Press Briefing

November 12, 2013 | 1:02:16 | Public Domain

White House Press Briefings are conducted most weekdays from the James S. Brady Press Briefing Room in the West Wing.

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Press Briefing by Press Secretary Jay Carney, 11/12/2013

James S. Brady Press Briefing Room

1:03 P.M. EST

MR. CARNEY:  Good afternoon, ladies and gentlemen.  Thank you for being here.  Happy Tuesday.  Hope you had an enjoyable Veterans Day, which reminds me that, as you probably know by now, the President is enjoying lunch with servicemembers at Molly Malone's, an establishment here in Washington, in advance of the annual dinner he'll be having with combatant commanders tonight.

I have a couple of toppers to give to you.  First, I wanted to note that the First Lady delivered remarks today at Bell Multicultural High School, a high school in the Washington, D.C. area.  The First Lady's remarks continued to expand her focus on issues of youth empowerment and education, in particular working to achieve the President's North Star goal that by the year 2020, America will once again have the highest proportion of college graduates in the world.

 In her remarks, the First Lady spoke directly to young people about committing to their education so that they can create a better future for themselves and their country.  Following the First Lady's remarks, she was participating in a conversation with a 10th grade class at Bell about her own personal story of working hard toward her education.  The Secretary of Education Arne Duncan also participated.

Secondly, I wanted to note that at 5:30 p.m. today the Senate will have a cloture vote on Nina Pillard, another of the President's three nominees to the D.C. Circuit Court.  Pillard is an accomplished litigator and professor.  Her career includes landmark accomplishments on behalf of women and families, such as helping defend the constitutionality of the Family and Medical Leave Act and helping open the doors of the Virginia Military Institute to female students. 

 It is time for Senate Republicans to stop playing politics with our courts.  Fifteen of the last nineteen judges confirmed to this court were nominated by Republican Presidents -- 15 of the last 19.  But now that a Democratic President is fulfilling his constitutional duty and nominating judges, Republicans make cynical arguments in an effort to maintain an ideological edge.  More of President Obama's nominees to the D.C. Circuit have been successfully filibustered than those of any other President in history.  We urge the Senate to consider all of these nominations on their merits, starting with tonight's cloture vote for Nina Pillard.

Finally, I wanted to note a phone call the President had earlier.  This morning, President Obama spoke with President Aquino of the Philippines to express our deep condolences for the lives lost and damage caused by super Typhoon Haiyan/Yolanda, one of the largest, strongest storms to ever hit land.  Over the weekend, the President directed the administration to mount a swift and coordinated response to save lives and provide assistance to alleviate suffering. 

USAID and the Department of Defense are providing significant assistance to the people of the Philippines.  Even before the storm reached land, USAID had deployed a disaster assistance response team to the area.  After landfall, U.S. Marines were some of the first to help deliver supplies for the relief effort.  American aircraft are delivering vital assistance and equipment.  The United States is also providing food aid to feed tens of thousands of people in the coming days.

Additionally, the aircraft carrier USS George Washington and several escort ships are on their way to the Philippines.  On arrival, they will help expand search-and-rescue operations, provide medical care, and serve as platforms for a base of helicopters working to deliver supplies. 

Our State Department and USAID team on the ground is coordinating with local officials and other organizations.  And in the days ahead, the United States will continue to work with the Philippines to deliver whatever help we can as quickly as possible. 

And with that, I take your questions.  Julie, I just want to remind people I think we have a preset for the President's announcement at 2:00 p.m.  Yes, Julie.

Q    Thanks, Jay.  I wanted to get your reaction to a comment that President Clinton made in an interview that was posted today.  He was talking about health care, and he said that President Obama should honor his commitment to people who have lost their health care or are losing their health care under the President's law, even if it means changing that law.  Does the President agree with that comment?

MR. CARNEY:  Well, I think as you saw the President say in an interview with NBC last week, the answer is yes.  The President has tasked his team with looking at a range of options, as he said, to make sure that nobody is put in a position where their plans have been canceled and they can't afford a better plan, even though they'd like to have a better plan.  So you heard the President address this very issue in his interview last week.

And I think it's important to note that President Clinton in that interview also said, and I quote, "The big lesson is that we are better off with this law than without it."  And he said, "The enrollment period did not come off well because the national website wasn't ready.  But this happened once before.  It happened when President Bush put in the Medicare drug program for seniors, which was not as complicated, but had exactly the same problem with the rollout.  It was a disaster.  There were people that lost their prescriptions for their existing medicine, and they fixed it.” 

So the President, as you know, has pledged to ask his team, task his team to look at potential actions that could be taken to address this problem, because his focus is on making sure that people get quality and affordable health insurance.

Q    But what the President said appears to be slightly different from what President Clinton said.  President Clinton seems to be talking about anybody who is losing their plan.  And what the President said, and officials afterwards said, was that they were focused more on people who were getting cancellations and then maybe weren't getting subsidies to cover higher premiums.  So is what President Obama is looking at more narrow than the broader universe of people getting cancellations?

MR. CARNEY:  Well, certainly the point we've made is that for more than half of those on the individual market who because their plans were not grandfathered in -- they did not exist or they were not participants in those plans prior to the passage of the Affordable Care Act -- more than half of those individuals will have higher quality insurance with better basic protections at the same or lower cost.  Roughly half -- or maybe that is roughly half -- more than half will qualify for subsidies.  Some will qualify for Medicaid in those states where Medicaid has been expanded.

For the universe of people of -- that smaller group of people within that 5 percent of the population for whom the fact that they've gotten a cancellation notice because they purchased plans perhaps in the last couple of years that do not meet the minimum standards and they are facing challenges in terms of affordability, the President has asked his team to look at ways to address that problem.  And that goes to the point he made about the vast majority of Americans here who, if they’re in employer-provided insurance or Medicare or Medicaid or VA, will not have any changes if they don’t want them.  In fact, the only changes they’ll see have to do with improvements to benefits.

