The ruling is yet another victory for the millions of Americans who are already benefitting from the law including the parents of children with preexisting conditions, women getting mammograms with no out-of-pocket cost, seniors saving hundreds of dollars on their prescription drugs, and one million young adults now newly insured through their parent’s plan.

The ruling also marks the third time a federal appeals court has ruled in favor of the law. Previously, the Sixth Circuit Court of Appeals and the Fourth Circuit Court of Appeals dismissed opponents’ cases against the law.

The Administration has also asked the Supreme Court to hear these cases. We’re confident that, like today, we will prevail. Here’s why:

• The Affordable Care Act, through the individual responsibility requirement, will require everyone, if they can afford it, to carry some form of health insurance since everyone at some point in time participates in the health care system, and incurs costs that must be paid for. For the 83% of Americans who have coverage and who are already taking responsibility for their health care, their insurance premiums will decrease over time.  Only those who are able to pay for health insurance will be responsible for obtaining it and new tax credits and other provisions in the law will make health insurance affordable for middle class families. That’s why the Congressional Budget Office estimated that only 1 percent of all Americans would pay a penalty for not having health insurance in 2016. 
• Opponents of reform wrongly claim that Congress exceeded its authority in regulating when and how people pay for health care. Those who claim that the “individual responsibility” provision exceeds Congress’ power to regulate interstate commerce are simply wrong. People who make a decision to forego health insurance do not opt out of the health care market.  Their action is not felt by themselves alone.  Instead, when they become ill or injured and cannot pay their bills, their costs are shifted to others. Those costs – $43 billion in 2008 alone – are borne by doctors, hospitals, insured individuals, taxpayers and small businesses throughout the nation.
• Additionally, banning insurance companies from discriminating against people with preexisting conditions helps to ensure that every American who can afford it has insurance.  We don’t let people wait until after they’ve been in a car accident to apply for auto insurance and get reimbursed, and we don’t want to do that with health care.  If we’re going to outlaw discrimination based on pre-existing conditions, people should not be allowed to game the system and raise costs on everyone else.  

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor

And what we’ve seen over the last year is not only did the financial sector -- with the Republican Party in Congress -- fight us every inch of the way, but now you’ve got these same folks suggesting that we should roll back all those reforms and go back to the way it was before the crisis.

As he also explained, his nominee to be the first head of the Consumer Financial Protection Bureau, former Ohio Treasurer and Attorney General Rich Cordray, is being blocked from office, noting that “Republicans have threatened not to confirm him not because of anything he’s done, but because they want to roll back the whole notion of having a consumer watchdog.”

Not surprisingly, those Republicans in Congress have looked for any excuse to avoid admitting that they are seeking to weaken these consumer protections – here are the facts behind their attacks on this important new watchdog for consumers:

Fiction: The CFPB is not accountable to Congress or the American public.

Fact: The CFPB is subject to oversight and constraints, including new constraints that do not apply to any other federal banking regulator.

• FSOC Veto: The Financial Stability Oversight Council (FSOC) may, at the request of a member agency, review regulations issued by the CFPB and, in some cases, even reject the consumer bureau’s regulations – this FSOC authority applies only to the CFPB’s regulations and not those of any other banking regulator.
• Capped Funding: The CFPB is the only banking regulator with a cap on its independent funding.  For additional funding, the CFPB must request an appropriation from Congress rather than levy fees on banks, as the other banking regulators may do.
• Small Business Cost Assessment: For each rule, the CFPB is the only financial regulator that must assess possible increases in the cost of credit for small businesses and consider alternatives that could minimize those costs.
• Small Business Panels: The CFPB is the only federal banking regulator required to obtain extensive feedback from small businesses on certain rules that will significantly impact them before even proposing the rule. 

Fiction: Subjecting the CFPB to the appropriations process will make the agency more accountable.

Fact: All federal banking agencies are funded independently, outside of the appropriations process.

Congress has consistently provided for independent funding for banking regulators to allow for long-term planning and to ensure that banks are examined regularly, thoroughly, and in a manner that is insulated from political influence.

• Banking supervisors cannot do their job if they are worried that their next examination report will lead to political retribution and funding losses.  
• As numerous Republicans and Democrats have noted, moving Fannie Mae’s and Freddie Mac’s regulator into the appropriations process crippled its ability to make politically difficult yet necessary decisions, which contributed to their failure when the financial crisis hit.

Fact: The CFPB is the only banking regulator with a statutory cap on its primary source of independent funding.

• Whereas other banking regulators can raise more money independently, the CFPB has to seek additional funding through the appropriations process.

Fiction: the government is spending too much money on Consumer Protection

Fact:  It would take nearly 15 years of operation for CFPB to spend as much money as it cost the government to resolve IndyMac – a single institution that failed during the financial crisis of 2008.

Fiction: Congress has no meaningful oversight over the CFPB.

Fact: Congress has ample oversight through hearings, reports, and audits that are required by law.

• The CFPB must submit annual financial reports and semi-annual budget justifications to Congress, report before the relevant House and Senate committees at least twice a year, and receive a yearly Government Accountability Office audit.
• Congress may also overturn any CFPB regulation through legislation if it disagrees with the CFPB’s judgment.
• An independent Inspector General reviews the CFPB’s activities and informs Congress and the public about the CFPB’s programs and activities.

Fiction: Regulators have no ability to prevent CFPB mandates that threaten the financial health of banks.

Fact: Other banking regulators possess multiple checks over the CFPB.

• Unlike any other financial regulator, CFPB’s rules are subject to review and rejection by the FSOC on grounds that they threaten the safety and soundness or stability of the U.S. financial system.
• Before issuing the report of an examination of a depository institution, the CFPB is required to share a draft of its report with the prudential regulator and take into account any comments received from the prudential regulator.
• For rules that the CFPB writes under consumer financial laws, the CFPB must consult with the appropriate federal banking regulators and respond to any written objections they raise.

Fiction: The CFPB’s structure provides the CFPB’s Director with unprecedented power.

Fact: The CFPB is led by an individual, just as the OCC has been for more than 100 years.

• The OCC, the agency charged with overseeing the safety and soundness of national banks, is led by a single Comptroller.

Fiction: There are no effective checks and balances against the CFPB Director’s power.

Fact: There are a number of checks and balances on the CFPB’s Director.

• The Director is subject to congressional oversight and required to testify at least twice annually.
• CFPB’s regulations are subject to FSOC review (as described above).
• CFPB’s regulatory actions can be overturned by Congress or judicial review. 

Today, the Senate Banking Committee will take a vote that is critical to implementing this law so that it fully protects consumers from hidden fees and abusive practices: the committee is scheduled to vote on the nomination of Richard Cordray to become the Director of the Consumer Financial Protection Bureau (CFPB). The CFPB was created as part of Wall Street reform to enforce consumer protections.   

Today’s vote, and the subsequent vote by the full Senate to confirm Richard Cordray, is so important because without a director the CFPB is hamstrung in its ability to protect consumers. Without a director, the CFPB will be unable to ensure that banks, debt collectors, private student loan providers and payday loan providers are properly supervised and that consumers are not put at risk of falling prey to the same kinds of abusive practices that helped cause the worst financial crisis since the Great Depression. 

But despite these important protections, Senate Republicans have pledged to oppose this nomination, choosing to support special interests at the expense of consumers. This move is just the latest in a string of efforts by Congressional Republicans to defund, delay and dismantle President Obama’s Wall Street Reform law. 

