway to possibly release him.  Can you explain why President Obama would consider that after for decades other Presidents have declined under pressure from the Israeli government?

MR. CARNEY:  Well, I’d say a couple things.  First of all, the President has not made a decision to release Jonathan Pollard.  Jonathan Pollard was convicted of espionage and he is serving his sentence.  As I said yesterday, I don't have any other update to provide to you on Mr. Pollard’s status.  There are obviously a lot of things happening in that arena, and I’m not going to get ahead of discussions that are underway.  What I will tell you is that the President has not made a decision to release Jonathan Pollard.


Q    Thanks, Jay.  You mentioned insurers.  There’s some concern among insurers of predictions of higher premiums.  I heard what you said about the premiums.  But if that is to happen, what is to prevent insurers from becoming villains in this story if, in fact, premiums rise and the popularity of the law takes a hit as a result?

MR. CARNEY:  Here’s what we know:  Premiums came in lower than expected, lower than projected for this year.  There is a process in place, state-by-state, involving state insurance commissioners, involving issuers, and then ultimately involving the federal government as it relates to the ACA that will produce premiums for the next year later this year.  What those premiums look like will depend on assessments that are made by issuers on the mix that they got in this first year under the Affordable Care Act.  A lot of actuarial work will be done to make those assessments.

What we know, again, is that this year’s premiums came in lower than projected.  What we know is that in the four years since the Affordable Care Act was passed and signed into law that the growth in health care costs has been slower than at any time in the past half-century, any time since these records have been kept.

And what we know is that the law itself, if the mix isn’t optimal, ensures that prices will stay affordable, through the reinsurance program, through the risk corridors program, and through the risk adjustment program. 

And Republican objections are a moveable feast here and I know that this is one of the ones that they are or will latch onto because their predictions of failure in the enrollment period have proven wrong.  But if they just read the law and understood that it contained these protections against prices becoming unaffordable, they would, A, recognize provisions that are similar to the ones that were in the Medicare Part D law that was passed under President George W. Bush -- some of them -- many of them -- were here and voted for it -- Republicans that is.  And they will know that those protections work.

So that's what we know now as we head into the next stage, post the end of open enrollment in this period.  And we feel confident that the law is written effectively.  We feel confident, as I said earlier, that there is and will be a good mix, broadly, demographically, in the population of those who enrolled through the federal and state marketplaces.  And then there will be a process by which insurance companies, working with state insurance commissioners, reach and set their levels for premiums next year.

Q    And on the politics of this, public opinion polls still show more Americans disapproving of the law than approving of it.

MR. CARNEY:  Not in one poll I saw -- The Washington Post/ABC.

Q    In a number of states, opponents of Democrats are running against Democrats on their support for Obamacare.  To what do you attribute that persistent political opposition to Democrats about this law and the success that Republicans seem to have with this message over and over?

MR. CARNEY:  Well, as I mentioned in my topper, there have been millions and millions of dollars spent in attacks on the Affordable Care Act.  There has been a remarkable intensity and focus among Republicans, especially in the House here in Washington, on efforts to repeal the law -- a focus that has prevented them from, say, working effectively in a bipartisan way to help the economy grow faster, or create more jobs, or ensure that Americans who are working full-time and trying to feed their families are paid a living wage, just to name a few.  But you have to commend their singular focus, right, even if it comes to naught, which it has come to naught and will come to naught. 

So there’s no question that this has been a political issue that's been a subject of a great amount of debate.  When it has been put to the voters, as it was after a presidential campaign in 2012, when this was the single most discussed policy item and on which there was the greatest disagreement between the two candidates, the President, who fought for and signed into law the Affordable Care Act, won reelection.  When it was brought to the Supreme Court, the law was upheld.  And now there are at least 7,040,000 Americans who have enrolled through the marketplaces for affordable, quality health insurance. 

And those who run against it, who run on repeal and offer nothing in return but the old status quo, the status quo ante, are, I think, going to have some explaining to do to those millions of Americans who now have the security of affordable health insurance. 

We understand that every district is different, every state is different, midterms are obviously different from presidential election years.  But the fact of the matter is these are concrete benefits that millions of Americans now have.  And the 7 million doesn’t count those who have insurance for the first time through the Medicaid expansion in those states where they didn’t deny their citizens that benefit.  It doesn’t count I think the 3 million-plus young Americans, young adults who have been able to stay on their parents’ plans up to the age of 26.  So you’re getting into real numbers and they’re certainly real people with real benefits.  So politics will always be politics, but the substance of what the American people are getting here is real.

Q    Can I ask you sort of an off-topic question?  A book was published this week that drew attention to high-frequency trading, a practice through which people use legal methods and regulated markets to make billions of dollars by sort of taking advantage of the average investor.  Does the President think that’s fair?  And is there anything the White House or his administration can do about that?