Q    On another point on health care, there are some reports out about enrollment numbers, putting them at about 40,000 to 50,000.  Can you confirm that those numbers are accurate?  And if not, can you tell us when the administration expects to put out numbers?

MR. CARNEY:  Sure.  I cannot confirm those numbers.  There have been a variety of reports saying a variety of different things.  The administration will be releasing data about enrollment in the middle of the month -- I anticipate it will be later this week -- as we’ve said all along, consistent with the way that data like this is released for other programs. 

So I would add two things.  First, it was always the case, even prior to the problems with the launch of the website, that enrollment in the first month would be low.  That is the experience we saw in Massachusetts and it is the experience we expect here -- because especially for healthier, younger people, the pattern of behavior is to shop around, to wait before you purchase when you don’t have to purchase before December 15th in order to have insurance on January 1st, which is the earliest possible date for coverage.  So we expect that pattern to play out with the marketplaces in the Affordable Care Act.

Secondly, the fact that the website has been so challenging and so problematic in that first month means that the enrollment numbers will be even lower than expected.  But beyond that, I don’t have specific figures.  I have not seen specific figures.  But I anticipate that we will be releasing data about enrollment by the end of the week.

Q    But you don’t have a specific date set?

MR. CARNEY:  I do not. 


Q    Thanks, Jay.  The President spoke last week about gaps and problems with the rollout of the website that need to be fixed.  What are those gaps?  And what fixes would you anticipate?

MR. CARNEY:  Well, he was referring to -- and I’ll quote -- “I’ve assigned my team to see what we can do to close some of the holes and gaps in the law.”  And he was addressing the issue of cancellations and some of the concerns that he has about individuals who have had their existing policies canceled, and that issue has obviously gotten a lot of attention. 

The problems with the website, which you just mentioned, are being addressed by a team of tech experts as well as by Jeff Zients, who’s verseeing that team.  And they essentially have a punch list of problems that need to be fixed in different areas of the website, and they’ve been working through that punch list and making progress -- gradual progress each day.  There’s no question that the website is functioning better today than it was a week ago or 10 days ago, and certainly much better than it was in the first two weeks of October.  But there is more work to be done as Mr. Zients has said.

So that work continues.  And our goal is to have that website functioning effectively for the vast majority of Americans by the end of this month.

Q    And if it’s not up to par by the end of the month, do you have a plan B in place, alternative?

MR. CARNEY:  We expect it to be functioning properly and effectively for the vast majority of Americans by the end of the month.  What we have been doing since the issues with the website arose, it has focused -- we’ve expanded our efforts to create ways through which Americans can get more information about the options available to them, both by in-person consultations or over the phone; they can also apply and enroll by mail.  So those efforts continue.

But we expect -- and I’m citing here -- those closer to the ground, that the site will be functioning effectively by the end of the month for the vast majority of users.  I think I said last week, and I would reiterate, and I think I said the week before, that any website of this size and complexity will occasionally have issues with it.  That’s true of major websites today in the commercial sphere.  But we expect it to be functioning effectively for the vast majority of users so that they can navigate through it, review their options, find out whether or not they’re eligible for tax credits, and choose coverage that fits their needs, both their financial needs and their coverage needs.

Q    Can you say whether Todd Park will testify before Congress tomorrow?

MR. CARNEY:  I can say a couple of things about that.  First of all, I’d like to point out the administration’s extraordinary cooperation with the six separate congressional committees currently conducting oversight into the Affordable Care Act.  As you have all seen and covered, administration officials have testified at numerous committee interviews and briefings, and they’ve testified at more than two dozen congressional hearings, including four in just the last two weeks.  The administration has also produced thousands of pages of documents, and our cooperation on these issues continues. 

The subpoena issued by House Republicans on Friday is an unfortunate and unnecessary step, since we made clear several times that Todd Park is willing to testify.  The issue for us is not a question of if he will testify, but when.  We had hoped the committee would work with us to find an alternative date to give Mr. Park time to focus on his immediate task at hand, which is getting the website fixed.  This is a goal that is ostensibly shared by the very House Republicans now demanding his appearance on Wednesday -- an appearance that would take him away from his work on the website.  In fact, Chairman Issa told CBS News a few weeks ago that he wanted the website fixed and “fixed quickly.”  Well, Todd Park is very much engaged in the effort of fixing it as quickly as possible. 

So I have no update on that except to tell you that the Office of Science and Technology has said they are reviewing the subpoena and they will respond as appropriate.

Q    Can I just ask about Iran?

MR. CARNEY:  Sure.

Q    Iran’s I guess foreign minister has sort of rejected the claim that it was Iran that was the result of the failure to reach an agreement in Geneva recently, and has said that divisions among Western nations were the cause of the failure of the talks.  Can you comment on that?  Is it really up to the West to --

MR. CARNEY:  Well, what I can tell you is simply that the P5-plus-1 were unified on the proposal that was put forward, and that the Iranians did not accept that proposal, and that’s a statement of fact.  There was important progress made at these negotiations, and they were cordial and substantive and serious.  But as I said, the P5-plus-1 were united there and we remain united in our proposal to Iran and our approach to these negotiations. 

Gaps remain, and there are still important issues to be addressed between the P5-plus-1 and Iran, and that is why there will be a break, as you know, and the P5-plus-1 will resume negotiations with Iran on November 21st and 22nd. 