Republicans on the Committee have admitted that their opposition has nothing to do with Cordray’s credentials. He is the former Attorney General and Treasurer of Ohio with a solid track record of cracking down on companies that break the rules while supporting companies that play by them.  Throughout his career, Cordray has tackled problems by partnering with others – regardless of party affiliation or ideology – to craft pragmatic and sensible solutions.  He addressed Ohio’s foreclosure crisis head-on with his “Save Our Homes” initiative working with bankers, businesses, nonprofits, and government officials to help responsible homeowners stay in their homes.  And he has been endorsed by elected officials on both sides of the aisle, consumer advocates and business leaders alike and editorial boards across the country. Despite his record as a pragmatic problem solver, Senate Republicans are opposing his nomination, standing with the financial industry and against the veterans, homeowners and middle class families that the CFPB is charged with protecting. 

We can’t afford to go back to a system where consumers were put at risk by those who gamed the system, and our whole economy was vulnerable to a massive financial crisis.  That’s why reform matters.  That’s why the CFPB matters.  And President Obama will fight efforts to repeal or undermine these important changes.  It’s time for Richard Cordray to be confirmed so that the CFPB can do its job and fully protect consumers. 

The American Jobs Act includes a series of proposals that will give a boost to the economy and get Americans back to work -- the kinds of proposals that have been supported in a bipartisan way in the past. It’s a plan that not only puts money back in the pockets of middle class families, and puts workers back on the job, but also includes the kinds of proposals that economists agree will help business grow and hire.  And it’s a plan that rebuilds the economy in the American Way – based on fairness, balance and ensuring there is the same set of rules for everyone from Wall Street to Main Street.  

Mr. Donahue questions whether the plan will create jobs.  The answer is simple: yes it will. Prominent, independent experts have said that the American Jobs Act could create 1.5 million or more jobs, increase growth by as much as two percentage points next year, and lower the unemployment rate.    

And the American Jobs Act is fully paid for, not adding a dime to the deficit. We share Mr. Donahue’s concern about cutting spending and reducing our deficit. That’s why the President recently signed into law the Budget Control Act, which locked in almost a trillion dollars in cuts to discretionary spending. The American Jobs Act increases the Joint Committee’s deficit reduction target to cover the full cost of the job creation provisions. On Monday, the President will outline his vision for a balanced approach deficit reduction to the Joint Committee.   

We also share the Chamber’s goals of investing in our nation’s infrastructure. A few weeks ago, the President was joined by representatives from the Chamber and the head of the AFL-CIO – groups that usually don’t agree on much – to come together and call on Congress to extend the surface transportation bill.  And that’s why the American Jobs Act makes the investments in our nation’s infrastructure that will put construction workers back to work and rebuild and modernize our nation.    

We hear a lot from the Republican Leadership and the Chamber on the need to reduce burdensome regulations. We agree. The President ordered a government-wide review of existing federal regulations. So far, we’ve identified over 500 reforms, which will save billions of dollars over the next few years.The number of rules we’ve reviewed and issued in the first two years of this Administration is actually lower than the number of rules issued in the last two years of the Bush Administration. 

But let’s be clear. The President will continue to protect the health, safety and well-being of American families – keeping their air and water clean, food and highways safe. He fought to ensure American families have the strongest consumer protections in history and protection against being discriminated against for having a preexisting condition. Overturning these reforms might be popular with Republican special interests and donors, but they aren’t good for American families and that’s why we will keep fighting to ensure they are implemented effectively. 

We also agree with Mr. Donahue on the importance of passing three Free Trade Agreements that the President negotiated that will support tens of thousands of American jobs, supporting affordable clean energy and ensuring our visa system is fair.  

The American Jobs Act contains ideas that are supported by both Democrats and Republicans that will put people back to work and put more money in the pockets of working Americans. It includes tax cuts. It keeps teachers in the classroom and cops on the beat. It rebuilds our roads and bridges. Bottom line, it puts Americans back to work right now.  

We should all agree is that the economy needs a boost, and that we need to do more to get the American people back to work. We hope that Mr. Donahue and the businesses his group represents will join us in this important goal for our nation.

Today’s decision marks the second victory for health reform in a federal appeals court. Previously, the 6th Circuit Court of Appeals found the Affordable Care Act constitutional.

In today’s ruling, the 4th Circuit determined that lawsuits filed by Liberty University and the Virginia Attorney General must be dismissed for jurisdictional reasons. Importantly, two judges -- Judge Davis and Judge Wynn – wrote that if the lawsuits were not dismissed, they would rule in favor of the Affordable Care Act.  Judge Wynn wrote:

...I would uphold the constitutionality of the Affordable Care Act…

And Judge Davis wrote:

Reaching the merits, I would hold that the challenged provisions of the Act are a proper exercise of Congress’s authority under the Commerce Clause to regulate the interstate markets for health services and health insurance.

In the weeks ahead, the legal process regarding the Affordable Care Act will continue. When it ends, we are confident we will prevail.
 

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor

Today, a different court ruled against the Affordable Care Act’s individual responsibility provision. We strongly disagree with this decision and we are confident it will not stand.

The individual responsibility provision – the main part of the law at issue in these cases – is constitutional. Those who claim this provision exceeds Congress’ power to regulate interstate commerce are incorrect. Individuals who choose to go without health insurance are making an economic decision that affects all of us – when people without insurance obtain health care they cannot pay for, those with insurance and taxpayers are often left to pick up the tab.

Judge Sutton, a Judge in the Sixth Circuit who upheld the law, declared that the individual responsibility provision is constitutional and wrote: “In choosing how to regulate [people who choose to self-insure], Congress also did not exceed its power.”

Judge Martin, another Judge who upheld the law in the Sixth Circuit, said the Affordable Care Act is constitutional under the Commerce Clause because “(1) virtually everyone requires health care services at some unpredictable point; and (2) individuals receive health care services regardless of ability to pay. Virtually everyone will need health care services at some point, including….those without health insurance.” 

That’s why the Affordable Care Act requires everyone who can afford it to take responsibility for their own health care and carry some form of health insurance. 

For the 83% of Americans who have coverage and who are already taking responsibility for their health care, the Affordable Care Act will help insurance premiums to decrease over time.  And only those who are able to pay for health insurance will be responsible for obtaining it.  The Congressional Budget Office estimated that only 1 percent of all Americans would pay a penalty for not having health insurance in 2016.

Without the individual responsibility provision, people could wait until they’re sick or injured to apply for coverage since insurance companies could no longer say no or charge more.  That would lead to double digit premiums increases – up to 20% – for everyone in the individual insurance market.

By bringing everyone into the health insurance system, we can not only lower costs for everyone but also finally ban discrimination against individuals with pre-existing conditions.

Today’s ruling is one of many decisions on the Affordable Care Act that we will see in the weeks and months ahead. In the end, we are confident the Act will ultimately be upheld as constitutional.

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor
 

Claim: The President has failed to put forward a plan to tackle our long term debt and deficits.

• Since the beginning of the current debate on the debt ceiling, the President has led with a comprehensive plan for deficit reduction.
   
• In April, the President released a fiscal framework for $4 trillion in deficit reduction, which described the President’s plans for closing tax loopholes and for responsible reforms of Medicare and Medicaid so they are strengthened for future generations. 
   
• Beginning less than a week after he announced this Framework, the President led four separate efforts to negotiate a compromise on the debt limit – talks with Vice President Joe Biden, meetings with all eight Congressional leaders from both parties, and two rounds of negotiations directly with Speaker Boehner.
   
• Throughout this process, the Administration put forward specific policy proposals with the goal of reaching an agreement on a $4 trillion package – an agreement which Speaker Boehner ultimately walked away from.

Claim: The GOP “won the policy debate” during the debt negotiations. 

• We believe that this agreement was not a victory for one party, but for the American people. If Congress did not act and allowed the United States to default on its obligations, the results would have been catastrophic for our economy and for millions of Americans still digging out from the last recession.
   
