NBC News | November 07, 2013
Thanks to you. I'll start -- with health care . It's probably the most quoted thing or requoted thing you have said in your presidency, "If you like your health care plan, you can keep it." You said it a lot during the run up. At this point, though, it's obviously something -- a promise that has not been able to be kept. Just today, the Denver Post 2 50,000 people in Colorado are seeing health insurance policies cancelled. Some of those people liked those policies. And they can't keep them. What happened?
Well -- first of all, I meant what I said. And we worked hard to try to make sure that we implemented it properly. But obviously, we didn't do enough -- a good enough job -- and I regret that. We're talking about 5% of the population -- who are in what's called the individual market . They're out there buyin' health insurance on their own.
A lot of these plans are subpar plans. And we put in a clause in the law that said if you had one of those plans, even if it was subpar -- when the law was passed, you could keep it. But there's enough churn in the market that folks since then have bought subpar plans. And now that may be all they can afford. So even though it only affects a small amount of the population, you know, it means a lot to them, obviously, when they get -- this letter cancelled.
And -- you know, I am deeply concerned about it. And I 've assigned my team to see what we can do to close some of the holes and gaps in the law -- because, you know, my intention is to lift up and make sure the insurance that people buy is effective. That it's actually going to deliver what they think they're purchasing. Because what we know is before the law was passed, a lot of these plans, people thought they had insurance coverage. And then they'd find out that they had huge out of pocket expenses. Or women were being charged more than men.
If you had preexisting conditions, you just couldn't get it at all. And we are proud of the consumer protections we put into place . On the other hand , we also want to make sure that -- nobody is put in a position where their plan's been cancelled. They can't afford a better plan, even though they'd like to have a better plan. And so we're gonna have to work hard -- to make sure that those folks -- are, you know, taken care of.
Do you feel like you owe these folks an apology for misleading them?
You know --
Even if you didn't intentionally do it, but at this point, they feel misled. And you've seen the anger that's out there.
You know -- I regret very much that -- what we intended to do, which is to make sure that everybody is moving into better plans because they want 'em, as opposed to because they're forced into it. That, you know, we weren't as clear as we needed to be -- in terms of the changes that were takin' place . And I want to do everything we can to make sure that people are finding themselves in a good position -- a better position than they were before this law happened.
Keep in mind that most of the folks who are gonna -- who got these c -- cancellation letters, they'll be able to get better care at the same cost or cheaper in these new marketplaces. Because they'll have more choice. They'll have more competition. They're part of a bigger pool. Insurance companies are gonna be hungry for their business.
So -- the majority of folks will end up being better off, of course, because the website 's not workin' right. They don�t necessarily know it right. But it -- even though it's a small percentage of folks who may be disadvantaged, you know, it means a lot to them. And it's scary to them. And I am sorry that they -- you know, are finding themselves in this situation, based on assurances they got from me. We've got to work hard to make sure that -- they know -- we hear 'em and that we're gonna do everything we can -- to deal with folks who find themselves -- in a tough position as a consequence of this.
You've been getting some tough criticism on this quote. Clarence Page , your hometown newspaper, The Chicago Tribune , this is not -- not White House. He's been pretty supportive of what you said. He characterized this as a political lie. He called it a sort of -- "the sort of rosy promise politicians sometimes make with such passion and confidence that they actually may have convinced even themselves that it is true." did politics play a role and you felt as if as the Republicans were throwin' stuff at the law that you're tryin' to pass it. You're tryin' to do this, that you shorthanded this?
No, I -- I think we, in good faith, have been trying to take on a health care system that has been broken for a very long time. And what we've been trying to do is to change it in the least disruptive way possible. I mean, keep in mind that there were folks on the left who would have preferred a single payer plan. That would have been a lot more disruptive. There were folks on the right who said, "Let's just get rid of -- you know, employer deductions for health care . And give people -- a tax credit and they can go buy their own health care in their own market ." That would have been more disruptive.
We tried to find -- a proven model. We've seen it work in Massachusetts . That would be as -- as undisruptive as possible. And in good faith, tried to write the law in such a way that people could keep their care. Although we really believe that ultimately, they're gonna be better off when they're buying health care through the marketplaces. They can -- access tax credits. And they're benefiting from more choice and competition. But obviously, we didn't do a good enough job in terms of how we crafted the law. And, you know, that's somethin' that I regret. That's somethin' that we're gonna do everything we can to get fixed. In the meantime --
By the way, that sounds like you're supportive of this legislation.