I want to caution everyone, because there’s been a substantial amount of speculation about the details of the proposal, against believing rumors and incorrect reports or prejudging outcomes.  Both the P5-plus-1 and Iran have been very disciplined in keeping the details of the negotiations private, and that is a sign of the seriousness of what is taking place, and it has also allowed us to make the progress that we have made.

So we’re not going to get into details about our negotiating positions.  But to be clear, the purposes of these negotiations is to prevent Iran from acquiring a nuclear weapon.  And I think that’s important.  There’s one objective here.  The reason why we are here, the reason why negotiations are taking place, is because of the very focused effort in building an international consensus and building a punitive sanctions regime around Iranian behavior and Iran’s refusal to comply with its international obligations.  Because of that effort, over the several years since it’s been in place, we now have a diplomatic opening.  We have a willingness, because of the concentrated effect of these sanctions, by Iran to pursue the possibility of resolving this diplomatically. 

Resolving this diplomatically is the best way to resolve it; it is the responsibility of the President to pursue a diplomatic opening.  Because the best way to ensure that Iran does not acquire a nuclear weapon is to achieve an agreement through diplomacy -- an agreement that’s verifiable, that’s transparent, and that requires Iran to take concrete steps. 

The alternative is military action.  The President has never taken any option off the table, and he does not now and will not.  But it is his responsibility as President to pursue a diplomatic opening, to see if it is possible to resolve this issue peacefully.

Q    Is there any assurance that Secretary Kerry can provide lawmakers on the Hill when he speaks to them that would persuade them to hold off on tightening sanctions?

MR. CARNEY:  Secretary Kerry and Under Secretary of State for Political Affairs Wendy Sherman are briefing the Senate Banking Committee tomorrow.  That’s part of a broader effort to consult with Congress and update them on the P5-plus-1 negotiations, as well as our consultations with our allies.  But when it comes to the issue of new sanctions legislation, it’s important to remember no one is suggesting an open-ended delay for new sanctions, because there may come a point where additional sanctions are necessary.

At the same time, it is important for Congress to reserve its ability to legislate for the moment when it is most effective in order to give the current P5-plus-1 negotiations the best chance to make real progress in achieving our shared goal of preventing Iran from obtaining a nuclear weapon. 

So again, this is not about being for or against sanctions.  This administration has imposed the most crippling sanctions in history against Iran, and we appreciate the leverage those sanctions have given us and we appreciate the partnership that Congress has given us in that effort.  But this is a decision to support diplomacy and a possible peaceful resolution to this issue.  The American people, justifiably and understandably, prefer a peaceful solution that prevents Iran from obtaining a nuclear weapon.  And this agreement, if it’s achieved, has the potential to do that.  The American people do not want a march to war.  And it is important to understand that if pursuing a resolution diplomatically is disallowed or ruled out, what options then do we and our allies have to prevent Iran from acquiring a nuclear weapon.

We’ve said all along, as we have ratcheted up sanctions and increased the isolation and pressure in Tehran, that the window for resolving this diplomatically was open, but that it would not remain open forever.  And short of an agreement, Iran will continue to make progress in its nuclear program.

So we need to pursue this.  We need to see if Iran is serious.  And any deal that we and the [P5-plus-1] might reach with Iran will be one that absolutely meets our standards that would be verifiable and concrete.  Any initial relief as part of the first phase would be reversible and modest.  It would not in any way change the sanctions architecture that’s in place, but it would allow for essentially putting some time on the clock, because it would halt [progress on] Iran’s program and roll back aspects of its program.  And if it doesn’t do that, the United States won’t agree to it.


Q    Jay, getting back to former President Clinton’s comments, you were saying at the beginning of the briefing that the President does agree with what former President Clinton said.  But former President Clinton did say, “I personally believe even if it takes a change in the law, the President should honor the commitment the federal government made.”  So the President agrees even if it takes a change in the law, that this pledge is going to be kept?

MR. CARNEY:  What I just said, Jim, is that the President has instructed his team to look at a range of options, and we haven’t announced one way or the other -- although, understandably, you and others ask us for details on what is under consideration, we haven’t announced any potential fixes or moves that we might be able to make to address this problem.  But the President is, as you heard him say in his interview with NBC -- he’s very interested in trying to address this problem, and looks forward to being presented the options that he might be able to pursue.

Q    But wouldn’t you be in a situation where if you were trying to help people keep the plans that they have now, wouldn’t you might be trying to put the toothpaste back in the tube?  And that hundreds of thousands, perhaps millions of Americans have received these notifications already, how do you go back and allow those people to keep those insurance plans?  That just seems practically impossible.

 MR. CARNEY:  Well, what I would say, Jim, is that I’m not going to get into specifics about avenues that might be available to the President to address this problem until he’s chosen which option he wants to pursue.  The broader thing that we have to remember here is that the overall majority -- overwhelming majority, rather, that the American people either get their insurance through their employers and will not see a change, get their insurance through Medicare or Medicaid or the VA and will not see a change, except for those changes that improve the coverage they get and improve the benefits they get, because they apply to everyone -- not just those who purchase plans in the marketplaces. 

Others, as you know -- because some states have made the decision to help their own constituents, their own people, by expanding the Medicaid program under the Affordable Care Act -- will extend insurance to hundreds of thousands, millions of Americans who will become newly eligible for Medicaid.  And then, others will be able to find an array of options available to them for purchase through the marketplaces.

Now, that effort, in terms of the shopping period, has been made more difficult, frustratingly so, because of the problems with the website.  But there is a team focused daily, seven days a week, on making improvements to that website so the American people have a better experience while they’re shopping for plans and registering and enrolling for coverage.

Q    And getting back to the interview that the President did with NBC, he apologized to the people who were losing their plans despite the assurances he gave.  But what about whether or not the statement itself was misleading -- “if you like your plan, you can keep it”?  The Senate Whip Dick Durbin was on CNN earlier today, and he said that perhaps if a couple of sentences had been added to the end of that pledge, that might have clarified things.  Does the President agree with that?

