Remarks by the President and Vice President at Signing of the Health Insurance Reform Bill

East Room

11:29 A.M. EDT

THE VICE PRESIDENT:  Thank you all.  (Applause.) 

AUDIENCE:  Fired up!  Ready to go!  Fired up!  Ready to go!

THE VICE PRESIDENT:  Thank you. 

Mr. President, I think we got a happy room here.  (Laughter.)  It seems ridiculous to say thank you all for being here.  (Laughter.)  Ladies and gentlemen, to state the obvious, this is a historic day.  (Applause.) 

In our business you use that phrase a lot, but I can't think of a day in the 37 years that I've been a United States senator and the short time I've been Vice President that it is more appropriately stated.  This is a historic day. 

And history -- history is not merely what is printed in textbooks.  It doesn’t begin or end with the stroke of a pen.  History is made.  History is made when men and women decide that there is a greater risk in accepting a situation that we cannot bear than in steeling our spine and embracing the promise of change.  That's when history is made.  (Applause.) 

History is made when you all assembled here today, members of Congress, take charge to change the lives of tens of millions of Americans.  Through the efforts of those of us lucky enough to serve here in this town, that's exactly what you’ve done.  You’ve made history.

History is made when a leader steps up, stays true to his values, and charts a fundamentally different course for the country.  History is made when a leader’s passion -- passion -- is matched with principle to set a new course.  Well, ladies and gentlemen, Mr. President, you are that leader.  (Applause.)

Mr. President, your fierce advocacy, the clarity of purpose that you showed, your perseverance -- these are in fact -- it is not hyperbole to say -- these are the reasons why we're assembled in this room together, today.  But for those attributes we would not be here.  Many, many men and women are going to feel the pride that I feel in watching you shortly, watching you sign this bill, knowing that their work -- their work has helped make this day possible.  But, Mr. President, you’re the guy that made it happen.  (Applause.)

And so, Mr. President, all of us, press and elected officials, assembled in this town over the years, we’ve seen some incredible things happen.  But you know, Mr. President, you’ve done what generations of not just ordinary, but great men and women, have attempted to do.  Republicans as well as Democrats, they’ve tried before.  Everybody knows the story, starting with Teddy Roosevelt.  They’ve tried.  They were real bold leaders. 
But, Mr. President, they fell short.  You have turned, Mr. President, the right of every American to have access to decent health care into reality for the first time in American history. (Applause.)

Mr. President, I’ve gotten to know you well enough.  You want me to stop because I’m embarrassing you.  (Laughter.)  But I’m not going to stop for another minute, Mr. President, because you delivered on a promise -- a promise you made to all Americans when we moved into this building. 

Mr. President, you are -- to repeat myself -- literally about to make history.  Our children and our grandchildren, they’re going to grow up knowing that a man named Barack Obama put the final girder in the framework for a social network in this country to provide the single most important element of what people need -- and that is access to good health -- (applause) -- and that every American from this day forward will be treated with simple fairness and basic justice.

Look, the classic poet, Virgil, once said that “The greatest wealth is health.”  The greatest wealth is health.  Well, today, America becomes a whole lot wealthier because tens of millions of Americans will be a whole lot healthier from this moment on.

Ladies and gentlemen, the President of the United States of America, Barack Obama.  (Applause.)

THE PRESIDENT:  Thank you, everybody.  Thank you.  (Applause.)  Thank you.  Thank you, everybody.  Thank you.  Thank you everybody.  Thank you so much.  Thank you.  Thank you.  (Applause.)  Thank you, everybody.  Please, have a seat.

Thank you, Joe.  (Laughter.)

THE VICE PRESIDENT:  Good to be with you, Mr. President.  (Laughter.)

THE PRESIDENT:  Today, after almost a century of trying; today, after over a year of debate; today, after all the votes have been tallied –- health insurance reform becomes law in the United States of America.  (Applause.)  Today.

It is fitting that Congress passed this historic legislation this week.  For as we mark the turning of spring, we also mark a new season in America.  In a few moments, when I sign this bill, all of the overheated rhetoric over reform will finally confront the reality of reform.  (Applause.)

And while the Senate still has a last round of improvements to make on this historic legislation -- and these are improvements I’m confident they will make swiftly -- (applause)  -- the bill I’m signing will set in motion reforms that generations of Americans have fought for, and marched for, and hungered to see.