MR. CARNEY:  I haven’t spoken with the President about the book or the issue that the book has highlighted, so I can’t characterize his thinking.  And on matters of sort of regulatory issues, I have to point you to those agencies that regulate the markets and the Department of Treasury and others -- Department of Justice if there’s a legal issue.  So I don’t have a White House view on that at this time.


Q    On Jonathan Pollard, you said the President has not made a decision, but is his release under discussion in any way?

MR. CARNEY:  Jim, the Israelis, of course, as you know, have frequently raised Jonathan Pollard in our discussions.  But I’m not going to get into the details of discussions that Secretary Kerry has had and is having in the region.  What I can tell you is that the President has not decided to release Jonathan Pollard, and he’s a person who was convicted of espionage and is serving his sentence.  Beyond that, I just don’t have an update on this status. 

Q    And are you concerned about the perception -- obviously this is going to be said -- that you may be thinking about trading the release of a prisoner who was convicted of espionage in exchange for making some progress when it comes to Middle East peace?

MR. CARNEY:  Well, I’d say a couple of things.  First -- or repeat what I did say, which is that I think it’s pretty well known that the Israelis frequently raise this issue and they have raised this issue in our discussions.  Beyond that, I’m not going to get ahead of the work that Secretary Kerry is doing and the conversations that he’s having.  That’s number one.

Number two, the need for and benefits of a peace between the Israelis and the Palestinians, a peace that provides the Palestinians with their own state and provides security to a democratic Jewish state of Israel, transcend this issue and many others that are part of the discussions that we have.  It’s in the interest of both parties to try to find a path forward to reach a peace agreement.  There have been very difficult issues over the years that have prevented a peace agreement from being reached. 

It’s not an accident that many American administrations have engaged in an effort to try to help bring the parties together and help them reach an agreement.  We are certainly actively engaged in that effort.  It’s never been easy; it’s not easy now. 

Q    And to get back to numbers -- you said over 7 million. 

MR. CARNEY:  Let’s get back to the numbers, shall we? 

Q    Let’s get back to the numbers.  Won’t you have to subtract the number of people who have not made that first payment on those premiums, who fail to make that payment, from this 7 million figure?  Not to be a stickler here, but you may not have hit 7 million, right?

MR. CARNEY:  Again, all I’ve reported to you today is that as of midnight last night, enrollments surpassed 7 million, and that was not counting figures from states across the country who have their own marketplaces for that final day.  And all of these states, by and large, experienced similar surges.  So once those numbers come in, we’ll have a more accurate total for the figure hit at the end of the open enrollment period.  It also doesn’t account for those who began the process but weren’t able to complete it because of the surge in volume.  And we’re going to be engaged with those individuals to make sure they’re able to complete their enrollments. 

So there’s that.  So whatever that total figure ends up being, we’ll be sure to get you that information when we have it. 

On the matter of payments, again, I’ll just refer you to what I said before.  In this, there is no difference between the past and the present.  People purchase health insurance; they have a premium to pay and overwhelmingly they pay them on time.  We’ll have, at some point, when we work with issuers and aggregate the data, some figures on what those percentages look like.  I think if you look anecdotally at what some major issuers have said, they look very much like they have in the past.

So I mean, that’s something you can look at, certainly.  And we’re not calling apples -- we’re not mixing apples and oranges; we’re giving you the data we have.  But I’d be disappointed, Jim, if you suggested that somehow 7 million wasn’t a big deal. 


Q    Jay, in another life you certainly were a political analyst and you’ve talked politics from that podium, so I just want to try one more time.

MR. CARNEY:  Let’s go for it.

Q    In light of these numbers, the success you’re touting here, would it be a mistake for Democrats not to embrace the Affordable Care Act in the upcoming midterm elections?

MR. CARNEY:  Jon, all I can say is that every district in every state is different, and every candidate and incumbent is different.  And each has to make --

Q    Just as a general principle, should Democrats be --

MR. CARNEY:  I’m not going to give --

Q    -- as a general principle, running on embracing --

MR. CARNEY:  -- campaign strategy pointers from this podium, again, because it is also a fact and probably will continue to be a fact that folks out there who want to take those benefits away from the American people, have those people who were uninsured and then are now insured be uninsured again, who are happy putting the insurance companies back in charge of this process are going to spend -- have spent and will spend millions of dollars making their argument, often using false examples and false facts to make it.  So that makes it challenging.  It has been.  It was for the President.  It will be for candidates this fall. 

So, again, I think every candidate, every incumbent will make his or her assessments on this.  But I think that what is incontrovertible is that what was predicted to be a failure has been a success when it comes to meeting the target set by independent experts.  And that has happened despite the fact that we basically lost two months because of the troubles with the website.  And that’s something that members of Congress who supported this effort can point to when they have to talk about why they voted to provide quality, affordable health insurance to their constituents, and why the system despite its early troubles ended up working effectively for all those millions of Americans who wanted the product offered.