Well, you -- you know --
Various things that are out there.
We're -- we're looking at -- a range of options. But the one thing I want to emphasize, though, Chuck , is everybody is acting as if the existing market was working. And the fact of the matter is that a whole lot of people who were in this individual market , who were buyin' health care on their own, because they're not gettin' it through their employer, they might be happy with it this year. And then suddenly next year, the cost got jacked up by 15%-20%.
The average increase on premiums in this individual market for somebody who kept their -- health care for awhile, the average increase was double digits. If they -- actually got sick and used the insurance , they might find the next year their premiums had gone up. Or the insurer might have dropped them altogether, because now they had a preexisting condition.
Women were being charged as much as double compared to men. So this is a market that wasn't working. And a whole lot of people were dissatisfied. And what we've done is to increase the consumer protections that are in place for those families and those folks . We've said, "You can't drop people when they get sick and need it most." We've said that you can't -- you know, have lifetime limits so that suddenly people think they've got insurance , the next thing they know they've got $30,000-$40,000 out of pocket expenses.
And over the long term, that is the right thing to do. But in this transition, you know, there are gonna be folks who get a cancellation letter, especially when a website 's not workin'. They're lookin' and sayin', "What am I gonna do now?" And -- you know, we have to make sure that they -- are not feeling as if they've been betrayed by an effort that -- is designed to help them.
Do you feel -- considering how much this quote has been -- it's late night, it's all sorts of things, that -- do you understand that people are gonna be skeptical of the next promise you make, of the next -- or are you concerned that people are gonna be wondering, "Jeez, what is the fine print that he's not telling me?" Do you get that people might be a little more skeptical? Forget the partisans here in Washington , just average Americans.
You know, I -- I -- I'll tell you, Chuck . I -- I think that -- I've now been in national public life for seven, eight years. I've been president for -- almost five. And I think for the most part people know that I speak my mind and I tell folks what I think and I've been very clear about what I'm trying to do. And I think most people know that -- even if they disagree with me on certain issues -- that I'm every day workin' hard to try to make life a little bit better for middleclass families who are -- and folks who are tryin' to get in the middleclass who are doin' the right thing and bein' responsible.
I think what most people I hope also recognize is that when you try to do something big like make our health care system better that there're gonna be problems along the way, even if ultimately what you're doing is gonna make a whole lot of people better off. And -- I hope that people will -- look at the end product. And they're gonna be able to look back and say, "You know what? We now have protections that we didn't have before. We've gotten more choice and competition. I didn't have health insurance . I now have it. I had bad health insurance . I now have good health insurance . The website 's actually workin'. I'm getting -- "
" -- I'm getting -- you know, I'm getting -- you know, my kid on my insurance plan, even though he's got asthma or some other preexisting condition." So ultimately, I think I'll be judged on whether this thing is better for people overall. And in the meantime, even if it's a small percentage of people. I mean, we're talkin' about 5% of the population. But -- but that's -- a significant number of people. Even though a whole lot of them are gonna be better off. There's gonna be a segment who -- you know, I've ultimately gotta make sure that -- you know, I'm speakin' to their needs and their concerns. And, you know -- I take that very seriously, because I want everybody out there to know that, you know, my entire intention here is to make sure that -- people have the security of affordable health care .
You have 21 days until November 30th . Is this website gonna be running smoothly enough? If it's not, at that point, do you sit there and say, "Okay, let's extend the enrollment period. Let's delay the mandate." Do all of those plan B 's start coming into focus if November 30th hits?
Well, that -- let me just say generally -- and I don't think I'm sayin' anything that people don't know and I haven't said before. I am deeply frustrated about -- how this website has not worked over the first couple of weeks. And, you know, I take responsibility of that. My team take responsibility of that. And we are working every single day, 24/7, to improve it. And it's better now than it was last week. And it's certainly a lot better than it was on October 1st .
I'm confident that it will be even better by November 30th and that the majority of people are gonna be able to get on there. They're gonna be able to enroll. They're gonna be able to apply. And they're gonna get a good deal -- a better deal than they've got right now when it comes to buyin' health insurance .