It will take four years to implement fully many of these reforms, because we need to implement them responsibly.  We need to get this right.  But a host of desperately needed reforms will take effect right away.  (Applause.)

This year, we’ll start offering tax credits to about 4 million small businessmen and women to help them cover the cost of insurance for their employees.  (Applause.)  That happens this year.

This year, tens of thousands of uninsured Americans with preexisting conditions, the parents of children who have a preexisting condition, will finally be able to purchase the coverage they need.  That happens this year.  (Applause.)

This year, insurance companies will no longer be able to drop people’s coverage when they get sick.  (Applause.)  They won’t be able to place lifetime limits or restrictive annual limits on the amount of care they can receive.  (Applause.)

This year, all new insurance plans will be required to offer free preventive care.  And this year, young adults will be able to stay on their parents’ policies until they’re 26 years old.  That happens this year.  (Applause.)

And this year, seniors who fall in the coverage gap known as the doughnut hole will start getting some help.  They’ll receive $250 to help pay for prescriptions, and that will, over time, fill in the doughnut hole.  And I want seniors to know, despite what some have said, these reforms will not cut your guaranteed benefits.  (Applause.)  In fact, under this law, Americans on Medicare will receive free preventive care without co-payments or deductibles.  That begins this year.  (Applause.)

Once this reform is implemented, health insurance exchanges will be created, a competitive marketplace where uninsured people and small businesses will finally be able to purchase affordable, quality insurance.  They will be able to be part of a big pool and get the same good deal that members of Congress get.  That’s what’s going to happen under this reform.  (Applause.)  And when this exchange is up and running, millions of people will get tax breaks to help them afford coverage, which represents the largest middle-class tax cut for health care in history.   That's what this reform is about.  (Applause.)  

This legislation will also lower costs for families and for businesses and for the federal government, reducing our deficit by over $1 trillion in the next two decades.  It is paid for.  It is fiscally responsible.  And it will help lift a decades-long drag on our economy.  That's part of what all of you together worked on and made happen.  (Applause.) 

That our generation is able to succeed in passing this reform is a testament to the persistence –- and the character -– of the American people, who championed this cause; who mobilized; who organized; who believed that people who love this country can change it.

It’s also a testament to the historic leadership -– and uncommon courage –- of the men and women of the United States Congress, who’ve taken their lumps during this difficult debate. (Laughter.) 

AUDIENCE MEMBER:  Yes, we did.  (Laughter.)

THE PRESIDENT:  You know, there are few tougher jobs in politics or government than leading one of our legislative chambers.  In each chamber, there are men and women who come from different places and face different pressures, who reach different conclusions about the same things and feel deeply concerned about different things.

By necessity, leaders have to speak to those different concerns.  It isn’t always tidy; it is almost never easy.  But perhaps the greatest –- and most difficult –- challenge is to cobble together out of those differences the sense of common interest and common purpose that’s required to advance the dreams of all people -- especially in a country as large and diverse as ours.

And we are blessed by leaders in each chamber who not only do their jobs very well but who never lost sight of that larger mission.  They didn’t play for the short term; they didn’t play to the polls or to politics:  One of the best speakers the House of Representatives has ever had, Speaker Nancy Pelosi.  (Applause.)

AUDIENCE:  Nancy!  Nancy!  Nancy!  Nancy!

THE PRESIDENT:  One of the best majority leaders the Senate has ever had, Mr. Harry Reid.  (Applause.) 

To all of the terrific committee chairs, all the members of Congress who did what was difficult, but did what was right, and passed health care reform -- not just this generation of Americans will thank you, but the next generation of Americans will thank you. 

And of course, this victory was also made possible by the painstaking work of members of this administration, including our outstanding Secretary of Health and Human Services, Kathleen Sebelius -- (applause) -- and one of the unsung heroes of this effort, an extraordinary woman who led the reform effort from the White House, Nancy-Ann DeParle.  Where’s Nancy?  (Applause.)

Today, I’m signing this reform bill into law on behalf of my mother, who argued with insurance companies even as she battled cancer in her final days.

I’m signing it for Ryan Smith, who’s here today.  He runs a small business with five employees.  He’s trying to do the right thing, paying half the cost of coverage for his workers.  This bill will help him afford that coverage.