• The debt agreement is consistent with the President’s commitment to protecting our nation from default and achieving significant deficit reduction through a balanced approach.  It represents an important down payment on reform of about $1 trillion and sets the stage for additional balanced deficit reduction by the end of the year.
   
• In enacting this bill, the President held to his principles—and prevented Republicans from ending Medicare as we know it, slashing Medicaid, and threatening Social Security. 
   
• The President prevented Republicans from using the prospect of default as leverage again in six months by pushing any additional debt limit increases to 2013.
   
• The cuts in the first phase are balanced between domestic and security spending, while protecting critical initiatives like aid for college students. 
   
• If the new Joint Committee on Deficit Reduction fails to act, the law includes a balanced enforcement mechanism—that divides automatic cuts 50-50 between defense and non-defense with low-income programs exempted. 

Claim: The President “warned Republican leaders not to call his bluff by sending him a bill without tax increases.”

• As the AP reported, President Obama warned Republicans not to call his bluff “by passing a short-term debt limit increase he has threatened to veto.”
   
• The President stood firm and forced Republicans to back down, preventing them from using the prospect of default as leverage again in six months by ensuring that any additional debt limit increases will not be needed until 2013.

Claim: Spending on Medicare, Medicaid and the Affordable Care Act is projected to skyrocket, while the House Republicans’ budget outlined a responsible approach to Medicare and Medicaid Reform.

• The Affordable Care Act was fully paid for, and according to the CBO will reduce the deficit by $200 billion over the next 10 years and by more than $1 trillion in the next decade.
   
• The Affordable Care Act will provide coverage to 34 million Americans and will extend the life of the Medicare trust fund.
   
• The House Republican plan would convert Medicare into a voucher program; increasing seniors’ health costs by $6,400 annually starting in 2022; raise health insurance premiums for middle-class Americans and small businesses; and cut Federal Medicaid spending by one-third by the end of the decade, which would cause 50 million to lose coverage.

Claim: The House Republicans’ plan would put the budget on a path to balance without tax increases, while President Obama tried to use the debt ceiling negotiations to raise taxes.

• The House Republicans’ plan would also put the nation on a path to end the guarantee of Medicare for our seniors while imposing deep spending cuts that would harm our economy to balance out tax cuts for the highest income earners.
   
• Their approach locks in many of the irresponsible policies that brought us to the debt limit this week including tax cuts for the wealthy, big corporations and special interests.
   
• In stark contrast, the President stands committed to a balanced approach with responsible entitlement reform, and comprehensive tax reform that produces a system which is fairer, has fewer loopholes, less complexity, and is not rigged in favor of those who can afford lawyers and accountants to game it.

While we don’t know exactly what stem cell research will yield, scientists believe this research could treat or cure diseases that affect millions of Americans every year. That’s why President Obama has long fought to support responsible stem cell research.

Less than three months after taking office in 2009, the President signed an Executive Order that removed barriers to responsible scientific research involving human stem cells. The previous Administration allowed the National Institutes of Health to fund human embryonic stem cell research on cell lines created before an arbitrary date, August 9, 2001, but prohibited research on cell lines created after that date. The Executive Order signed by President Obama lifted this restriction.

Since then, scientists and experts in the private sector and at the National Institutes of Health have been investigating new responsible research opportunities with stem cell lines that adhere to the new guidelines, but were not available to experts under the old restrictions.

For too long, patients and families have suffered from debilitating, incurable diseases and we know that stem cell research offers hope to millions of Americans across the country. President Obama is committed to supporting responsible stem cell research and today’s ruling was another step in the right direction.

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor

To solve our deficit problems, the President is willing to make tough choices -- it’s time for members of both parties to do the same. But, solving our fiscal problems requires shared sacrifice -- which means the wealthiest and special interests should pay their fair share. 

Here are a few highlights from today’s press conference:

Tackling Our Debt and Deficit

What I emphasized to the broader group of congressional leaders yesterday is, now is the time to deal with these issues.  If not now, when?  I've been hearing from my Republican friends for quite some time that it is a moral imperative for us to tackle our debt and our deficits in a serious way.  I've been hearing from them that this is one of the things that's creating uncertainty and holding back investment on the part of the business community.  And so what I've said to them is, let's go. And it is possible for us to construct a package that would be balanced, would share sacrifice, would involve both parties taking on their sacred cows, would involved some meaningful changes to Medicare, Social Security, and Medicaid that would preserve the integrity of the programs and keep our sacred trust with our seniors, but make sure those programs were there for not just this generation but for the next generation; that it is possible for us to bring in revenues in a way that does not impede our current recovery, but is fair and balanced. 

We have agreed to a series of spending cuts that will make the government leaner, meaner, more effective, more efficient, and give taxpayers a greater bang for their buck.  That includes defense spending.  That includes health spending.  It includes some programs that I like very much, and we – be nice to have, but that we can’t afford right now.

Putting Politics Aside

So I continue to push congressional leaders for the largest possible deal.  And there's going to be resistance.  There is, frankly, resistance on my side to do anything on entitlements.  There is strong resistance on the Republican side to do anything on revenues.  But if each side takes a maximalist position, if each side wants 100 percent of what its ideological predispositions are, then we can’t get anything done.  And I think the American people want to see something done.  They feel a sense of urgency, both about the breakdown in our political process and also about the situation in our economy.

So what I’ve said to the leaders is, bring back to me some ideas that you think can get the necessary number of votes in the House and in the Senate.  I’m happy to consider all options, all alternatives that they’re looking at.  The things that I will not consider are a 30-day or a 60-day or a 90-day or a 180-day temporary stopgap resolution to this problem.  This is the United States of America, and we don’t manage our affairs in three-month increments.  We don’t risk U.S. default on our obligations because we can’t put politics aside. 

Asking Very Wealthiest to Pay Fair Share

I want to be crystal clear – nobody has talked about increasing taxes now.  Nobody has talked about increases – increasing taxes next year.  What we have talked about is that starting in 2013, that we have gotten rid of some of these egregious loopholes that are benefiting corporate jet owners or oil companies at a time where they're making billions of dollars of profits.  What we have said is as part of a broader package we should have revenues, and the best place to get those revenues are from folks like me who have been extraordinarily fortunate, and that millionaires and billionaires can afford to pay a little bit more…

And what I've also said to Republicans is, if you don't like that formulation, then I'm happy to work with you on tax reform that could potentially lower everybody's rates and broaden the base, as long as that package was sufficiently progressive so that we weren’t balancing the budget on the backs of middle-class families and working-class families, and we weren’t letting hedge fund managers or authors of best-selling books off the hook.

Protecting Critical Investments

If you look at the numbers, then Medicare in particular will run out of money and we will not be able to sustain that program no matter how much taxes go up.  I mean, it’s not an option for us to just sit by and do nothing.  And if you’re a progressive who cares about the integrity of Social Security and Medicare and Medicaid, and believes that it is part of what makes our country great that we look after our seniors and we look after the most vulnerable, then we have an obligation to make sure that we make those changes that are required to make it sustainable over the long term.

And if you’re a progressive that cares about investments in Head Start and student loan programs and medical research and infrastructure, we’re not going to be able to make progress on those areas if we haven’t gotten our fiscal house in order.

So the argument I’m making to my party is, the values we care about – making sure that everybody in this country has a shot at the American Dream and everybody is out there with the opportunity to succeed if they work hard and live a responsible life, and that government has a role to play in providing some of that opportunity through things like student loans and making sure that our roads and highways and airports are functioning, and making sure that we’re investing in research and development for the high-tech jobs of the future – if you care about those things, then you’ve got to be interested in figuring out how do we pay for that in a responsible way… But the reason we’ve got a problem right now is people keep on avoiding hard things, and I think now is the time for us to go ahead and take it on.