Now that -- you know, having said that -- given that I've been burned already with -- a website -- well, more importantly, the American people have been burned by -- a website that has been dysfunctional. What we've also been doing is creating a whole other set of tracks. Makin' sure that people can apply by phone effectively. Making sure that people can apply in person effectively. So what I'm confident about is that anybody who wants to buy health insurance through the marketplace, they are gonna be able to buy it. And --
So no delays? You -- you have no --
-- plans or might -- might --
Keep in mind -- keep in mind that the open enrollment period, the period during which you can buy health insurance is available all the way until March 31st . And we're only five weeks into it. So we've got a whole bunch of time not only to get the website fixed, to work out all the kinks, to make sure that everybody has the information that they need. And what we'll do is -- continue to assess if there are roadblocks for people, we're gonna clear out those roadblocks. We are gonna make sure that they can access --
-- whatever it takes?
Whatever it takes for people to be able to get what is good-quality health insurance at cheaper prices or better insurance for the same price as bad insurance -- that they've got right now. We're gonna make sure that they have access to that market .
You still have full confidence in Kathleen Sebelius ?
You know, I think Kathleen Sebelius , under tremendously difficult circumstances over the last four and a half years -- has done a great job in setting up -- the insurance markets so that there is a good product out there for people to get. You know, Kathleen Sebelius doesn't write code. Yeah, she wasn't our I.T. person . I think she'd be the first to admit that -- if we had to do it all over again, that there would have been a whole lot more questions that were asked, in terms of how this thing is working. But my priority right now is to get it fixed. And -- you know, ultimately, the buck --
Is she still the right person ?
Ultimately, the buck stops with me. You know, I'm the president. This is my team. If it's not working, it's my job to get it fixed.
I want to talk about a larger question. You've discussed the website issue. But there seems to be this growing p -- perception, some of it is the -- press reporting, some of it's your staff, that you're not always on top of some things. Or this idea that you didn't know certain things. So, for instance, we talked about the website . Did the warnings get to your desk or not? N.S.A., did you -- did you really not know you were tapping Angela Merkel 's phone until Edward Snowden leaked it?
Well, look -- these are two different issues. First of all, I can guarantee you that I've been more deeply involved in our intelligence -- operations -- on a whole set of areas where there are real threats against us than just about any president. Well, let me put it this way. As much as any president. When I am presented intelligence , particularly if it pertains to allies like Germany -- I'm not pokin' and probing about where --
You didn�t --
-- we get certain information.
You didn't know this until after ?
The -- if we're talking about Al Qaeda . If we're talking about -- you know, other states that pose a threat to the United States , then not only am I interested in the information, but also how we obtained it, because that's -- very relevant. There's no doubt when it comes to the N.S.A. generally that -- over the last, you know, 30, 40, 50 years, we have tried to extend our intelligence capabilities all around the world . That's what every intelligence agency does. What's changed is technology. What's changed is capacity. We're just so much better than -- anybody else at this. And technology has given us so much more reach than in the past --
-- that now we've got -- we've got to adapt to the architecture of what we do to our capacity. In -- in some ways, the technology and the budgets and the capacity have outstripped the constraints. And we've got to rebuild those in the same way that we're havin' to do on -- a whole series of capacities, military, you know, what we do in terms of -- you know, our drone operations.
So -- so that's a whole big piece of business. But this idea that somehow -- every president is -- you know, looking at the raw intelligence and figuring out what sources those are, that's just not the case. You know, I think that my previous reputation was that I was this policy wonk that was diggin' into stuff all the time.
And -- and -- and -- was -- was immersed in the details. I think that stereotype is probably a little more true than -- the latest one. But -- listen, when you've got the -- a health care rollout that is as important to the country and to me as this is and it doesn't work like a charm, that's my fault. That's somethin' that I've got to -- I've gotta do -- some examination of how that happened. And rather than push down blame on a whole bunch of people underneath me, you know, the easiest thing to do is to, you know -- fire a whole bunch of folks and say, you know -- that -- you know, w -- "They should have done this. They should have done that." My job right now is to make sure that with the assets that we have, we get it done, we get it fixed, and, you know, there are gonna be some lessons learned . I'll -- I'll give you one example -- very quickly.
You know, one of the lessons -- learned from this whole process on the website -- is that probably the biggest gap between the private sector and the federal government is when it comes to I.T. How we precure -- procure it, how we purchase it. This has been true on a whole range of projects.
You know what your supporters say --
How did you -- how did you not be able to do this?