MR. CARNEY:  Well, the President gave a pretty extensive interview in which this was the central topic of discussion, and I would point you to what he said.  He obviously expressed regret about the fact that the law has not addressed some of these individuals the way that he would like, and therefore he has asked his team to come up with some solutions that he can review.

So the overall effort here has to be on implementing the Affordable Care Act, standing up the marketplaces so that these millions of Americans are presented with the far better options that the Affordable Care Act allows them for affordable, quality health insurance for many of whom that’s something that’s been out of reach for a long time. 

And he is focused on getting it right -- because it is a fact that, come January 1st, there will be millions more Americans with insurance coverage who didn’t have it before, and there will be millions -- other millions of Americans who will have higher quality insurance than they had before.  They won’t be subjected to a marketplace in which insurers could charge Julianna double for the same plan that you’ve got because she’s a woman.  They can’t put a lifetime or annual cap on the benefits that you receive.  They can’t carve out exemptions for certain conditions, chronic conditions that you might have, that you might need benefits to cover. 

So that is the underlying purpose of the Affordable Care Act -- to make sure that there’s a structure in place that creates higher competition under the private sector model that we’ve had, keeps down prices, and allows millions of Americans to get access to affordable, quality insurance and health care that they have not had in the past.

Q    And on those enrollment numbers, is the administration confident that those numbers will be accurate given all the problems with the insurers being able to sort through the data and figure out which applications are correct and properly submitted, and so forth and so on?

MR. CARNEY:  Well, I know that they’re going to work very hard over at CMS and HHS to compile the data and present the most accurate data available.  I think that’s a good question in light of the fact that some on Capitol Hill have been demanding data daily.  And we’ve made the point that, consistent with the release of data for other programs, that is in the interest of everybody to do this on a monthly basis so that the data is as accurate as possible.


Q    Jay, you’ve been crystal clear the number is going to be low for the first month.  Is there any number that would concern the White House?  Is there any number that is so low --

MR. CARNEY:  Well, I can guarantee you that the number that is released will be lower than we had hoped and anticipated because of the problems with the website.  And that is why it is so important to focus our energies on fixing the problems, and that goes to the subpoena we were talking about earlier, and the attempt to remove somebody who’s very much a key part of the effort to fix the website from his job for a certain amount of time.  And it raises questions about how sincere critics are when it comes to joining with us in the effort to try to fix the problems that exist.

Q    But I guess what I’m asking -- all that, I said you made it very clear, as I said.  But is there any number that would be so low that you would say, wow, alarm bells are going off, we have a problem?

MR. CARNEY:  Again, Jon, I think it’s a very creative way to try to set expectations.  And the only expectations I’ll set is that we expect them to be low.  We expected them to be low as a percentage of the overall number of people who would enroll by the end of the six-month period in any case, because that is the experience that we’ve seen in Massachusetts and in similar kinds of programs.  Younger, healthier people, especially, tend to wait until the last minute to enroll in these kinds of programs.  And overall, I think, whether you’re young or old, if you don’t have to enroll until a certain time, you’re going to take your time to look at your options and wait until late in the process.  That was certainly what happened in Massachusetts.

Q    And when you’re defining enrollment, there’s been some reporting about how the numbers would be.  Are you going to be including people who have picked out a health care plan and put it in their shopping cart but haven’t actually paid for it?

 MR. CARNEY:  I would refer you to HHS and CMS for how they define enrollment.  I can tell you that it is consistent with the way Massachusetts did it.  It is consistent with the way the states are doing it.  The marketplace experience or process ends when a person selects a plan -- essentially presses “enroll” in a plan.  And after that, it becomes a contract between the private insurer and the individual.  So the process they’re using, as I understand it, will be consistent with what Massachusetts did and with what the states are doing.  And more details obviously will be available when those data are released.

Q    Is the number of people who enroll going to be lower than those that have been receiving cancellation notices?

MR. CARNEY:  Jon, I would simply ask you to wait until the data are released.  I think it’s fair to say that the enrollment figures will be low and were going to be low anyway.  They will be significantly lower because of the challenges posed by the faulty website.

Q    What will that say?  I mean, what kind of message is that if more people are receiving cancellation notices than have actually been able to enroll?

MR. CARNEY:  I would say that it would say two things.  One, the history of these kinds of programs -- and Massachusetts is the best model -- show that enrollment is very slow early on.  I think there were only 123 people in Massachusetts who enrolled in the first month.  And while it’s a small state, it’s a reasonably populous state, and 123 is a very low number.

In the end, I think more than 36,000 people enrolled in Massachusetts.  So I think as a guidepost, I think that’s a pretty good indicator, even without troubles with the website of what kind of sort of phased-in process of enrollment we’re likely to see.  That lowness will be undoubtedly compounded by the problems with the website that have made it so much harder for individuals to shop and enroll.

 Q    And just a clarification on the Bill Clinton -- he said even if it takes changes to the laws, is the White House open to legal changes to an act of Congress to address this issue?

MR. CARNEY:  All I can say at this point, Jon, is that the President has asked his team to come up with a range of options, and we’re not focused on any particular one.  We’re looking at ones that effectively address the problem.

Q    Those that have been described here are within the context of the law and working with state insurance commissioners.  Is that the orbit the President is looking at and asked his team, meaning they don’t include seeking a change to the law that would have to go through Congress?  Because people who have talked to me about it believe the legislative climate is just too difficult to look in that direction.

MR. CARNEY:  Well, I would beg your indulgence and give you the same answer I just gave Jon, which is that at this time, the President has asked his team to look at the options that might be available to pursue.  And once we have an announcement to make, we’ll make one.