Shared Sacrifice

Now, what I will say is, is that the revenue components that we’ve discussed would be significant and would target folks who can most afford it.  And if we don't do any revenue – because you may hear the argument that why not just go ahead and do all the cuts and we can debate the revenue issues in the election – right?  You’ll hear that from some Republicans.  The problem is, is that if you don't do the revenues, then to get the same amount of savings you’ve got to have more cuts, which means that it’s seniors, or it’s poor kids, or it’s medical researchers, or it’s our infrastructure that suffers. 

And I do not want, and I will not accept, a deal in which I am asked to do nothing, in fact, I’m able to keep hundreds of thousands of dollars in additional income that I don’t need, while a parent out there who is struggling to figure out how to send their kid to college suddenly finds that they’ve got a couple thousand dollars less in grants or student loans. 

That’s what the revenue debate is about.  It’s not because I want to raise revenues for the sake of raising revenues, or I’ve got some grand ambition to create a bigger government.  It’s because if we’re going to actually solve the problem, there are a finite number of ways to do it.  And if you don’t have revenues, it means you are putting more of a burden on the people who can least afford it.  And that’s not fair.  And I think the American people agree with me on that.

Building Confidence to Grow the Economy

So as part of a component of a deal, I think it’s very important for us to look at what are the steps we can take short term in order to put folks back to work.  I am not somebody who believes that just because we solve the deficit and debt problems short term, medium term, or long term, that that automatically solves the unemployment problem.  I think we’re still going to have to do a bunch of stuff -- including, for example, trade deals that are before Congress right now that could add tens of thousands of jobs. 

Republicans gave me this list the beginning of this year as a priority, something that they thought they could do.  Now I’m ready to do it, and so far we haven’t gotten the kind of movement that I would have expected.

We’ve got the potential to create an infrastructure bank that could put construction workers to work right now, rebuilding our roads and our bridges and our vital infrastructure all across the country.  So those are still areas where I think we can make enormous progress. 

I do think that if the country as a whole sees Washington act responsibly, compromises being made, the deficit and debt being dealt with for 10, 15, 20 years, that that will help with businesses feeling more confident about aggressively investing in this country, foreign investors saying America has got its act together and are willing to invest.  And so it can have a positive impact in overall growth and employment.

Now Is the Time

And when you ask them, well, what would you do?  “We’ve got to get government spending under control and we’ve got to get our deficits under control.”  So I say, okay, let’s go.  Where are they?  I mean, this is what they claim would be the single biggest boost to business certainty and confidence.  So what's the holdup?

We’re gratified by today’s ruling, which came from judges appointed by Democratic and Republican Presidents who agreed that the law’s individual responsibility provision (sometimes called the minimum coverage provision) is constitutional. In today’s ruling, the court held that:

…the minimum coverage provision is a valid exercise of legislative power by Congress under the Commerce Clause...

Judge Martin also addressed the claim that the individual responsibility provision somehow regulates “inactivity.” He wrote:

Furthermore, far from regulating inactivity, the minimum coverage provision regulates individuals who are, in the aggregate, active in the health care market…The vast majority of individuals are active in the market for health care delivery because of two unique characteristics of this market: (1) virtually everyone requires health care services at some unpredictable point; and (2) individuals receive health care services regardless of ability to pay. Virtually everyone will need health care services at some point, including, in the aggregate, those without health insurance. Even dramatic attempts to protect one’s health and minimize the need for health care will not always be successful, and the health care market is characterized by unpredictable and unavoidable needs for care.

Judge Sutton agreed that the individual responsibility provision is constitutional and wrote:

In choosing how to regulate [people who choose to self-insure], Congress also did not exceed its power.

There are a number of cases regarding the Affordable Care Act that will continue to be heard in courts nationwide, and at the end of the day, we are confident the constitutionality of these landmark reforms will be upheld.   For more information about the individual responsibility provision, check out this post I wrote in May that outlines the importance of this provision.

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor

In all of these cases, the plaintiffs may be different, but the arguments they bring to the courthouse are essentially the same. The challenges focus primarily on one provision of the law - people on both sides of the debate agree that the vast majority of the act is clearly constitutional.  And the arguments for overturning the Affordable Care Act are simply without merit.

Opponents of reform claim that the law’s individual responsibility provision exceeds Congress’ power to regulate interstate commerce because it penalizes “inactivity.” They are wrong. Individuals who choose to go without health insurance are actively making an economic decision that affects all of us. When people without insurance obtain health care they cannot pay for, those with insurance and taxpayers are often left to pick up the tab.

That’s why the Affordable Care Act requires everyone who can afford it to carry some form of health insurance. 83 percent of Americans already have insurance and only those who are able to afford health insurance will be responsible for obtaining it. And the Congressional Budget Office estimated that only 1 percent of all Americans would pay a penalty for not having health insurance in 2016.

The individual responsibility provision also enables us to finally ban discrimination against individuals with pre-existing conditions. Without the individual responsibility provision, people could wait until they’re sick or injured to apply for coverage since insurance companies could no longer say no or charge more.  That would lead to double digit premiums increases – up to 20% – for everyone in the individual insurance market.

We know that there will be a number of arguments and decisions in courts across the country in the weeks and months ahead and when the legal process ends, we are confident that the Affordable Care Act will be found constitutional.  

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor.

We’re confident that the Affordable Care Act is constitutional. Already, two additional judges have found the law to be constitutional. And the facts are on our side.

• Those who claim that the “individual responsibility” provision exceeds Congress’ power to regulate interstate commerce because it penalizes “inactivity” are simply wrong. Individuals who choose to go without health insurance are actively making an economic decision that affects all of us.
• A new report released today from the Department of Health and Human Services makes clear that those without insurance struggle to pay for health care. According to the report, uninsured people cannot pay the full cost of 88 percent of their hospital bills.  Even the uninsured with the greatest income and assets cannot fully pay for half of their hospital bills. 

When people without insurance obtain health care they cannot pay for, those with insurance and taxpayers are often left to pick up the tab.

The Affordable Care Act requires everyone who can afford it to carry some form of health insurance.

• For the 83% of Americans who have coverage and who are already taking responsibility for their health care, the Affordable Care Act will help insurance premiums to decrease over time.
• Only those who are able to pay for health insurance will be responsible for obtaining it.
• The Congressional Budget Office estimated that only 1 percent of all Americans would pay a penalty for not having health insurance in 2016. 

To lower the cost of health care for everyone, we have to stop making those who act responsibly pick up the health care tab for those who don’t – and that means we need everyone to be a part of the health insurance marketplace. Bringing everyone into the system will also enable us to finally ban discrimination against individuals with pre-existing conditions. Without the individual responsibility provision, people could wait until they’re sick or injured to apply for coverage since insurance companies could no longer say no or charge more.  That would lead to double digit premiums increases – up to 20% – for everyone in the individual insurance market.

We are confident the various cases regarding the law will be decided quickly, long before the law is scheduled to be fully implemented. And we are confident we will prevail.

Today, we are releasing State-by-State charts that provide more detailed information on how seniors in your State are benefitting from the Affordable Care Act. Check out the data for your State below.

Unfortunately, some in Congress want to undo this progress and take us backwards. Under the Republican Medicare plan, a typical 65-year-old who becomes eligible for Medicare would pay an extra $6,400 than what he or she would pay if the plan were not adopted. You can learn more about the Republican plan here.