I’m signing it for 11-year-old Marcelas Owens, who’s also here.  (Applause.)  Marcelas lost his mom to an illness.  And she didn’t have insurance and couldn’t afford the care that she needed.  So in her memory he has told her story across America so that no other children have to go through what his family has experienced.  (Applause.)

I’m signing it for Natoma Canfield.  Natoma had to give up her health coverage after her rates were jacked up by more than 40 percent.  She was terrified that an illness would mean she’d lose the house that her parents built, so she gave up her insurance.  Now she’s lying in a hospital bed, as we speak, faced with just such an illness, praying that she can somehow afford to get well without insurance.  Natoma’s family is here today because Natoma can’t be.  And her sister Connie is here.  Connie, stand up.  (Applause.)

I’m signing this bill for all the leaders who took up this cause through the generations -- from Teddy Roosevelt to Franklin Roosevelt, from Harry Truman, to Lyndon Johnson, from Bill and Hillary Clinton, to one of the deans who’s been fighting this so long, John Dingell.  (Applause.)  To Senator Ted Kennedy.  (Applause.)  And it’s fitting that Ted’s widow, Vicki, is here -- it’s fitting that Teddy’s widow, Vicki, is here; and his niece Caroline; his son Patrick, whose vote helped make this reform a reality.  (Applause.)

I remember seeing Ted walk through that door in a summit in this room a year ago -- one of his last public appearances.  And it was hard for him to make it.  But he was confident that we would do the right thing.

Our presence here today is remarkable and improbable.  With all the punditry, all of the lobbying, all of the game-playing that passes for governing in Washington, it’s been easy at times to doubt our ability to do such a big thing, such a complicated thing; to wonder if there are limits to what we, as a people, can still achieve.  It’s easy to succumb to the sense of cynicism about what’s possible in this country.

But today, we are affirming that essential truth -– a truth every generation is called to rediscover for itself –- that we are not a nation that scales back its aspirations.  (Applause.)  We are not a nation that falls prey to doubt or mistrust.  We don't fall prey to fear.  We are not a nation that does what’s easy.  That’s not who we are.  That’s not how we got here.

We are a nation that faces its challenges and accepts its responsibilities.  We are a nation that does what is hard.  What is necessary.  What is right.  Here, in this country, we shape our own destiny.  That is what we do.  That is who we are.  That is what makes us the United States of America. 

And we have now just enshrined, as soon as I sign this bill, the core principle that everybody should have some basic security when it comes to their health care.  (Applause.)  And it is an extraordinary achievement that has happened because of all of you and all the advocates all across the country.

So, thank you.  Thank you.  God bless you, and may God bless the United States.  (Applause.)  Thank you.  Thank you.

All right, I would now like to call up to stage some of the members of Congress who helped make this day possible, and some of the Americans who will benefit from these reforms.  And we’re going to sign this bill.

This is going to take a little while.  I’ve got to use every pen, so it’s going to take a really long time.  (Laughter.)  I didn’t practice.  (Laughter.)

(The bill is signed.) 

We are done.  (Applause.)

END
11:56 A.M. EDT

Declaraciones del President sobre el Voto en la Camara sobre la Reforma del Sistema de Seguro de Salud

21 de marzo, 2010

Salón Este

11:47 P.M. EDT

EL PRESIDENTE: Buenas noches a todos. Esta noche, tras casi cien años de palabras y frustraciones, tras décadas de intentos y un año de debate y esfuerzo sostenido, el Congreso de Estados Unidos por fin declaró que los trabajadores, familias y pequeñas empresas de Estados Unidos merecen la seguridad de saber que aquí, en este país, ni enfermedad ni accidente debería hacer peligrar los sueños hechos realidad tras una vida de trabajo.
 
      Esta noche, cuando los expertos decían que ya no era posible, nos liberamos del peso de nuestra conveniencia política; rechazamos la injustificada influencia de los intereses especiales; no caímos en las garras del recelo ni el cinismo ni el temor. En vez de eso, probamos que todavía somos un pueblo capaz de hacer grandes cosas y de hacerles frente a nuestros mayores desafíos. Probamos que este gobierno, un gobierno del pueblo y por el pueblo, todavía trabaja para el pueblo.
 