Q    And in terms of the numbers, isn’t the -- I mean, after all, these exchanges were set up so that people who didn’t have health insurance could buy health insurance through a marketplace.  So isn’t the critical number here how many people were able to get insurance who didn’t have insurance before?  Isn’t that -- I mean, that’s what this is all about, right, providing insurance for the previously uninsured?

MR. CARNEY:  Let me refine what it’s all about, if I may.  It is obviously about ensuring that everybody has access to quality and affordable health insurance.  And that includes those Americans and their families who are on the individual market and subject to the vagaries of the individual market.  It was one of the most -- one of the least regulated arenas within the broader health insurance market.  The kinds of minimum benefits that the Affordable Care Act puts in place in that market did not exist and you often had people who paid a very hefty price for a product that ended up not covering the very illness that they suffered, or would not extend coverage to their kid with a preexisting condition, or would charge your twin sister twice what they charged you.

So the reform that the Affordable Care Act put in place, the reforms that it put into place were designed to address a lot of problems within this market that was broken and needed fixing.  And I think it’s been demonstrated that it is fixing many of those problems.

On the issue of the overall percentage of uninsured, we’re going to see -- we’ve seen some early data from public polling outfits and also from various other state and private agencies that suggest that the percentages of uninsured have been coming down as a result of the Affordable Care Act and people signing up and getting insurance through the marketplaces.  And that is certainly one of the objects. 

Overall, remember that the projections that were made by independent experts about the broader impact on the percentage of uninsured in the United States were projections over three years. So we’re year one into a process that will lead to greater numbers of Americans who were uninsured getting insurance.  And that includes potentially, should the leaders of these states change their minds or be changed out themselves, further expansion of Medicaid into those states that haven’t accepted the expansion offered in the Affordable Care Act, because that in and of itself will mean more and more millions of Americans who are uninsured getting insurance.

Q    But just to be clear, you still have no idea how many of these 7 million who have signed up previously had health insurance policies that were cancelled, many of them because of the Affordable Care Act?

MR. CARNEY:  Jon, what I can tell you is we’re going to -- we’re aggregating a lot of data here.  What I just described to you is what the Affordable Care Act was designed to address -- the many problems in the system that it was designed to address, including the challenge of getting the uninsured insured.  And there’s no question, as, for example, the percentage of Americans without insurance continues to fall, measuring 15.9 percent so far in 2014 compared with 17.1 percent in the fourth quarter of 2013. 

So the whole purpose of -- what you’re seeing with the implementation of the Affordable Care Act and the conclusion of the first open enrollment period is progress on all fronts identified by the Affordable Care Act.  And that is a good thing.

Another point I made yesterday about trying to pinpoint at an individual level who was uninsured and is now insured, who would have been uninsured in a world without the ACA but is insured, is very difficult because every year in the past, people were losing their health insurance on the individual market as well as in the broader market.  And that was going to continue no matter what, and it actually accelerated over the past couple of decades.

So what we know is that there were going to be people in 2014 who were uninsured, were going to be uninsured, absent the Affordable Care Act, who now have insurance.  It’s impossible to know precisely who those individuals were because they were able to sign up for quality, affordable health insurance through the marketplaces before they found out whether or not they were going to lose the insurance that they had.


Q    The White House may have described this earlier today, but could you repeat, how did the President get the total, the number, the actual tally?  And could you also describe -- like, did he call Secretary Sebelius, or will we see her this afternoon, to say thank you to the HHS staff, or whatever?  The color.  (Laughter.)  Old habits.

MR. CARNEY:  I used to beg for color.  So he was informed when -- I think we put out a photograph of this -- but some of the team here, members of the team here who have worked with great intensity on this issue briefed him I think before his PDB on the data that we had at that point, which was reflected in what I just told you.

So I think he’s -- and he obviously saw, as we all did, with the surge and other sort of -- the increasing indicators that the numbers were going to be strong, so he knew yesterday that it was possible we could get to 7 million, but he didn’t get that hard figure until this morning.  So I’d say that everybody in that picture is pretty happy about that result. 

I don’t have any phone calls that he’s made to read out to you.  He’ll obviously talk about this issue later today, so maybe he’ll give you some color then.

Q    I have a follow-up question on Jonathan Pollard.  In the past, Presidents who have been asked to weigh in on this, executive clemency questions, received the data, the request or the proposal in a formal way in which the intelligence community, the Justice Department and the State Department would have been able to weigh in.  Since you have said the President has made no decision that suggests that he’s been asked to make this decision.  Could you describe how the process is underway here today?