President Obama is committed to strengthening Medicare and building on the Affordable Care Act. As the new charts show, millions of seniors are already receiving better health care and paying less thanks to this landmark law – and, each year, these benefits will get even better.

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor.

No Guaranteed Coverage

The Congressional Republican plan privatizes Medicare, ending the program as we know it. Insurance companies would be under no obligation to offer insurance to seniors, so many older Americans could be left with no insurance at all.

The Affordable Care Act preserves Medicare and improves it by making prevention and prescription drugs more affordable, lowering its costs, and improving the quality of care. And health reform extends the life of the Medicare Trust Fund and helps ensure Medicare will continue to provide coverage to seniors in the decades to come.

Get Older, Pay More

The Republican plan repeals Medicare’s current policy where seniors are not charged more because of their age. Under the Republican plan, seniors could be forced to pay more for their health care every year, simply because they’ve grown older.
 

No Affordable Choices

The Republican Medicare plan makes health coverage less affordable for seniors.  In the first year it goes into effect, a typical 65-year-old who becomes eligible for Medicare would pay an extra $6,400 for health care, more than doubling what he or she would pay if the plan were not adopted. And the Republican plan would replace extra coverage for low-income enrollees with a capped, insufficient medical savings account. 

In sharp contrast, the Affordable Care Act lowers costs for people in Medicare by improving its performance and squeezing out waste, fraud and abuse. The law also provides free preventive care and cheaper prescription drugs for people in Medicare. As a result, we estimate that a typical senior could save $3,500 over the next decade as a result of the Affordable Care Act. 

Less Transparency

The Affordable Care Act will help make the health care system more open, more transparent and easier to understand. 

The Republican plan takes us in the opposite direction. Today, people in Medicare can quickly learn about their benefits. Under the Republican plan, they’d be left in the dark. The Republican plan would force seniors to purchase insurance on their own and critical consumer protections that would make the insurance marketplace easier to understand would be repealed. 

Silver Lining

The facts are clear: the Affordable Care Act and the Republican plan to end Medicare as we know it are very different. It’s heartening to see Republicans aspire to produce a plan that resembles the historic reforms President Obama signed into law.  But if they want a proposal that is similar to the Affordable Care Act, they’ll have to head back to the drawing board.

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor.

Nan Warshaw owns a record company in Chicago, Illinois, and makes the health insurance decisions for her seven person staff. Her company covers the full cost of insurance for her employees. Like other small business owners, she has seen premiums skyrocket in recent years. But thanks to the tax credits for small businesses in the Affordable Care Act, providing health insurance for her employees will be a little easier.

Today, small businesses pay 18 percent more for health insurance premiums than large businesses.   The Affordable Care Act changes that by providing tax credits for small businesses that offer employees health insurance.  Up to 4 million small businesses could be eligible for relief from high health insurance premiums and, according to the independent Congressional Budget Office, the tax credit will save small businesses $40 billion by 2019. And the tax credit is available to small business owners like Nan today.

The tax credits are just one of the ways the health reform law will help small businesses. The law will also help level the playing field with large employers by allowing small businesses to band together to get a fairer deal from insurance companies through the creation of competitive private health insurance markets called Exchanges that go into effect in 2014. Exchanges help organize the health insurance marketplace to help consumers and small businesses shop for coverage in a way that permits easy comparison of available plan options based on price, benefits and services, and quality. Pooling people together can help bring costs down and Exchanges will make our health care system more transparent and competitive by making it easier for consumers to compare costs and benefits.

Listen to Nan’s story:

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor.

It’s important to remember what repealing the Affordable Care Act would mean to millions of Americans. Without the new law:

• Over 1.2 million young adults will lose their insurance coverage through their parents’ health plans.
• Up to 4 million small businesses that would have been eligible for health care tax credits will pay higher taxes.
• 44 million Americans on Medicare will be denied free preventive care and seniors who hit the donut hole will pay more for their prescription drugs.
• Insurance companies will have free rein to once again deny coverage to people, including children, with pre-existing conditions, cancel coverage when people get sick, and limit the amount of care people get, even when they need it.  
• Insurance companies will be free to once again raise premiums by double digits with no recourse or accountability. 
• As many as 32 million Americans who would have gained insurance under the new law will go without coverage.
• Families will pay higher premiums. For example, compared to what they would have paid without the law, the Affordable Care Act could save a family of four with an income of $33,525 as much as $14,900 per year.

By rolling back the Affordable Care Act, Republicans are also voting to add a trillion dollars to the deficit. The non-partisan Congressional Budget Office has concluded that repealing the Affordable Care Act would add nearly a quarter of a trillion dollars to the deficit in the first decade – $230 billion – and more than a trillion dollars in the second decade.  

And according to independent experts, repealing the Affordable Care Act would prevent 250,000 – 400,000 jobs from being created each year.

President Obama and his team are committed to moving forward and delivering the benefits of the new law to the American people. We know that health reform is already delivering tax credits to small business owners like Betsy Burton of Salt Lake City, Utah. Thanks to the new law, young Americans like Kayla Holmstrom of Brookings, South Dakota are able to stay on their parent’s health plan. James Howard of Katy, Texas, a brain cancer patient, has the treatment he needs. And Cathy Lynn Howell from Marblehead, Ohio finally has insurance after being locked out of the insurance marketplace because of her pre-existing condition.

We featured all of these Americans in our Voices of Health Reform project and they are just a few of the millions of people who are already benefitting from the Affordable Care Act. And we’re committed to moving forward, strengthening the health care system for all of us and delivering the benefits of reform to the American people.

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor.

The decision issued on Monday is one district court decision, and we believe it to be very wrong.   The Department of Justice has made clear that it is reviewing all of its options in responding to this case, as it does in all cases. Implementation will continue.

Legal experts agree with our assessment of Judge Vinson’s ruling. Here’s what they are saying about the ruling and the case:

Boston College Law Professor Brian Galle:

“The ACA and its accompanying incentives to buy insurance overcome a collective action problem among states.  Thus, the ACA is easily distinguished from the court's parade of broccoli horribles; even if one thought that the federal government should deal only with uniquely national problems, the ACA easily meets that standard.”

David Engstrom, Stanford Law School Faculty Member:

“The issue that the court has ruled on has been specifically contradicted by two other district courts. So, the idea that the Obama administration should somehow stand down from implementing the act, based on a fourth district court, doesn't have any basis in law.”

NYU Constitutional Law Professor Rick Hills:

“Consider the following train wreck of Necessary & Proper reasoning contained in Judge Vinson's opinion striking down the individual mandate:

• It is a legitimate end for Congress to regulate the insurance industry to prevent "insurers from excluding or charging higher rates to people with pre-existing conditions" (pages 60-61);
• The Individual Mandate in the ACA is "necessary" to enable Congress to regulate the insurance industry in this manner (page 63). Yet...
• "[T]he individual mandate falls outside the boundary of Congress’ Commerce Clause authority and cannot be reconciled with a limited government of enumerated powers."

Huh? How can a means that is conceded to be necessary for a legitimate end not be within Congress' implied powers to pursue that end? Judge Vinson never presents even the simulacrum of an argument: Instead, he engages in hand-waving.”

George Washington University Law Professor Orin Kerr:

“I think Judge Vinson’s argument on the Necessary and Proper Clause is not persuasive…Rather, my point is that Judge Vinson should not have used a first principle to trump existing Supreme Court caselaw when that principle may not be consistent with existing caselaw. Either Justice Thomas is wrong or Judge Vinson is wrong, and Judge Vinson was not making a persuasive legal argument when he followed the first principle instead of the cases. Because Judge Vinson is bound by Supreme Court precedent, I would think he should have applied the cases.”