      Quisiera agradecer a todos los miembros del Congreso que se pusieron de pie esta noche con valentía y convicción para hacer realidad la reforma del seguro médico. Y sé que para muchos, no fue una votación fácil. Pero fue la votación correcta. Quiero agradecerle a la presidenta de la Cámara de Representantes Pelosi por su extraordinario liderazgo; y al líder de la mayoría Steny Hoyer y al encargado de disciplina de la mayoría Jim Clyburn por su compromiso con realizar la labor. Quiero agradecerles a mi sobresaliente vicepresidente, Joe Biden, y mi maravillosa Secretaria de Salud y Servicios Humanos Kathleen Sebelius por su trabajo fantástico sobre este asunto. Quiero agradecerles a los muchos miembros del personal en el Congreso, y a mi propio personal increíble en la Casa Blanca, quienes trabajaron incansablemente el último año con estadounidenses de todas las esferas para forjar un conjunto de medidas para una reforma que finalmente es merecedora del pueblo al que vinimos a servir.

      El voto de hoy es la respuesta a los sueños de tantos que han luchado por esta reforma. A los anónimos estadounidenses que se dieron tiempo para sentarse y escribir una carta o un correo electrónico esperando que su voz se escuchara... se escuchó esta noche; a los innumerables voluntarios que tocaron puertas e hicieron llamadas, que se organizaron y movilizaron con la firme convicción de que el cambio en este país no viene de arriba para abajo, sino de abajo para arriba... permítanme reafirmar esa convicción: este momento es posible gracias a ustedes.
 
      Y lo que es más importante, el voto de hoy es la respuesta a las oraciones de todos los estadounidenses que tenían profunda esperanza en que se haría algo respecto a un sistema de cuidado de salud que funciona para las aseguradoras, pero no para la gente promedio. Para la mayoría de estadounidenses, este debate nunca ha sido acerca de debates abstractos entre la derecha y la izquierda, republicanos y demócratas, siempre ha sido algo mucho más personal. Se trata de todos los estadounidenses que han experimentado el shock de abrir un sobre y ver que sus primas han aumentado otra vez en una época que de por sí ya es bastante difícil. Se trata de  todos los padres que han experimentado la desesperación de tratar de encontrar seguro para un niño con una enfermedad crónica y recibir negativas una y otra vez. Se trata de todos los dueños de pequeñas empresas obligados a escoger entre asegurar a sus empleados o mantener su empresa a flote. Es por ellos que nos comprometimos con esta causa.
 
      La votación de hoy no es una victoria para ningún partido... es una victoria para ellos. Es una victoria para el pueblo estadounidense. Y es una victoria para el sentido común.
 
      Probablemente no necesito mencionar que la votación de esta noche dará lugar a un frenesí de análisis instantáneos; conteos de ganadores y perdedores en Washington; y predicciones de lo que significa para los demócratas, republicanos, para mi en los sondeos, para mi gobierno. Pero mucho después de que el debate haya terminado, que las predicciones hayan terminado, y hayamos vuelto a la rutina, lo que quedará no es el sistema controlado por el gobierno que algunos temían, ni el status quo que sirve los intereses del sector seguros, sino un sistema de seguro de salud que incorpora ideas de ambos partidos, un sistema que funciona mejor para el pueblo estadounidense.
 
      Si tienen seguro médico, esta reforma les acaba de dar mayor control para frenar los peores excesos y abusos del sector seguros con algunas de las medidas más estrictas de protección al consumidor que este país conoció jamás, para que realmente reciban algo por lo que están pagando.
 
      Si no tienen seguro, esta reforma les da la oportunidad de ser parte de un gran grupo que comprará seguro mancomunadamente, lo que les dará opciones y competencia y precios más bajos para comprar seguro. E incluye el mayor recorte tributario en la historia para las familias trabajadoras y pequeñas empresas que adquieren seguro médico, de modo que si pierden el empleo, cambian de trabajo o abren un nuevo negocio, finalmente podrán comprar cuidado de salud de calidad y a buen precio, y tendrán la seguridad y tranquilidad que resultan de ello.
 
      Esta reforma es la medida correcta para nuestras personas mayores. Le da más solidez a Medicare y más solvencia, pues extiende sus fondos por casi una década más. Y es la medida correcta para nuestro futuro. Reducirá nuestro déficit en más de $100,000 millones en la próxima década y más de $1 billón en la década que sigue.
 
      Así que ésta no es una reforma radical. Pero es una reforma significante. Esta ley no solucionará todos los problemas de nuestro sistema de cuidado de salud. Pero nos encamina decisivamente en la dirección correcta. Ésta es la cara del cambio.
 