MR. CARNEY:  I don’t have the underlying activity that you just mentioned to describe to you.  And as a general matter, I think it’s fair to say when these issues are raised, that kind of work is done.  But as I pointed out earlier, these issues are raised by the Israelis -- or this particular issue has been raised by the Israelis in our conversations for some time.  So what I can tell you is that the President has not decided to release Jonathan Pollard.  And I can tell you, obviously, that he was convicted of espionage, and he is serving a sentence as a result of that conviction. 

Q    Right.  But you were suggesting almost that it’s a political equation, that this is entirely a political question.  This is part of the diplomatic discussion -- no?

MR. CARNEY:  I’m limiting what I’m saying pretty clearly, so implications that you find in what I say aren’t there.

Q    No, I’m looking for the words, actually.  I’m just looking for you to say -- the President is weighing this?

MR. CARNEY:  What I’ve said is that, as has been reported and I think is reasonably well known, the Israelis have frequently raised Jonathan Pollard in our discussions.  But I’m not going to get into details of those discussions that Secretary Kerry is currently having and has been having in the region.

On the specific issue of the President’s decision-making process, I can report to you that the President has not decided to release Jonathan Pollard.  And I have no further update on his --

Q    -- is it ruled out?

MR. CARNEY:  I’m not going to -- you’re engaging, like, rule in, rule out.  Here’s what I’m saying -- and I’ll say it again and again when people ask me --

Q    I know, but you said you don’t want to get ahead of Secretary Kerry’s conversations.  That suggests it’s on the table.

MR. CARNEY:  I’m saying that the Israelis have -- well, the Israelis raise this issue, as I’m telling you now and has been reported.  So we’re involved in conversations with the Israelis; they raise the issues of Jonathan Pollard.

Q    But you’re not going to rule it out?

MR. CARNEY:  I’m just saying the President has not made a decision to release Jonathan Pollard.


Q    If I could just follow up on this -- it’s not at all new for the Israelis to raise this, as you know and as every press secretary knows and every previous President knows.  That’s not unusual.  What is unusual, in our -- and sparked this curiosity, is that an administration is now willing to consider it in the context of negotiations over Middle East peace.  You said a few moments ago that the benefits of Middle East peace transcend this and other issues.  What I’m curious about is it appears that this is on the table not in the context of a deal but just prolonging negotiations in pursuit of a deal.  And for some, that seems like an awfully large U.S. concession just to keep talks going that are not guaranteed or even reliably predicted to succeed.  Why that change in emphasis and willing to put something of such value to the Israelis as Jonathan Pollard on the table just to keep talks going?

MR. CARNEY:  As you always do, Major, you state things very well.  (Laughter.)   What I can tell you is that the Israelis have frequently raised Jonathan Pollard as an issue, and the President has not made a decision to release Jonathan Pollard.  I understand everything else you’re saying, and obviously the Secretary has been engaged in fairly intensive discussions with both parties and others in the region for some time now.  And I’m just not going to play in those vineyards right now because it’s a pretty complex set of issues and those conversations have to do with the broader goal of achieving a peace between the Palestinians and the Israelis. 

Q    I listened to every word you said in response to Jon’s question about those who were uninsured and those who now have coverage, so please don’t repeat it because I really -- I was very attentive. 

MR. CARNEY:  Okay.

Q    But I want you to respond to what -- something Madam Pelosi said, Madam Leader Pelosi said, that is not really a big issue whether they were insured or not before, that there’s so many other things about the health care law that are important that that’s really sort of a secondary issue.  When those of us who covered the issue at the time remember -- at least I remember -- that getting the uninsured covered, to my memory, was the biggest part of the Affordable Care Act and was its most important legislative, policy and political calling card.  Are you backing away from that?


Q    And isn’t it not a legitimate question to ask?  Yes, people were uninsured before, but if there’s churn in 2013 and 2014 caused by Obamacare because people lost their individual market policies and then got insured, isn’t that a legitimate question? 

MR. CARNEY:  I never suggested it wasn’t a legitimate question.  What I’m saying is that --

Q    -- judge its overall success.

MR. CARNEY:  Leader Pelosi is absolutely correct in saying, as I did, that the reforms that the Affordable Care Act put into place, made law, provide benefits that are not limited to making quality, affordable health insurance available to those who were previously uninsured.  That is included among the benefits that the reforms create.

Q    Which is like the --

MR. CARNEY:  Well, no, it’s a pretty major goal here.  What I would say is that the goal of reducing the percentage of Americans who are uninsured is one that will be met over the course of more than one year.  And certainly no projection ever suggested that that population would be eliminated in one year.  None.  And no outside independent expert would have predicted that. 

And our efforts to reach that goal more quickly were severely hampered by Republican governors and state legislators who refused to expand Medicaid to their own constituents under a provision under the Affordable Care Act that made sure that the costs of that extension was borne by the bill and not by the states, substantially.  So they're denying coverage to uninsured residents of Texas and so many other states around the country for political reasons.  And that's a mistake. 