Cornell University Law Professor Mike Dorf:

“Judge Vinson appeared to base the total nonseverability decision partly on what he took to be Congressional intent.… Judge Vinson's approach ought to be especially unappealing to the Supreme Court's “textualists,” who don't even like to speculate about what Congress subjectively intended by the language it enacted.  How much worse it should be to speculate about what Congress might have done if it had known that a provision it enacted would subsequently be found invalid.”

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor.

Today’s ruling – issued by Judge Vinson in the Northern District of Florida – is a plain case of judicial overreaching.   The judge’s decision contradicts decades of Supreme Court precedent that support the considered judgment of the democratically elected branches of government that the Act’s “individual responsibility” provision is necessary to prevent billions of dollars of cost-shifting every year by individuals without insurance who cannot pay for the health care they obtain.  And the judge declared that the entire law is null and void even though the only provision he found unconstitutional was the “individual responsibility” provision.  This decision is at odds with decades of established Supreme Court law, which has  consistently found that courts have a constitutional obligation to preserve as a much of a statute as can be preserved. As a result, the judge’s decision puts all of the new benefits, cost savings and patient protections that were included in the law at risk.

Under today’s view of the law, seniors will pay higher prices for their prescription drugs and small businesses will pay higher taxes because small business tax credits would be eliminated. And the new provisions that prevent insurance companies from denying, capping or limiting your care would be wiped away.

We don’t believe this kind of judicial activism will be upheld and we are confident that the Affordable Care Act will ultimately be declared constitutional by the courts.

History and the facts are on our side. Similar legal challenges to major new laws -- including the Social Security Act, the Civil Rights Act, and the Voting Rights Act -- were all filed and all failed. And contrary to what opponents argue the new law falls well within Congress’s power to regulate economic activity under the Commerce Clause, the Necessary and Proper Clause, and the General Welfare Clause.

Those who claim that the “individual responsibility” provision exceeds Congress’ power to regulate interstate commerce because it penalizes “inactivity” are simply wrong. Individuals who choose to go without health insurance are actively making an economic decision that impacts all of us. People who make an economic decision to forego health insurance do not opt out of the health care market.  As Congress found, every year millions of people without insurance obtain health care they cannot pay for, shifting tens of billions of dollars in added cost onto those who have insurance and onto taxpayers.   There can be no doubt that this activity substantially affects interstate commerce, and Congress has the power to regulate it. 

The Affordable Care Act, through the individual responsibility requirement, will require everyone, if they can afford it, to carry some form of health insurance since everyone at some point in time participates in the health care system, and incur costs that must be paid for. For the 83% of Americans who have coverage and who are already taking responsibility for their health care, their insurance premiums will decrease over time.  Many of those who are currently struggling to pay for insurance will get a new tax credit. Only those who are able to pay for health insurance will be responsible for obtaining it. Because most people would voluntarily purchase coverage as it becomes more affordable and the policy exempts those for whom purchase would cause a financial hardship, the Congressional Budget Office estimated that only 1 percent of all Americans would pay a penalty for not having health insurance in 2016.  

The Affordable Care Act also bans insurance companies from discriminating against people with pre-existing conditions.   However, unless every American is required to have insurance, it would be cost prohibitive to cover people with pre-existing conditions. 

Here’s why:  If insurance companies can no longer deny coverage to anyone who applies for insurance – especially those who have health problems and are potentially more expensive to cover – then there is nothing stopping someone from waiting until they’re sick or injured to apply for coverage since insurance companies can’t say no.  That would lead to double digit premiums increases – up to 20% – for everyone with insurance, and would significantly increase the cost health care spending nationwide. 

We don’t let people wait until after they’ve been in a car accident to apply for auto insurance and get reimbursed, and we don’t want to do that with healthcare.  If we’re going to outlaw discrimination based on pre-existing conditions, the only way to keep people from gaming the system and raising costs on everyone else is to ensure that everyone takes responsibility for their own health insurance.  

Two federal courts and more than 100 constitutional scholars agree with these arguments. And representatives from important organizations like the American Cancer Society Action Network, the American Diabetes Association, the American Heart Association, the American Hospital Association and the American Nurses Association have all filed amicus briefs in similar cases supporting the Administration’s position. Event President Reagan’s Solicitor General Charles Fried has written, “the health care law’s enemies have no ally in the Constitution.”

In the end, we’re confident our arguments will carry the day and the health reform law will continue to make the health care system stronger for all of us.

Stephanie Cutter is Assistant to the President and Deputy Senior Advisor.

In his remarks, the President highlighted two Americans that you may have heard about here on the White House website, Janine Vaughn, of Spokane, Washington and Gail O’Brien, of Keene, New Hampshire. Here is part of what the President said:

“I don’t want to tell students that we’re booting them off their parents’ coverage.  I don’t want to tell seniors that their medicine is out of reach again.  I don’t want to tell Janine her taxes are going back up, or Gail that she’s got to choose between keeping her home and getting well….

I don’t want that for America.  I don't want that for our families.  That’s not who we are and that’s not what we stand for.”
 

Janine and Gail are just two of the millions of Americans who are benefiting from the Affordable Care Act. You can listen to Janine’s story and watch a video of President Obama calling Gail at home.

Be sure to visit obamawhitehouse.archives.gov/healthreform in the days ahead to listen to more stories from Americans who are benefiting from the Affordable Care Act and to learn about how health reform is making health care better for all of us.

• Read the President’s full remarks to the Families USA Health Action 2011 Conference.
 

President Barack Obama addresses the Families USA's 16th Annual Health Action Conference at the Hyatt Regency Washington on Capitol Hill in Washington, D.C., January 28, 2011. (Official White House Photo by Pete Souza)

Before reform passed, too many young adults like Kayla struggled to get the care they need:

• 42% of young adults either lost or switched coverage once they graduated from school – 46% of which were uninsured for two or more years.
• 76% of young adults who were uninsured reported not getting needed care because they couldn’t afford it.
• 11.3 million young adults, both uninsured and insured, who were surveyed said they were paying off medical bills.  

The Affordable Care Act will help 1.2 million young adults remain on their parent’s health insurance plan and drive down costs for all Americans. The law also provides additional protections for people like Kayla by making it illegal for insurance companies to discriminate against anyone with a pre-existing condition.

And the Affordable Care Act helps everyone in Kayla’s generation by reducing the deficit by a trillion dollars through provisions that crack down on waste, fraud and abuse, and stop hundreds of billions in unfair and irresponsible subsidies to insurance companies that are now paid by taxpayers.

Listen to Kayla’s story here:

Stephanie Cutter is Assistant to the President for Special Projects.

In previous analyses of the Affordable Care Act, the Actuary discounts proposals that other independent experts credit with getting at the root causes of health care cost growth.  The Affordable Care Act, for example:

• Creates new, competitive state-based insurance Exchanges.  Exchanges will enable individuals and small businesses to pool together and use their market strength to buy coverage at a lower cost, the same way large employers do today.
• Establishes ways for Medicare to adopt cutting-edge payment reforms, such as the new Innovation Center. These benefits will spill over to the private sector.
• Creates Accountable Care Organizations and other ways to promote value – so that patients are getting better care not just expensive care. The plan gives health care providers incentives to coordinate care to improve the quality of care as well as efficiency.

These policies will bring down health care costs, but they are undervalued by the Actuary.

The Actuary has also raised concerns that implementing these cost control measures may not be possible. Once again, we disagree. History shows that it is possible to implement measures that will save money for Medicare and the federal government. For example, both the Office of the Actuary and the Congressional Budget Office substantially underestimated the savings that were achieved by the Balanced Budget Act.