      Pero aunque este día es histórico, no es el fin de la travesía. El martes, el Senado abordará las revisiones hechas por la Cámara de Representantes, revisiones que han fortalecido esta ley y eliminado cláusulas que no tienen lugar en ella. Algunos predicen otro asedio de maniobras parlamentarias con el fin de demorar la adopción de estas mejoras. Espero que no sea el caso. Es hora de llevar este debate a su fin y empezar la difícil tarea de implementar esta reforma apropiadamente por el bien del pueblo estadounidense. Este año, y los años venideros, tenemos la solemne responsabilidad de hacerlo bien.
 
      Y este día tampoco representa el fin de la labor que nuestro país enfrenta. Continúa la labor de revitalizar nuestra economía. Continúa la labor de promover la generación de empleo en el sector privado. Continúa la labor de volver a poner los sueños al alcance de las familias estadounidenses. Y seguimos adelante, con confianza renovada, con más energía por lograr esta victoria para ellos.
 
      Al final, lo que este día representa es una piedra más, firmemente sentada en los cimientos del Sueño Americano. Esta noche, respondimos al llamado de la historia, como lo hicieron muchas generaciones de estadounidenses antes que nosotros. Cuando tuvimos que lidiar con una crisis, no nos acobardamos ante el desafío, lo superamos. No evadimos nuestra responsabilidad, la aceptamos gustosos. Y no le tuvimos temor a nuestro futuro, lo forjamos. Gracias, que Dios los bendiga y que Dios bendiga a Estados Unidos de Norteamérica.

FIN                 11:55 P.M. EDT
 
 

Extractos de las Declaraciones del Presidente Sobre la Reforma del Seguro Médico el Viernes en la Universidad George Mason

Patriot Center, Universidad George Mason
Fairfax, Virginia

11:27 A.M. EDT

EL PRESIDENTE: ¡Hola, George Mason! ...

No sé si recuerdan, pero visité esta universidad por primera vez hace tres años. (Aplausos) En ese momento, mi campaña para la presidencia apenas comenzaba. Tenía unas tres semanas, creo. No teníamos mucho dinero. No teníamos mucho personal. Nadie podía pronunciar mi nombre. (Risas.) En las encuestas, nuestros números eran bastante bajos. Y mucha gente, mucha gente en Washington, no pensaban que valía la pena tratar...Pero incluso entonces, contábamos con un grupo de estudiantes aquí en George Mason  -- (aplausos) -- que creían que si nos esforzábamos lo suficientemente, y luchábamos  lo suficiente, si organizábamos a suficientes partidarios, finalmente podríamos producir cambios en la ciudad del otro lado del río. (Aplausos.) Creíamos que a pesar de toda la resistencia, podíamos hacer que Washington trabajara, no a favor de los cabilderos, no a favor de los intereses especiales, no a favor de los políticos, sino a favor de los estadounidenses...Y precisamente de eso se trata esta votación sobre el cuidado de salud. (Aplausos.)

A pocas millas de aquí, el Congreso se encuentra en la recta final de un debate sumamente significativo para el futuro del seguro médico en Estados Unidos. (Aplausos.) Es un debate que se remonta no sólo al último año, sino a gran parte del siglo pasado... Es un debate que no sólo se limita al costo de nuestro cuidado de salud, no solo a lo que estamos haciendo por la gente que recibe trato injusto de sus compañías de seguro. Es un debate sobre el carácter de nuestro país – (aplausos.) -- sobre si aún podemos afrontar los desafíos de nuestros tiempos; si aún tenemos la valentía para darle a todos nuestros ciudadanos, no solo a algunos, la oportunidad de alcanzar sus sueños.  (Aplausos.)

En este debate la cuestión principal es si vamos a aceptar un sistema que funciona mejor para las compañías de seguro que para los estadounidenses. (Aplausos.)  Porque si esta votación falla, el sector de seguros continuará sin control. Continuarán negándoles cobertura a las personas. Continuarán negándoles atención a las personas. Continuarán aumentando las primas 40% ó 50% ó 60% como lo han hecho en las últimas semanas sin tener que rendir cuentas en absoluto. Lo saben. Por eso, sus cabilderos están recorriendo los pasillos del Congreso en este preciso instante y gastando millones de dólares en anuncios negativos. Por eso están haciendo todo lo que pueden para acabar con este proyecto de ley.