And we have seen, despite the objections, a steady increase in the number of states who have made the decision to expand Medicaid so that those vulnerable populations who would be covered because of the expansion are covered.  And that will improve the bottom line when it comes to reducing the number of uninsured and under-insured in the United States.

But I think it’s just -- again, I would point you to probably coverage you did and maybe -- you and I go all back all the way to covering health care reform in the early ‘90s -- the challenges of the insurance market that drive people from being insured to uninsured were growing with each passing year and each passing decade.  And what is incontrovertibly true is that every year the individual market churned people out from being insured into the uninsured population, separate and apart from anything that had to do with the Affordable Care Act.  And that was going to happen and had been happening for some time and getting to be a greater and greater problem. 

And on that market, prior to the Affordable Care Act, there were not minimum standards, minimum benefits that plans had to offer.  So what you have now is an environment where folks who get insurance on that individual market now can be assured that even the lowest-cost plans provide an extensive minimum level of benefits for them and their families, and they are quality and affordable plans.  And millions and millions of Americans and their families qualify for subsidies under the Affordable Care Act, and for those residents of those states where Medicaid has been expanded, there are lower-income Americans who now can get coverage through Medicaid who weren’t able to before.

But we’re not at all dismissing the goal of reducing the percentage of uninsured in America.  That is a primary objective of the Affordable Care Act.  And the evidence we’ve seen is that we’re making progress against that objective, and we’re going to continue to make progress.  And one way to make a lot more progress fast is for those governors and legislatures to decide that their constituents deserve the benefits that other Americans have gotten.

Q    Jay, since that’s an objective, is the administration committed to releasing some sort of figure on what the net number is then at what Major was getting at?

MR. CARNEY:  Sure.

Q    When?

MR. CARNEY:  I mean, this is data that we have to aggregate and compile.  The open enrollment period ended at midnight -- right?.  We still are waiting on data from state exchanges from yesterday.

Q    So can we get it tomorrow?

MR. CARNEY:  Look, Ed, I don’t doubt --

Q    What’s your reasonable timetable?  A month?  Two months?

MR. CARNEY:  I would give you -- I would point you to CMS, who are the experts on compiling the data. 

Again, on the question -- but I’m going to make clear on the question of uninsured versus insured, you have to look at aggregate data about percentages, because you can’t -- there are individuals who would have been uninsured in 2014 but don’t know it because of the ACA, right?  So it’s impossible to say that this person, person to person -- identify who is insured now that wouldn’t have been insured in the past because they never got uninsured because the Affordable Care Act was in place.

Q    On your point about the numbers and you can’t possibly turn them around that quickly because they’re coming in very quickly -- at the beginning of all of this when the website was having so much trouble, there were only hundreds or thousands of people signing up in the first month.  You were saying then, I’m not going to cherry pick the numbers.  We’re going to put out the numbers monthly of the people who are signing up.  So now when you’ve got record numbers of people coming into the website, how can you turn around these numbers within 24 hours and tell us with accuracy --

MR. CARNEY:  Because our systems have gotten a lot better, which I think anybody who went on in October and went on it in the last week can attest. 

Q    -- you know that it’s an accurate number?

MR. CARNEY:  I think that we got better and better at compiling and collecting the data.  Remember, in October and November, was creating problems at the frontend and at the backend.  It created a lot of challenges for those who were trying to assess exactly how many people had enrolled successfully.  And we all here remember those challenging days in trying to explain what was happening and how the fixes were going to be implemented.

And, again, we’re obviously offering initial data that’s going to be refined as we get more information, and will be refined in the way that a lot of you have asked about when it comes to demographics and other breakdowns, as we’re able to sort through the data. 

Q    The DNC Chairman was on with Chuck, I believe, yesterday or today and was asked to name one bill that she could support to fix the law.  And she said she couldn’t think of one. And there have been various Senate Democrats in particular who put out laws -- bills to say, look, let’s fix the law.  There are some tweaks we want to make.  Do you think Democrats on the Hill are committed to actually improving the law where they see problems, or are they looking for political cover?

MR. CARNEY:  I’m not sure I understand the question.

Q    Are they committed to actually coming up with legislation?  And is the President committed to working with them?

MR. CARNEY:  I think Democrats who supported -- voted for and who support the Affordable Care Act and its implementation are very much interested in making sure it works effectively, and have supported the President and HHS and CMS as they have made decisions administratively that have helped smooth the transition.  What we know -- I mean, I guess this gets at who wants to fix it, who wants to repeal it.  I remember getting a question I think yesterday insisting that Republicans had changed strategy and now were running on fixing the Affordable Care Act. And I had to scratch my head and wonder what the questioner was talking about.

