msnbc.com staff and news service reports
updated 4/16/2009 12:58:34 PM ET 2009-04-16T16:58:34

Throughout the campaign, Barack Obama made many promises to the American people. Msnbc.com has chosen 14 of these to explain, explore, and track. See if the new president keeps his word, and vote on his progress during the first 100 days.

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Obama’s words: "My plan begins by covering every American. If you already have health insurance, the only thing that will change for you under this plan is that the amount of money you will spend on premiums will be less…If you are one of 45 million Americans who don't have health insurance, you will after this plan becomes law."

The issue: As President Barack Obama noted when making this promise, estimates put the number of Americans lacking health insurance coverage at about 45 million people. This is nearly five million more people than in 2000, partly because some employers have cut back on the coverage they provide.

The cost of health insurance, which has been growing faster than the rate of inflation and wages year after year, is forcing many workers to pay more out of pocket for insurance coverage.

The list of politicians who have tried to overhaul America’s health insurance system is a long one; it includes Secretary of State Hillary Clinton.

If Obama is to succeed, he’ll have to reconcile the competing interests — doctors, hospitals, insurance companies, drug-makers, and consumers. Ideology complicates the debate as well – those on the right tend to favor free-market approaches while those on the left tend to prefer a single-payer system, with the government as the chief funder.

Following through: In early February, Congress approved a bill extending health coverage to 4 million uninsured children, a first step toward Obama's promise of universal coverage.

The legislation, funded by an increased federal excise tax on cigarettes, was almost immediately signed into law by the president. But still, many more Americans, particularly adults, remain without insurance.

The $787 billion stimulus plan passed by Congress and signed by the president also includes some provisions for health care funding.

Included in the package's funding:

  • $24.7 billion to provide a 65 percent subsidy of health care insurance premiums for the unemployed under the COBRA
  • $86.6 billion to help states with Medicaid
  • $19 billion to modernize health information technology systems
  • $10 billion for health research and construction of National Institutes of Health facilities
  • $1 billion for prevention and wellness programs

On March 5, Obama convened a health care summit to debate ideas for overhauling the nation's costly system.

"In this effort, every voice has to be heard. Every idea must be considered. ... There should be no sacred cows," Obama said as he opened his White House forum.

Mindful that opponents derailed Bill Clinton's plan 15 years ago, Obama also issued a warning: "Those who seek to block any reform at all, any reform at any cost, will not prevail this time around."

On April 15, Obama's top health care adviser said a compromise is within reach on a government health plan for the middle class that wouldn't drive private insurers out of business.

Nancy-Ann DeParle said one idea to create a public plan that pays hospitals and doctors rates similar to what private insurers pay.

© 2013 msnbc.com

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