Right. Well, the reason is is that when it comes to my campaign, I'm not constrained by a bunch of federal procurement rules, right? And how we write -- specifications and -- and how the -- the whole things gets built out. So part of what I'm gonna be looking at is how do we across the board, across the federal government , leap into the 21st century. Because when it comes to medical records for veterans, it's still done in paper.
Medicaid is still largely done on paper. When we buy I.T. services generally, it is so bureaucratic and so cumbersome that a whole bunch of it doesn't work or it ends up being way over cost. And yeah, in some ways, I should have anticipated that just because this was important and I was saying this was my top priority. And I was meeting with folks once a month telling 'em, "Make sure this works."
Understanding that you had some structural problems there -- you know, that's on me. That's something that I've got to -- refocus on. And -- I actually think that once we get this -- this particular website fixed, there are gonna be some lessons learned that we can apply to -- the federal government generally.
All right, let me take advantage of those two more questions. negotiations on easing sanctions against Iran start tomorrow, essentially. This -- or they've been going on, but there's -- more talks tomorrow. Why are you so sure you're gonna be able to trust the Iranians on some sort of temporary deal? Or how is it that you're going to figure out if you trust them or not --
Well, fir -- fir -- first of all -- our job is not to trust the I -- Iranians. Our job is to put in place -- mechanisms where we can verify what they're doing and not doing when it comes to their nuclear program . And the negotiations taking place are not about easing sanctions. The negotiations taking place are about how Iran begins to meet its international obligations and provide assurances not just to us but to the entire world --
-- that they are not --
-- until they do something.
That they are not developing nuclear weapons , that their nuclear energy program is peaceful. And frankly, because of their actions in the past, the world doesn't trust 'em on that. That's why we're able to construct these sanctions that have squeezed them very hard. Our job now is to test how serious they are about resolving this conflict or this dispute through peace -- peaceful means, through diplomacy.
And there is the possibility of a phased agreement in which the first phase would be us, you know, halting any advances on their nuclear program , rolling some potential back, and putting in place -- a way where we can provide them some -- very modest relief, but keeping the sanctions architecture in place , keeping the core sanctions in place , so that if it turned out during the course of the six months when we're tryin' to resolve some of these bigger issues that they're backing out of the deal, they're not following through on it, or they're not willin' to go forward and finish the job of -- giving us assurances that they're not developing a nuclear weapon . We can crank that dial back up.
So we don't have to trust them. What we have to do is to make sure that there is a good deal in place from the perspective of us verifying what they're doin'. And that they're actually movin' in the right direction. We can test it. We don't have to dismantle sanctions to do it. If, in fact -- that proves to be -- a possibility, then -- it's greatly preferable to us ratcheting up that conflict higher and higher, which ultimately might lead to -- some sort of confrontation.
And I 've said that I won't take any options off the table, including military options, to prevent Iran from -- getting a nuclear weapon . But -- the best way to -- assure ourselves that -- Iran 's not getting a nuclear weapon is if we've got a verifiable means that they have decided themselves and -- are dismantling that program -- and international organizations can see what they're doin' and we can see what they're doin'.
Final question, did you really not know that your campaign was researching this idea of swapping Joe Biden for Hillary Clinton ?
You know -- again, Chuck , the -- the problem that we've got -- and this goes back to the earlier question you asked. You know, I am in charge of two million people in the federal government . And that was true, by the way, even when -- I was running for president. So people do all kinds of stuff. Some of it -- they clear with me, sometimes they're tryin' to figure somethin' out -- particularly on the political side. And I 'm not somebody who delves into polling and -- all that data.
Here's the one thing I can say for certain. That -- if they had asked me, I would have said there is no way that I'm not running again with Joe Biden . Because I genuinely believe that he has been one of the best vice presidents in our history. He also happens to be a friend. He also happens to be one of my most important advisors on domestic foreign policy . I like him. When my back's up against the wall, he has my back. And --
You know -- I've now been in this town long enough to know that -- folks like to seem important by gettin' -- their version of events in the press -- or books or what have you. And, you know, that's just kind of part of the atmosphere that you live in.
Did you and the vice president talk?
Absolutely. And -- and I -- what I told him -- and he knows and he believes me is that -- I would not -- I would not be here if it weren't for the support that I've had from Joe Biden . He -- he is a personal friend and -- advisor. It's one of the best decisions that I've ever made was selecting him as vice president. I couldn't be prouder of the job that he's done.
Thank you, sir.