These are just some of the reasons why we are confident the Affordable Care Act will help bring down health care costs. And we’re not alone. Health policy experts and economists who have studied the bill agree that the new law utilizes almost all the possible tools to reduce health care costs. Just yesterday, nearly 250 leaders, including two Nobel laureates, for former Council of Economic Advisors members, one former Congressional Budget Office chief, high ranking economists and budget experts signed a letter saying, “The Affordable Care Act contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending.”

Our Administration is committed to bringing down health care costs. That’s why we’re moving quickly and carefully to implement the Affordable Care Act and deliver the benefits of reform to the American people.

Stephanie Cutter is Assistant to the President for Special Projects.

Janine has been in business for more than a decade and has seen her health insurance costs rise dramatically each year. She also spends a significant amount of time combing through various insurance plans to secure the best possible option for her employees, trying to compare the plans.

The Affordable Care Act is already providing immediate relief to business owners like Janine. Today, small businesses pay 18 percent more for health insurance premiums than large businesses.   The Affordable Care Act changes that by providing tax credits for small businesses that offer employees health insurance.  Up to 4 million small businesses could be eligible for relief from high health insurance premiums and, according to the independent Congressional Budget Office, the tax credit will save small businesses $40 billion by 2019. And small business owners like Janine are benefiting from the tax credit today.

Janine says that the Affordable Care Act has given her more peace of mind. Before it was signed into law in March 2010, she had to think hard about whether she was going to be able to even offer insurance to her employees in the future, but now, the tax credits remove that worry.

And Janine likes how the law helps consumers compare “apples to apples” when searching for insurance plans. You can see more about how the law does this on HealthCare.gov, which includes an Insurance Finder that compares details about private plans.

Listen to her story:

Stephanie Cutter is Assistant to the President for Special Projects.

James Howard from Katy, Texas was diagnosed with brain cancer in March, 2010 and later thought his lack of health insurance was a death sentence. One of his prescription drugs alone cost $10,000 a week and he had no idea how he would afford the costs of prescriptions, doctor’s visits, tests and treatments. James searched, but could not find affordable health insurance until he discovered the Pre-Existing Condition Insurance Plan. Here’s how the Pre-Existing Condition Insurance Plan works:

The Pre-Existing Condition Insurance Plan is a bridge to 2014, when the health insurance exchanges will offer people like James and small businesses a competitive marketplace where they can shop for more affordable insurance based on price and quality. In addition, in 2014, denying coverage or charging higher premiums based on a pre-existing condition will be prohibited.

But we know that people like James need immediate relief. Between now and 2014, the Pre-Existing Condition Insurance Plan offers health insurance to Americans who have been uninsured for at least six months and have a pre-existing condition or have been denied health coverage because of their health condition. Depending on where you live, the plan is operated by either your state or the Department of Health and Human Services.

James is grateful for the coverage the Pre-Existing Condition Insurance Plan offers and says that without it, he would not have been able to continue his treatments.

Tonight, you’ll be able to spot James as he watches the State of the Union address here in Washington with First Lady Michelle Obama and other Americans from across the country. You can listen to his story now:

Stephanie Cutter is Assistant to the President for Special Projects.

Jim Houser and his wife have owned an auto repair shop in Portland, Oregon for over 25 years, and it’s important to them to retain their employees and keep them healthy. They invest time, energy and money to train their workers and they don’t want to lose valuable employees. 

That’s why Jim has always provided health insurance to his employees. But in the last ten years, Jim has been forced to contend with skyrocketing premium increases, with premiums making up over 20% of his payroll.

Thanks to the Affordable Care Act, Jim and small business owners like him are getting immediate relief.

The health reform law provides tax credits for small businesses that offer employees health insurance. Up to 4 million small businesses could be eligible for relief from high health insurance premiums and, according to the independent Congressional Budget Office, the tax credit will save small businesses $40 billion by 2019. And small business owners like Jim are benefiting from the tax credit today. Jim estimates that the tax credits will save him over $10,000.

Tax credits aren’t the only benefit for small businesses in the Affordable Care Act. The law creates new, competitive state-based insurance Exchanges.  Exchanges will enable individuals and small businesses to pool together and use their market strength to buy coverage at a lower cost, the same way large employers do today, giving them the freedom to launch their own companies without worrying whether health care will be available when they need it.

Small businesses are the engine of our economy and President Obama and his team will continue to do all we can to help small businesses grow, create jobs and succeed. That’s why the President called on Congress to eliminate the overly burdensome 1099 reporting requirement requires businesses to report to the IRS all purchases that exceed $600.  

As Jim notes, the Affordable Care Act is already helping businesses like his “offer the kind of support that keeps employees with your company.” Listen to his story:

Stephanie Cutter is Assistant to the President for Special Projects.

Paul Horne and his wife from Indianapolis, Indiana, have spent a lot of their time thinking about or making life decisions based on their health care coverage.

A few years ago, Paul went without medical treatment for the better part of a year because he didn’t have enough coverage, or money to pay for it. As a result his condition worsened.

Now Paul is on Medicare and his health has improved, but he has been forced to contend with the prescription drug coverage gap known as the donut hole. Hitting the donut hole has devastating consequences for millions of seniors. In some cases, Americans in the donut hole are forced to choose between paying their mortgage bill, buying groceries or getting the medicine they needed.

But that’s changing thanks to the Affordable Care Act. The Affordable Care Act has already provided a $250 rebate check to more than 3 million seniors like Paul who hit the donut hole. This year, seniors who hit the donut hole will receive a 50 percent discount on their brand name prescription drugs. And by 2020, the donut hole will be closed completely.

If the Affordable Care Act is repealed, the donut hole will remain and seniors will pay more for their prescription drugs.  But under the new law, Paul won’t have to struggle to afford the prescription drugs he needs.

Paul’s family is also benefiting from the other provisions in the Affordable Care Act that prohibit insurance companies from limiting the amount of care you can receive even if you need it. Paul’s wife’s policy had a one million dollar lifetime limit on the amount of care she could receive. Paul says the provision in the law that eliminates lifetime limits “kind of freeing, makes you think your health care [plan] actually has something to it.”

Listen to his story:

Stephanie Cutter is Assistant to the President for Special Projects.

Natalie had a previously undiagnosed condition, went into cardiac arrest while at school, beat the odds and survived. But Libbie knew that such an episode would be classified as a pre-existing condition and make it very difficult for Natalie to find quality, affordable health insurance. And she worried about what her daughter would do when she graduated from college and had to find insurance on her own.

She also knew that Natalie’s pre-existing condition might make it impossible for her to take a job or other opportunity if it didn’t come with health insurance. Libbie didn’t like that her daughter would feel constrained in her life choices, or have to worry about the cost of being covered when she should be able to focus on going to college, getting an education and pursuing her dreams.

Thankfully, the Affordable Care Act is helping people like Natalie across the country. Thanks to the new law, Natalie will be able to stay on her parent’s insurance plan until she turns 26. And when it comes time for her to look for health insurance on her own, insurance companies will be prohibited from discriminating against her because of her pre-existing condition.

The new law is giving young adults like Natalie the freedom to focus on priorities other than health insurance, and letting parents like Libbie breathe a sigh of relief.

Listen to her story:

Stephanie Cutter is Assistant to the President for Special Projects.

In the latest installment, we’re highlighting the story of Betsy Burton, of Salt Lake City, Utah. Betsy started the King's English book store 33 years ago in Salt Lake City and pays the full cost of health benefits for many of her employees, even as premium costs rise.

Betsy is one of millions of Americans who will benefit from the tax credits included in the new law that will make it easier for small business to provide coverage to their workers.