I think it’s fair to say that he wants to address this problem and have as many people who are affected here helped as possible.  And so he would look for an option that is effective rather than one that cannot be achieved.

 Q    Would you acknowledge that that’s going to be hard to do?  People who are experts in this area have said insurance policies have already gone out and it’s very difficult to retroactively, as Jim mentioned, un-cancel something; that you need state insurance regulatory permission to do that -- that that’s why you need to have these conversations with the state insurance commissioners. 

And the law itself has very-defined poverty levels -- 400 percent -- if you are above that, how do you create a new subsidy tranche for people who don’t fall into that income category that’s just defined by the law?  I mean, this seems like a very difficult thing for you to handle outside of a legislative fix.  Would you acknowledge that?

MR. CARNEY:  Well, I think in general these issues are challenging, which is why it took a century of effort for it to come to fruition -- the passage of comprehensive health insurance reform.  And you described some of the general challenges that are out there.  I would send you over to CMS and their daily briefing for more details.  My guess is they’re going to ask that you wait for details about what the President is going to decide until --

 Q    -- they’ll send us here. 

 MR. CARNEY:  Well, probably not to send you over here, but to simply say what I can tell you, which is I’m not really going to discuss in any detail the options the President might be considering, because when he makes a decision we’ll let you know.

And just to clarify, because it’s been described this way to me -- what the President is looking at is for those who are in the individual market, who don’t qualify for subsidies but that their premiums are higher than they can afford, this is kind of a -- to use your phrase, the elegy from the past -- a slice of a slice of a slice.  Is that what the President is trying and asked his team to identify and solve?

 MR. CARNEY:  I don’t want to overly define the universe because that’s work that’s being done by policy experts, but I think that --

Q    Is that a fair characterization?

 MR. CARNEY:  Well, I think it's a fair characterization of people who are most affected by this problem.  Obviously, if you're somebody who enrolled in a plan and you now have a -- and paid for it and it was a substandard plan, and now you are eligible for Medicaid, because you --

Q    Right, the President is not asking his team to figure out those --

MR. CARNEY:  So what I'm saying is it's obviously not every individual in the individual market today.  But beyond that, I'm not going to get into defining the population here.  I'll let the policy experts --

Q    What's the timeline for this?

MR. CARNEY:  I don't have a timeline for it, except the President asked for something, and when he asks for something people tend to work on it very quickly.

Q    Very good.  On Iran, quickly.  It sounded here, Thursday, as if you had rhetoric to describe what you thought might happen, and it didn't happen.  And the theory behind what was trying to be accomplished in Geneva was sort of a cap on a cap -- the Iranians cap where they are and the P5-plus-1 agrees to cap sanctions.  That's a general formulation I've seen as describing what was being sought.  Is that still the goal?  Or did this experience in Geneva make the U.S. and the P5-plus-1 reconsider this idea of an initial agreement that would come before a much bigger one?

MR. CARNEY:  It is our approach, and the P5-plus-1's approach, to essentially phase this in, in two phases.  The first phase would halt progress on Iran's nuclear program and roll back key aspects of the program.  The second component of that, the relief component, would -- the only relief we would consider would be limited, it would be temporary, and it would be reversible.  We would take no steps -- and this addresses the cap on sanctions -- it would take no steps that undermine the architecture of our sanctions regime.

I think I described it last week as essentially a spigot that you could turn down a little bit or turn up, but it would be something that would be easily reversible.  It would be temporary, and it would require steps taken by Iran to halt progress on its nuclear program and to roll back certain aspects of it. 

And I can tell you that the areas that we are concerned about, our most serious concerns are the possibility of Iran producing a sufficient quantity of highly enriched uranium for one nuclear weapon, which is commonly referred to as a “breakout capability.”  Two, the possibility of Iran stockpiling centrifuges or increasing the efficiency of those -- of the centrifuges they have.  Also, Iran's ability to produce plutonium using the Arak reactor.  And finally, bringing unprecedented transparency and monitoring of Iran's program.

 So those are the four areas around which the negotiations are focused when it comes to actions, concrete actions that the P5-plus-1 is asking Iran to take.  And again, when it comes to the relief component of this, it's very important to be clear:  The sanctions regime stays in place.  We built the regime working with our allies, the most punishing regime in history.  And it has had a profound effect, and it has created this opportunity potentially for resolving this international challenge diplomatically.  We ought to pursue that option, pursue that opportunity.  But as Secretary Kerry and the President and others have made clear, we will only reach an agreement, we and the other members of the P5-plus-1 with Iran, if it's a good deal that ensures concrete Iranian actions that are verifiable and transparent.

Q    You asked a rhetorical question a few months ago:  What options then do we have?  This is the Chief Executive -- the President of the United States, the Commander-in-Chief.  He knows the answer to that question.

MR. CARNEY:  No question.  And the President has made abundantly clear throughout his presidency that he takes no options off the table, and that remains true today when it comes to dealing with the potential for Iran acquiring a nuclear weapon.  But it is his responsibility to pursue a diplomatic resolution of this problem if one is available, and we have to test whether or not it is available.  It is in the interest of the American people that we do that.

Alternatively, if pursuing a diplomatic opening is something that some say we should not do, they ought to be explicit about the fact that they're suggesting the only alternative is use of force.  The President believes that we should never take the use of force off the table, but that it is his responsibility as Commander-in-Chief, his responsibility as President to take advantage of the impact of this comprehensive sanctions regime and the opening it has created to see if Iran is serious about resolving this peacefully.

