TIME’s Exclusive Interview with President Obama

By Karen Tumulty
TIME
July 29, 2009
Karen Tumulty: But some things have changed. I mean, for instance you were very much against an individual mandate. Could you describe how your thinking has evolved on this issue…
President Obama: I feel pretty good that I’ve been pretty consistent on this. The individual mandate is probably the one area where I basically changed my mind. The more deeply I got into the issue, the more I felt that the dangers of adverse selection justified us creating a system that shares responsibility, as long as we were actually making health insurance affordable and there was a hardship waiver for those who, even with generous subsidies, couldn’t afford it. And that remains my position.
Karen Tumulty: What about — you mentioned that subsidies have to be there. What’s — you’re hearing now — 300% [that the government would provide assistance to people earning up to 300% of poverty]. Is that enough? Is that really —
President Obama: Until I actually see the numbers, I don’t want to give a definitive answer on that. I do think that if we can figure out what is a fair, appropriate percentage of your income that you’re paying on health care, and peg it — peg subsidies so that it’s meeting that test, potentially with some regional variation then we’ll get it right. And I think that the committees are working on that. That’s the kind of detail that we had anticipated working through in conference. If it turns out that Congress just can’t get there and that’s the holdup, then we’ll give a very definitive idea of where we need to go on it.
http://www.time.com/time/politics/article/0,8599,1913410-1,00.html

Detail? Figuring out how to make insurance affordable if it is to protect families from the financial burden of the $16,771 already being spent on average for health care? 300 percent of poverty? 400 percent of poverty?
Play with the numbers all you want. Using the model of reform selected by the President and Congress automatically limits the total subsidies to an amount that will not increase the deficit in the federal budget. Even if the majority of employers continue to displace wage or salary increases in exchange for health benefits, the number of hardship waivers issued will have to be much larger than most are projecting. If employers finally bail out, the majority of us would require hardship waivers.
You don’t believe me? Do the numbers, starting with the amount of money they propose to spend on subsidies.

By Karen Tumulty
TIME
July 29, 2009

Karen Tumulty: But some things have changed. I mean, for instance you were very much against an individual mandate. Could you describe how your thinking has evolved on this issue…

President Obama: I feel pretty good that I’ve been pretty consistent on this. The individual mandate is probably the one area where I basically changed my mind. The more deeply I got into the issue, the more I felt that the dangers of adverse selection justified us creating a system that shares responsibility, as long as we were actually making health insurance affordable and there was a hardship waiver for those who, even with generous subsidies, couldn’t afford it. And that remains my position.

Karen Tumulty: What about — you mentioned that subsidies have to be there. What’s — you’re hearing now — 300% [that the government would provide assistance to people earning up to 300% of poverty]. Is that enough? Is that really —

President Obama: Until I actually see the numbers, I don’t want to give a definitive answer on that. I do think that if we can figure out what is a fair, appropriate percentage of your income that you’re paying on health care, and peg it — peg subsidies so that it’s meeting that test, potentially with some regional variation then we’ll get it right. And I think that the committees are working on that. That’s the kind of detail that we had anticipated working through in conference. If it turns out that Congress just can’t get there and that’s the holdup, then we’ll give a very definitive idea of where we need to go on it.

http://www.time.com/time/politics/article/0,8599,1913410-1,00.html

Comment:

By Don McCanne, MD

Detail? Figuring out how to make insurance affordable if it is to protect families from the financial burden of the $16,771 already being spent on average for health care? 300 percent of poverty? 400 percent of poverty?

Play with the numbers all you want. Using the model of reform selected by the President and Congress automatically limits the total subsidies to an amount that will not increase the deficit in the federal budget. Even if the majority of employers continue to displace wage or salary increases in exchange for health benefits, the number of hardship waivers issued will have to be much larger than most are projecting. If employers finally bail out, the majority of us would require hardship waivers.

You don’t believe me? Do the numbers, starting with the amount of money they propose to spend on subsidies.