Fortunately, the Speaker of the House came to my assistance in announcing for everyone to hear that their primary objective legislatively remains repeal the Affordable Care Act, repeal of insurance for millions and millions of Americans -- far in excess of 7 million, because, of course, that doesn’t include those on Medicaid in the expanded states, or those who were on their parents’ policies because of the Affordable Care Act -- repeal of a law that forbids insurance companies from denying you coverage if you have a preexisting condition; repeal of a law that provides assistance to seniors in paying for their prescription drugs, provides free preventive services for Americans, millions of them, across the country.  And I want to thank the Speaker for that clarification.  I wish it were not so, but it seemed like some folks out here hadn’t heard.


Q    Does the President have more confidence in Kathleen Sebelius today than he did back in November?

MR. CARNEY:  The President has had and has confidence in his Secretary of Health and Human Services.  And I think that --

Q    He’s not wavered at all?  Because he has been -- he has not always, when given the opportunity to express confidence in her, he hasn’t always done it. 

MR. CARNEY:  I certainly don’t agree with that.  And every time I’ve been asked -- and I’m his spokesman -- I have made clear that the President has confidence in her.  And what I can tell you is, Chuck, that those were hard days for a lot of folks who bore the responsibility of making the implementation of the Affordable Care Act a success.  But the response, to a person, was not to point fingers of blame, but to roll up their sleeves and get to work fixing the problems. 

I think you and I and others have talked about what was unique about that challenge last year compared to other challenges that we’ve had in this administration was the self-inflicted nature of it.  And that meant that we bore even greater responsibility to fix it and get it right on behalf of the millions of Americans who wanted quality, affordable health insurance.  And Secretary Sebelius was at the front of the line getting to work to make sure those problems were fixed.

Q    But the President did say he was going to look at possibly doing an after-action report now.  I mean, he said, after -- is that still in the works?

MR. CARNEY:  You’re connecting that to an individual.  And I’m saying that obviously the President is very interested in effective performance, and what he has seen since those challenging days is an all-out effort at a very high level of professionalism to get it right.  And I think it’s fair to say -- and I won’t do it today -- but I have a lot of headlines that you guys wrote and spoke back then  -- including something about not enough people enrolled to fill the stadium at the University of Michigan, Chuck -- that certainly made it seem like we would never get to where we are today.

And I’m not faulting you guys at least too much for that doom and gloom, because those were obviously tough times.  But if you look at what we were saying in the run-up to October 1st about the markers that we needed to hit and what would happen over the course of the open enrollment period, if you set aside  -- and it’s a big set-aside -- the fact that the website turned out not to function effectively for a substantial period of time at the outset, we hit all those markers, in terms of when there would be surges of enrollment, what we would be doing to reach out to various communities to try to get them the information they needed, and what our numbers would look like based on our agreement with the assessments of independent experts about what we could expect if everything functioned effectively.  And it turned out that even though it didn’t as regards the website, we got where we were supposed to be.

Q    But given how big this moment is in the last 12 hours, 24 hours, 48 hours, we haven’t seen Kathleen Sebelius anywhere.  She’s been on Twitter, but you guys haven’t brought her out here. She’s not done any TV interviews. 

MR. CARNEY:  I wanted this all to myself today.

Q    No, no, no, you say that, but in other moments when there are big -- there are the array of players -- she is the point person on health care, is she not?

MR. CARNEY:  She’s the Secretary of the agency that handles --

Q    The point person -- we should not read anything into the fact that she has been --


Q    Not at all?  You guys have not put her out front and center at all --

MR. CARNEY:  It’s been a few hours.

Q    -- for the last two weeks, three weeks, four weeks?

MR. CARNEY:  I think you’re obsessing on something that I promise you needs not obsession.


Q    Hoping to do lightning round, do you know how --

MR. CARNEY:  Me, too.  (Laughter.)

Q    Do you know how many people are in the queue, who got in line --

MR. CARNEY:  We don't.  That's a great question, and again, we’re just a half a day or a little longer since the enrollment period closed.  And we’re -- or not “we,” not me personally, definitely -- and sifting through and reaching out to individuals who left their phone numbers, who started the process, weren’t able to finish, and we don't have a figure on what that population looks like.

But once we do, and once the work is fully underway to assist them in completing their enrollment process, we’ll have a better sense of, A, how many people we’re talking about; and, B, what the timeframe is for getting that work done.  So it’s a great question.  We just don't have an answer yet.

Q    And do you have Medicaid numbers?  And that's in addition to the 7 million?

MR. CARNEY:  I don't have any updated Medicaid numbers.  As you know, and we always introduce this caveat, the numbers that have been -- we’ve talked about in the past that have been in addition to the enrollments on the marketplaces, the Medicaid numbers, are not disaggregated from those in the states where they’ve qualified for Medicaid.  A significant portion of those have been newly qualified individuals under Medicaid because of the expansion, but that includes others also who are requalifying for Medicaid, for example. 