Q    One last question.  It was credibly reported last week that already the administration had slightly eased up on some of the financial sanctions.  Josh Rogin reported that last week.  Can you categorically say whether or not any softening or easing of the sanctions has been undertaken in order to signal to the Iranians that this would be a worthwhile endeavor for them to engage in?

MR. CARNEY:  I’m certainly not aware of that, and I would refer you to Treasury when it comes to financial matters.  The fact is the sanctions regime is in place and it is extremely broad and punishing and effective.

Q    It’s not going to alter it in a way?

MR. CARNEY:  Again, the specific programs function in different ways.  So for specifics about those programs that especially deal with financial matters and institutions, I would refer you to Treasury.  But there has certainly been no agreement reached that would provide any kind of relief with the Iranians.  As you know, there was not an agreement in Geneva; there was progress, and it was a productive and substantive, cordial series of negotiations, and very serious.  But there’s only even moderate, modest relief if the Iranians agree to concrete actions.

Q    Jay, is the President troubled by security concerns in the website which one CMS memo described as “limitless”?

MR. CARNEY:  I think you are elliptically referring to the selectively released memo to CBS that -- by the committee, in the habit that it tends to embrace, which had to do with portions of the website that are not and will not be operative until the spring. 

So the fact of the matter is security is a constant issue that is addressed.  The head of CMS and others have discussed this in their testimony, and it is absolutely imperative -- and we go through this process rigorously -- to ensure that security is maintained so that people’s personal data is protected.  And that is the case, and it will continue to be the case.

Q    Does he support Senator Hagan’s call for an investigation of cost overruns? 

MR. CARNEY:  I’m sorry, I haven’t seen that.

Q    Jay, if I can very quickly, getting back to what President Clinton said.  He said that he thought the President should honor the commitment and let them keep what they’ve got.  So just to be very clear, is the President’s commitment to try to look for fixes to let people keep the plans that they already have, or to accommodate them in terms of new plans they would be required to get through Obamacare?

MR. CARNEY:  Peter, I’m not going to review the options available to the President.  I’m going to let him review those options and make a decision about how we want to move forward on this issue, which he said on your network is one that concerns him.  Once a decision is made, we’ll let you know.

Q    Okay.  We spoke with one of the architects of both the plan -- the Massachusetts health care system and the Obamacare health care system, who said a variety of things, and basically said that if some people are allowed to stay on their old plans and other people are then forced to get in the Obamacare system because they didn’t have any coverage, then the whole system collapses; basically, there’s no way to balance both.  Does the White House acknowledge that there is no way to make both of those work?

MR. CARNEY:  Well, it’s written into the law that those with grandfathered plans can stay on those plans indefinitely, so I think that would --

Q    I’m referring to the additional people, people who presently have plans through 2013 -- so after the March 2010 date through 2013.  In other words, if the President tries to accommodate for saying, “If you like your plan, you can keep your plan,” and says, you bought your plan in July of 2012; I didn’t mean it to come out that way, but I’m going to let you keep your plan -- according to the architects of both plans in Massachusetts and the federal plan, the system would collapse.  It creates an imbalance.  Does the White House concede that much?

MR. CARNEY:  All I would say is I think this gets to some of the proposed legislation, that any fix that would essentially open up for insurers the ability to sell new plans that did not meet standards would create more problems than it fixed, because it would essentially allow insurers to offer plans that charged women double, or didn’t cover basic services, or imposed caps and then charged prices that undercut prices of other plans that kept to the basic coverage.

Q    So it wouldn’t cover it in that system.

MR. CARNEY:  Well, but Peter, I think, again, the law as written allowed for the grandfathering in of any plan if somebody wanted to keep it that was in existence prior to the passage of the law.  So obviously, there is some capacity for that.  It’s also true, depending on the state and what’s allowed by state insurance rules, that insurers have the option and insured individuals on the individual market have the option of taking early renewal of existing individual insurance plans.  But that obviously depends on the state and depends on the insurance company.  Some insurance companies haven’t offered those early renewals as I understand it. 

So I think it’s a little -- I know that muddies up the clarity of your question, but the clarity of your question doesn’t really apply to the pretty complex circumstances here.

Q    Okay.  And then, very quickly, you said a little bit earlier that while you’re considering potential actions right now, and while the desire is that by the end of the month the vast majority of Americans will be able to enroll through the website, I guess the question very simply is:  Right now, is the White House telling Americans who are considering enrolling right now that they should not go to the website and do not begin that effort until December 1st?  Are you saying, hey, try it, but I can’t promise you it will work right now

MR. CARNEY:  Well, we’ve been saying all along that the website has functioned at a sub-effective level since October 1st, but there have been those who have been able to enroll, shop.  And as --

Q    Is this a good use of your time right now, or is the message, wait?

MR. CARNEY:  I think every individual ought to avail himself or herself of the options that are presented here in terms of getting information.  It is certainly a good place to go if you want to shop for, look at the options broadly that you have, type in your ZIP code and other data.

Q    I guess, is it safe and does the information get through accurately?  Is it fair to tell those people that it’s safe and the information will get through accurately?

MR. CARNEY:  It is safe, and I would refer you to CMS and HHS for more details.  But the fact is -- again, somebody was just citing reports of enrollment figures.  The fact is whatever the numbers are that we release, people are getting enrolled.  They are simply having a much more difficult time because of the website than is acceptable, and that’s why we have to make sure that the website improvements continue so that the -- you said the vast majority of the American people.  I think you meant --

Q    Of the uninsured.

MR. CARNEY:  -- the vast majority of Americans who want to explore their options on the marketplaces, which are really designed for about 15 percent of the American people, are able to do so.

New York Times.