Today, small businesses pay 18 percent more for health insurance premiums than large businesses.   The Affordable Care Act changes that by providing tax credits for small businesses that offer employees health insurance.  Up to 4 million small businesses could be eligible for relief from high health insurance premiums and, according to the independent Congressional Budget Office, the tax credit will save small businesses $40 billion by 2019. And small business owners like Betsy are benefiting from the tax credit today.

The tax credits are just one of the ways the health reform law will help small businesses. The law will also help level the playing field with large employers by allowing small businesses to band together to get a fairer deal from insurance companies through the creation of competitive private health insurance markets called Exchanges that go into effect in 2014. Exchanges help organize the health insurance marketplace to help consumers and small businesses shop for coverage in a way that permits easy comparison of available plan options based on price, benefits and services, and quality. Pooling people together can help bring costs down and Exchanges will make our health care system more transparent and competitive by making it easier for consumers to compare costs and benefits.

Betsy feels very strongly about providing insurance to her employees and is thrilled that the new tax credits for small business owners will make it easier for her to give them the benefits they have earned and deserve.

Listen to her story:

Stephanie Cutter is Assistant to the President for Special Projects.

If you haven’t struggled in the health care system yourself, you’ve probably met someone who has – seniors who struggled to pay for their prescription drugs, families whose children were denied coverage for a pre-existing condition and business owners who wanted to provide high benefits to their employees, but just couldn’t afford it.

Thankfully, the Affordable Care Act is already changing all of this.  And over the coming days, you’ll have a chance to hear directly from some of those Americans who are already benefiting through a new online feature, Voices of Health Reform. Every day, you can hear from average Americans about how the new law is making the health care system better for them.  

Today, we’re highlighting Cathy Lynn Howell Allen from Marblehead, OH. Cathy is a healthy and energetic small business owner, but before the Affordable Care Act became law, she couldn’t get insurance because she had a pre-existing condition. Considered “uninsurable” because of a history of Systemic Lupus, Cathy had been denied private insurance several times though she has required very little medical treatment over the last two decades.

Thanks to the Affordable Care Act, Cathy recently purchased private health insurance for the first time in many years. She is now enrolled in the Ohio High Risk Pool – a new program created by the health reform law that provides affordable private insurance options for people with pre-existing conditions between now and 2014. And in 2014, discriminating against ANYONE with pre-existing conditions like Cathy will be illegal.

Cathy now has peace of mind and less worry about losing her business or retirement because of the financial instability that goes with being uninsured.

And Cathy is just one of the millions Americans with more freedom and control in their health care choices thanks to the Affordable Care Act. Thanks to the law, families are freed from worrying about losing their insurance or having it capped unexpectedly if someone is an accident or becomes sick. The health reform law frees Americans from the fear of insurance companies raising premiums by double digits with no recourse or accountability. And it frees Americans from discrimination when insurance companies deny women health insurance because they are pregnant, or refuse to provide coverage to children who are born with disabilities.

Be sure to check back each day for more Voices of Health Reform and to learn more about the Affordable Care Act, visit obamawhitehouse.archives.gov/HealthReform.

Note: Today, the Department of Health and Human Services released a new report indicating that anywhere from 50 to 129 million (19 to 50 percent of) Americans under age 65 have some type of pre-existing condition and would be at risk of losing coverage or not getting it at all without the Affordable Care Act. Read the full report.

Stephanie Cutter is Assistant to the President for Special Projects.

Since the President signed the Affordable Care Act into law last March, the economy has created over 1 million private sector jobs, including the 113,000 private sector jobs created in December announced today.   So, at a time when our economy is getting stronger, repealing the law would hamper that important economic progress by increasing costs on individuals and businesses, weakening the benefits and protections that Americans with private insurance are already enjoying, and adding more than a trillion dollars to our deficits.  

Opponents’ claim that the law is “job-killing” is in direct contradiction to what has actually been happening in the economy since enactment.  In fact, repealing the law would likely slow down the growth of our economy.    Here are the facts:

• Since the Affordable Care Act was signed into law, the economy has created over 1 million private sector jobs.  The unemployment rate is 9.4%, lower than it was in March 2010—9.7%. 
• In the period during and right after the enactment of the law, the economy grew by 2.7%.
• Consumer confidence in a range of areas have improved, including retail and food sales by 4%, and auto sales by 7% since the enactment of the law.
• Slowing the growth of health care costs—as the Affordable Care Act does—will have the likely impact of creating more jobs since businesses will have to spend less on health care for their employees.  This reduction could create more than 300,000 additional jobs. 
• The law widely expands coverage to Americans, thereby reducing the hidden tax of about $1,000 that families with insurance pay each year in additional premium costs to cover the uncompensated costs of the uninsured. 
• The law reduces small businesses’ health care expenses by giving them $40 billion worth of tax credits, and through the creation of new, competitive state-based insurance Exchanges.  Exchanges will enable individuals and small businesses to pool together and use their market strength to buy coverage at a lower cost, the same way large employers do today, giving them the freedom to launch their own companies without worrying whether health care will be available when they need it.
• The law will lower the deficit by over $100 billion this decade and by over $1 trillion in the following decade. 

Repealing the Affordable Care Act would have a devastating impact on our economy.  In addition to hurting some of the economic progress that has been made over the past ten months the Congressional Budget Office found that repealing the law would add over a quarter of a trillion dollars--$230 billion—to the deficit in the first decade, and more than a trillion dollars in the second decade; increase the number of uninsured by 32 million Americans; increase premiums for large employers; and will force consumers who buy coverage on the individual market to pay more out of pocket for fewer benefits.

In addition, Harvard Economist David Cutler found in a report released today by the Center for American Progress that repealing the law would significantly increase costs and reduce job growth.  It will “…revert us back to the old system for financing and delivering health care and lead to substantial increases in total medical spending” by:

• Adding up to $2,000 annually to family premiums and increasing overall medical spending $125 billion by the end of this decade. 
• Preventing 250,000 to 400,000 jobs from being created annually over the next decade.
• Suppressing entrepreneurship among workers who may have started new businesses, or sought new opportunities in the economy since they will no longer be free from worrying whether affordable coverage would be available to them in the new Exchanges, when they need it the most.

Again, these facts speak for themselves.  Repealing the Affordable Care Act would hurt families, businesses, and our economy.  

• View a blog post about how many jobs our economy has created.
• View the full Center for American Progress report on the economic consequences of repealing the law.

Stephanie Cutter is Assistant to the President for Special Projects.

For people with insurance, the law introduces new insurance market rules that ensure greater transparency and accountability, including better value for premium dollars, as well as important new consumer protections.  For people seeking insurance, the law helps make sure you have ways to access it.  

These new reforms halt the worst insurance industry abuses, and provides much needed relief that would be taken away under a repeal.

To provide an update on implementation of the law, Health and Human Services Secretary Kathleen Sebelius, Labor Secretary Hilda L. Solis, and Treasury Secretary Tim Geithner sent a letter to Members of Congress yesterday. They also discussed how the law will continue to give Americans more freedom in their health care choices and protection from insurance company abuses as implementation continues in 2011.
 
Here’s an excerpt:

Since March, we have made great strides toward a health care system that is stronger and more affordable and that will work better for all Americans. 
 
If the Affordable Care Act were repealed as some have proposed, the individuals we have heard from plus the millions of families, seniors, other individuals, and small businesses already helped would lose this support and these protections.
 
We urge you to consider all that this law has already done to improve the health and financial security of so many Americans – and what it will mean to hundreds of millions or more in the next several years – as you evaluate any proposal that would set the Nation back on a path to higher costs and skyrocketing premiums, less competition, and fewer consumer protections against industry abuses.

Read the full letter.

Learn more about health reform.

Stephanie Cutter is Assistant to the President for Special Projects.