But those figures through March 31st aren’t available yet.  At least we don't have them.

Q    Okay.  And on the Michigan trip, why Michigan -- aside from having great basketball teams and all those things?

Q    Not that good.  (Laughter.)  Not Final Four quality.

Q    Careful, careful. 

MR. CARNEY:  I had them both in my Final Four, but -- no, I didn't, actually.  I had one of them.  But go ahead.

Q    So why Michigan?  Is it because there’s a competitive Senate race?  Is it because they might have an initiative on the minimum wage?  Or does the President just like Michigan?  (Laughter.)

MR. CARNEY:  We love Michigan, everybody here.  We’ll have more information about the trip.  I think we’re focusing on economic issues associated with some of the things they're working on in Michigan.  And the implementation of the Affordable Care Act is a piece of an overall agenda the President has to expand security for the middle class, and through expanding security through, for example, making sure that people are insured, giving them more opportunity to expand -- well, giving them more opportunity to find the job that's right for them, that offers the best for their families.

And I think that that's something that we’ve talked about in the past when it comes to the need to have mobility in the health insurance market.  And that's something that the Affordable Care Act provides and will help create greater dynamism in the labor market.

Q    Thank you.

MR. CARNEY:  Tommy.

Q    Thanks, Jay.  I have two questions for you.  You were just saying that in order to judge the number of uninsured who are now insured you have to look at the aggregate.  And I just wanted to clarify, that Gallup poll that you cited, isn’t it true that in October when the ACA went into effect, the percentage was at 18 percent, and then that 15.9 percent you quoted is from earlier this month and would not include the surge in enrollment at the end?

MR. CARNEY:  Yes, that was data obviously that -- from that survey that predates the March surge.  And I’m pointing to it not as holy writ, but just as an example of indicators that have shown progress in reducing the number of uninsured.  There are going to be other -- there will be other data that helps clarify the picture as we get more information.  But that was one -- you’re right, that that doesn't -- my understanding is that that particular survey doesn't take into account the surge that we’ve seen in the enrollments in state and federal marketplaces in the last several weeks.

Q    My second question is, for the past several days you’ve been talking about how the press has covered the Affordable Care Act, and it's my observation that it’s been sort of a series of negative narratives.  There’s the sometimes deserved, like the rollout, but there were also those -- story after story on TV about people who were supposedly disadvantaged by the ACA and they turned out not to be true.  And then there’s the 40 percent number.  Do you think that with this 7 million figure, which could end up being considerably more, do you think that this is going to be like a turning point, and maybe not with opponents of the law who are always going to find a reason not to like it, but with the way it gets covered?  Or will it just be the next -- and here are some indications of it now, like, how many that were uninsured -- do you think that this might be a turning point in the way that the press covers?

MR. CARNEY:  Well, would that it were so, but I would just say -- I’d say a couple things.  The negative coverage that we saw in October and November was earned, and that's fair.  I think, having been a practitioner myself, that I understand that conflict is news, and good news is often not news.  There’s still a conflict here, though, and I think it merits coverage, which is that there are now many more than 7 million people in the United States who have quality, affordable health insurance because of the Affordable Care Act, and then there is an active constituency within one party that is making it their number-one priority to repeal those benefits from those millions of Americans.  That's a conflict, and it merits attention.

And I’m not suggesting that just because we crossed this threshold that everything is going to be perfect on this issue.  There are going to be a lot of dedicated professionals working every day on the implementation of the Affordable Care Act going forward.  We’ve crossed one milestone here, but there are many more to cross in the future.

So I think that -- the only thing that can sometimes be frustrating I think to me personally is -- for example, I saw in a couple of major newspapers today reporting on yesterday that would suggest that it was one of the worst days that the Affordable Care Act ever had, when, in fact, it was very much the best day the Affordable Care Act ever had.  So I scratch my head over that.  The fact is, yes, there were some glitches in the website again because of the incredible volume.  And despite the glitches, which were fixed, we saw exponential increases in the traffic and the enrollments across the board.  So, you know -- but I get it. 

We’re focused on making sure that the folks that have real stories to tell about the benefits and the security that this law has given them and will give them in the future are heard, and that those -- everybody here in Washington understands that this is about real people for whom health care is a vital concern.  It’s not just a political football. 

And that's why the President set out to do what he did.  That's why those members of Congress who were with him, and worked with him in crafting the legislation, and voted for it did what they did.  And that's why, years from now, I’m confident we’re going to look back and see a highly effective, functioning law that has created real change and progress in the way that Americans receive their health care.

Q   Thanks, Jay.

Q    Jay, do you have anything on Kerry having to cancel his trip?