Q    So just one last time to make sure I understand.  Forget about what the President’s options are.  Can you just clarify for us what the problem is he wants to solve?  Is it helping people keep their insurance, or is it helping people afford new insurance that they are going to be still required to get?  Those are not -- that doesn’t have anything to do with what the options are that are in front of him.  Which is the problem that he’s pledging to fix?

MR. CARNEY:  I think you heard the President address this in his interview.

Q    I was confused, so help me.

MR. CARNEY:  (Laughter.)  I think it’s pretty clear that the President is concerned about those individuals who find themselves -- because they either purchased insurance in the last year or two since the Affordable Care Act passed, or there’s been so much churn in the market that their plans were changed and downgraded, and they are confronted with a situation where even though the coverage is better, the cost may be a challenge for them.  I’m not going to define the affected population here more specifically because I think I want to let the policy people do that who are looking at the options here.

Q    But it sounds like you’re -- I mean, without necessarily saying it 100 percent, it sounds like you’re heading towards that latter piece where you’re saying the real concern here is the affordability question, and that the direction you guys are heading is, we’re not going to let people keep substandard plans -- which, frankly, you guys have always railed against anyway and say that they’re awful.  So we’re not going to let people keep those, we’re simply going to find a way somehow, with extra subsidies or something -- which are the options that you’re not talking about -- to fix the affordability question.

MR. CARNEY:  I think that you’ve accurately diagnosed the problem that is most concerning to the President.  How he assesses the options available for addressing that problem, I will leave to him and to the experts who are compiling the options.

What is not, I think, an effective fix is one that, as envisioned on the Hill by some legislation, that would simply tell insurers that they can sell substandard plans to anybody who might purchase them, because that would cause more problems and create more problems and do more harm than any good it would do for individuals in this market who might be affected.

Q    One last quick question on a different subject.  Does the President still retain full confidence in Mr. Clapper going forward -- the DNI?  There were some suggestion in some article today in our paper, that --

MR. CARNEY:  (Laughter.)  Some -- like, you make it sound like something on a blog in -- you know?  The President does, yes.

Q    Jay, can I just follow up on what we were just talking about?  Because you’re addressing the legislation, can you clarify?  The President is saying that Senator Landrieu’s approach and Congressman Upton’s approach, which is gaining some Democratic sponsors, is in his view the wrong approach to resolve the problem of those who got transition letters in the individual market.

MR. CARNEY:  What I would tell you is that the Upton bill allows insurers to sell 2013 plans in 2014 to anyone.  It does not just continue 2013 plans in 2014 for people enrolled in those plans.  That creates the problem that I just described, and creates all sorts of problems for insurers who are trying to sell plans that meet the basic standards.  And it allows those insurers who would sell those 2013 plans that either charge you double or put caps on benefits, or do any of a number of things that make those plans insufficient when it comes to basic coverage, and basically sell them to any takers.  And obviously, if the coverage is substandard, they would at least potentially be able to undersell those plans and undermine the basic premise of the Affordable Care Act, which is to provide basic benefits for affordable, quality health insurance for everyone.

Q    And the same would be the case for the Senate --

MR. CARNEY:  I don’t have the details on that.  I would just say that, broadly speaking, that applies to the Upton legislation, that broadly speaking that -- we do not see that as fixing the problem, we see that as throwing the baby out with the bathwater. 

Q    And one practical follow-up.  You were talking earlier about the President’s desire to find an option that would be effective.  You know that this population of people, however small it may be, have until practically December 15th, relatively speaking, to try to find new insurance January 1.  Some people have suggested that even if the President had the legal authority to expand the subsidies -- in other words, to change the income levels -- if he were able to do that through executive action, that would have to be programmed in to and new software would have to be written, new coding, all that.  As part of the effective, is the President open to the idea of any kind of option that would change in the next month?

MR. CARNEY:  Alexis, I think those and other questions are excellent, but I will stick to what I said before, which is I’m not going to describe or get into detail about the specific options available to the President that his team is working on.  Once the President reviews those options and makes some decisions, we’ll have an announcement for you. 

Let me move around a little.

Q    Jay?

MR. CARNEY:  April.

Q  The President, when he was interviewed by Chuck Todd, talked about how federal regulations guided the website construction.  Are federal regulations prohibiting a new -- a totally new creation, a whole new website to kind of eradicate what’s going on now and just bring out something new before the 30th, or on the 30th of November?

MR. CARNEY:  I don’t think that’s what he was saying, but for more details about the regulations that govern the creation of a federal website, I would have to refer you to CMS to start, because they obviously take the lead on this one. 

I think that there are issues with, as the President discussed in his interview, federal IT programs that have been a persistent problem.  But that’s sort of a related but bigger issue that I know concerns the President.

Q  Does this White House now wish they would have followed some of the conversations and the guides from some leaders on Capitol Hill who suggested that you do not focus primarily on the website -- use more navigators, more phone, more grassroots help to get people involved in or enrolled in the ACA?

MR. CARNEY:  Well, I think that that’s always been part of the effort, the broad effort to get information to people, help educate people about the options available to them and the benefits available to them.  It was never just limited to the website.  I think what the President believes is that the website should be working more effectively and should have been working more effectively on October 1st.  It’s an important portal through which Americans across the country should be able to and will be able to get information that they need and enroll in affordable insurance plans.

Q  In the initial offering on October 1st, you had momentum there, you had everyone looking at it.  Do you think that you’ve lost that momentum now that there are so many glitches and it’s found out that there’s been low enrollment?  Do you think you’ve lost that momentum for people --

MR. CARNEY:  I would say that there’s no question that this has created a challenge.  And we have to work even harder to make sure that those Americans who have benefits available to them through the Affordable Care Act and through the marketplaces are getting the information they need so that they can make decisions about their insurance coverage.  So that’s on us, and we’re working hard to make sure that happens.