MR. CARNEY:  I don't have any updates on that.  I think that there have been some reports about what President Abbas and others have said and what their plans are, and I would just refer you to the State Department.

Q    Just a quick clarification.

MR. CARNEY:  Yes, sure.

Q    The 3 million young adults that's from the HHS report  --  they're not part of the 7 million who signed up?

MR. CARNEY:  Correct.

Q    Okay.

MR. CARNEY:  Those are folks who were on their -- I think those are numbers related to --

Q    That's since ’10, right?  That goes back to ’10?

MR. CARNEY:  That provision of the ACA took effect --

Q    No, but that number -- that 3 million number is over three years --

MR. CARNEY:  I don't know.  You have to ask --

Q    -- rather than one year?

MR. CARNEY:  Well, obviously, you’re not 25 forever, right?

Or even 39 as it turns out. 

Q    Yes, yes.  Or 41.

MR. CARNEY:  But that's a good question.  I’m not sure.  I know that’s a figure related to young folks being able to stay on their parents’ plans.

Jessica, last one.  And then Zeke and then we’ll get out of here.

Q    Foreign policy question for you.  On the DPRK, what does the White House make of this announcement that there’s a maritime exclusive zone on both sides of the coast?  Some people are reading that as a sign that there could be another ballistic missile test.

MR. CARNEY:  Well, as I said yesterday, actions taken by DPRK are dangerous and provocative, and their continued threats and provocations merely aggravate tensions in a region that's already tense and further the DPRK’s isolation.  We remain steadfast in our commitment to the defense of our allies, and remain in close coordination with both the Republic of Korea and Japan. 

There are laws on the books, if you will, regarding these matters.  And any nuclear tests or any ballistic missile launches would be significant violations of those laws on the books, and by that I mean U.N. Security Council resolutions, including resolutions 1718 and 1874.  So we call on the DPRK to comply with its international obligations, and to refrain from actions that threaten regional peace and security.

Q    Do you read it as an advancement or a progression in any way, though? 

MR. CARNEY:  Well, we obviously see in activity out of the regime in North Korea sort of ebbs and flows in these kind of provocative actions.  I’m not predicting where we’re headed except to say that what they’ve done so far is provocative and dangerous.


Q    Thanks, Jay.  ACA implementation obviously has taken up a lot of staff time here at the White House, a lot of resources, people brought in to deal specifically with this issue.  Now that the enrollment has closed, this is maybe the end of the President -- what he called in November his last campaign, the one final campaign.  Does the administration have any plans to shift their focus onto other issues, move on to whether it be back to minimum wage or some of the other issues, or back to the -- or is to the midterm elections?  What’s next for the White House?

MR. CARNEY:  Well, there are a bunch of things I can say.  First of all, no, it’s not onto the midterm elections.  We’ve got a lot of business we can get done on a host of issues that you’ll hear the President talk about, including raising the minimum wage, including investing in our infrastructure, including actions we can take with Congress and administratively to move the ball down the field when it comes to the President’s principal preoccupation, which is expanding opportunity, making sure that people who work hard and take responsibility for themselves and their families are adequately rewarded for that effort and have the opportunities that sort of define what it is to be an American and to be in America.

It also includes the potentially historic accomplishment that would happen if the House of Representatives would follow the work that the Senate did and pass comprehensive immigration reform.  That would be great for our economy, great for our security, great for innovation in this country and for our businesses.  So there’s a lot of things that we’re going to keep focusing on.

But we are not going to take our eye off the ACA ball.  We have, as I said earlier, crossed an important milestone here but it’s not the finish line.  And fortunately for the security of the American people, that finish line is so far off in the distance you can’t see it because this law is going to become very much a part of our lives, as people gain coverage through it and the benefits that it provides through it, and as we move on to another open enrollment period in November, as well as, before we even get to that, we make sure that those who were in line, essentially, both virtually and physically, to enroll before March 31st are shepherded through the process so that they get their coverage.  And then obviously we need to continue to build on the progress we’ve made.  So there are going to be a lot of people still working very hard on this effort after today.

Q    Jay, when will you have the breakdown for race, gender, and age?

MR. CARNEY:  I said earlier, April, that we’re going to have demographic breakdowns when the numbers are crunched and it’s all disaggregated.  I don’t have a time for you.  CMS might have it, but it will take a little time to get it done.

Q    Will it take a little time because it was optional on the race part to --

MR. CARNEY:  I don’t know in terms of when people filled out their signups -- I don’t know the answer to that.  CMS would know.  I mean, I think it’s -- obviously, the focus is on getting people enrolled and that was the effort.  And in terms of providing data, the focus was on getting that top-line number as quick as we could. 

And now the work, as has been the case in previous -- at previous moments along the road here, people will work on getting the demographic data done.

Thanks very much.

2:50 P.M. EDT