The goal here has always been not an effective website so much as an effective marketplace for Americans to get the quality, affordable health insurance that they deserve.  I mean, it is -- the criticism of the website is legitimate, it is a problem, it is frustrating, and the President is more frustrated than anyone about it, as he has said.  And that’s why he has tasked this team of experts to make the fixes necessary to bring it up to standard.

It is important throughout this to remember what the status quo looks like; to remember what the health insurance marketplace looked like in the United States and why a century of Presidents engaged in efforts to try to reform it.  It’s important to remember that prior to the passage of the Affordable Care Act, health care inflation was astronomical and increasing at a rate that made it unsustainable for employers and individuals and for the government in the long term.  Something needed to be done and is being done to bring that cost growth under control. 

And do not forget that even as we have these challenges with the website and other challenges associated with the standing up of the marketplaces, that since the passage of the Affordable Care Act, we’ve had the three years of slowest growth in health care costs ever recorded, essentially in a half a century.  And that has extreme benefits for the long term -- for individuals, for the government, and for private employers.  And in the meantime, we’re going to get the website right and we’re going to get the marketplaces right, and we’re going to make sure that the goal here is achieved, which is to deliver the benefits to the American people that the Affordable Care Act promises. 

And if we do that -- and millions of Americans who were not insured have insurance, and other Americans who were underinsured who had crummy insurance have better coverage -- then we will have achieved the objective.  Because coupled with the reduction in the growth of health care costs and the expansion of affordable, quality insurance to the American people, we will have achieved what the Affordable Care Act set out to do and what this President set out to do, and against some pretty entrenched establishment interests here. 

There's a reason why it hasn't been achieved in the past -- because a lot of forces fought against it.  And citing President Clinton is absolutely appropriate, and it's important to remember that he tried this.  He tried to reform our health insurance market, and that effort was blocked. 

So the American people deserve quality, affordable health insurance.  They deserve the certainty of knowing that they will not go bankrupt because they get sick.  That's the goal here.  The implementation of this website is not meeting anybody's standards here and we admit that.  And it's a problem and we're fixing it.  But don't forget the goal.  Don't forget the objective.


Q    The White House announced today the President is going to Cleveland on Thursday to deliver a speech on the economy.  Do you have any more details of what exactly he is going to be --

MR. CARNEY:  I'm sure we will provide more details as we get closer to the day.  The President, obviously, is very focused on the steps we need to take to continue the economic growth that we've seen and to expand it -- to continue the creation of high-quality jobs for the middle class. 

We've been creating jobs at a pace of more than 2 million a year.  We need to keep doing that as an economy and to increase that pace, because -- and that's his number-one objective here.  His top priority when he wakes up every morning is what steps are we taking to make the investments that are necessary to create the jobs that we need to make the middle class more secure and to have our economy grow.

And I think that it's important to remember, as we talk about bigger budget issues, that growth and job creation are the President's focus.  On his watch, we've reduced the deficits by half.  Don't forget that when he came into office -- and this is before the passage of the Affordable -- or the American Recovery Act -- he inherited the largest deficits in history and a cascading economic catastrophe.  And in order to forestall a depression, legislation was passed that included some temporary spending that increased even more the deficit. 

But the fact is, on his watch, the deficits have been cut in half.  And we need to continue that work, but we need to focus, first and foremost, on growth and job creation. 


Q    Alberta Premier, Alison Redford, is here in town to lobby for the Keystone Pipeline.  Is she going to be meeting with anyone here at the White House?  And can you characterize the President's thinking after all this time?  Is he leaning for or against the pipeline?

MR. CARNEY:  I don't have any meetings to announce and/or any new developments on that issue, which is housed and being addressed over at the State Department.  And I would refer you to them for any progress reports.

I'll do one more. 

Q    Jay, in light of President Clinton's comments, a year ago he was being called the "secretary of explaining stuff" by the President.  Is he still a metatron for the President's policies on health care?

MR. CARNEY:  I think I would point you to the answers I gave in the seven or eight previous questions to this along these lines, and simply say that President Clinton said something that, as the explainer-in-chief, he would know, which is that the big lesson, and I quote, is that, "We are better off with this law than without it." 

And that goes to what I was saying in answer to April's question.  The goal here is to achieve what President Clinton and Presidents both Democratic and Republican sought to achieve in the past, which is to reform our health care system in a way that builds on the private sector system that we have, that makes it more affordable, with better coverage, for more Americans.  And that's what the Affordable Care Act does, and it does it while reducing health care cost inflation, which has enormous benefits to our overall economy.

So the President himself addressed the issue of cancellations in the interview he gave last week, and I would point you to what he said.  And I think it’s consistent with the spirit of what President Clinton was saying today.

But President Clinton knows from experience.  And some of the same folks who fought him tooth and nail successfully in the end are still in Congress fighting the Affordable Care Act today.  And they didn't then and they don't now have an alternative.  They do not have an alternative to the Affordable Care Act that would make sure that you have coverage even if you have a preexisting condition; that would make sure that insurers can't charge you double if you're a woman; that would provide free preventive services that are so essential to the long-term health of the nation and to every individual who benefits from them.

So this is tough work, but the goal here is what the President remains focused on.

Thanks very much, everybody.

Q    If the House doesn't take up and pass ENDA, is the President going to sign the executive order?

MR. CARNEY:  Look, we believe very strongly -- I appreciate the question -- that the time to pass that legislation has come, that those who oppose passage of ENDA in the House and throw up a lot of reasons why, the reasons they cite are reasons that we’ve heard in the past in opposition to seminal civil rights legislation.  And those who oppose previous civil rights legislation were wrong, and history has proved them wrong.  And those who oppose passage of ENDA are wrong, and history will prove them wrong.

Thank you.


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