Entonces, la única pregunta ante nosotros es la siguiente:  ¿Vamos a permitir que ganen los intereses particulares de nuevo?

AUDIENCIA: No!

EL PRESIDENTE: ¿O vamos a darle esta victoria al pueblo estadounidense?  (Aplausos.)

AUDIENCIA: Sí se puede! Sí se puede!

EL PRESIDENTE: George Mason, éste es el momento de la reforma...Hemos tenido – hemos tenido un año de debates fuertes. Todas las propuestas están sobre la mesa. Todos los argumentos han sido planteados. Y hemos incorporado las mejores ideas de los demócratas y republicanos en la propuesta final, que se basa en el sistema de seguro privado que tenemos actualmente. El sector de seguros y sus partidarios en el Congreso han tratado de hacer que esto se vea como un cambio radical...Pero cuando -- resulta que de lo que estamos hablando aquí es de una reforma de sentido común. Eso es todo de lo que estamos hablando. (Aplausos.)

Si están satisfechos con su médico, podrán seguir viendo a su médico. Si están satisfechos con su plan, mantengan su plan. No creo que el gobierno ni las aseguradoras deban tener más control sobre el seguro médico en Estados Unidos. Creo que es el momento de darles a ustedes, el pueblo estadounidense, más control sobre su seguro médico. (Aplausos.)
 
Y ya que ustedes han escuchado una cantidad de disparates, seamos claros sobre exactamente lo que hará la propuesta sobre la que votarán en un par de días. Va a --va a cambiar el cuidado de salud de tres maneras: En primer lugar, acabaremos con las peores prácticas de las compañías de seguro...A partir de este año, miles de estadounidenses sin seguro que tienen enfermedades preexistentes podrán adquirir seguro médico, algunos por primera vez. (Aplausos.) A partir de este año, se prohibirá para siempre que las compañías de seguro les nieguen seguro a niños con enfermedades preexistentes. (Aplausos.) A partir de este año, se prohibirá que se cancele la cobertura si el asegurado se enferma...Esas prácticas acabarán.
 
Si se promulga esta reforma, se requerirá que todos los nuevos planes de seguro ofrezcan atención preventiva gratuita a sus clientes. (Aplausos.) Si compran una póliza nueva, ya no habrá límites ni restricciones anuales o de por vida al monto de atención que reciben de su aseguradora. (Aplausos.) Y también, a todos los jóvenes que están aquí presentes: a partir de este año, si no tienen seguro, todos los planes nuevos les permitirán permanecer en la póliza de sus padres hasta que tengan 26 años. (Aplausos.)

Así que tendrán algo de seguridad al graduarse. Si ese primer trabajo no ofrece cobertura, usted va a saber que cuenta con cobertura. Porque lo último de lo que se deben preocupar cuando empiezen su vida y su carrera, es de si se van a ir a la quiebra sólo porque se enferman...El segundo cambio en el actual sistema es que por primera vez, los dueños de pequeñas empresas que no podían pagar el precio del mercado de seguros tendrán las mismas opciones de seguro privado que tienen los miembros del Congreso. (Aplausos.)

Lo que significa esto es, es que los dueños de pequeñas empresas y las familias de clase media podrán formar parte de lo que se conoce como un grupo grande de clientes colectivos que pueden negociar con las aseguradoras. Y eso significa que pueden adquirir seguro médico de menor precio en un mercado competitivo. (Aplausos.) Así que no están comprando por su cuenta. Estarán entre millones de personas que pueden comprar juntos. Y si aun así no pueden pagar una póliza en este nuevo mercado, aunque será menos costoso que lo que pueden conseguir por su cuenta, les ofreceremos créditos tributarios para ayudarlos, créditos tributarios que, en términos históricos, representan el mayor recorte tributario otorgado a la clase media por seguro médico. (Aplausos.)

Claro, estos créditos tributarios cuestan dinero...cuesta unos $100,000 millones al año. Pero la mayor parte del costo...Lo que estamos haciendo es tomando dinero que Estados Unidos ya gasta en el sistema de salud, pero que se gasta mal, que resulta en despilfarro y fraude o subsidios otorgados injustificadamente a las aseguradoras, y estamos tomando ese dinero y asegurándonos que esos dólares se usen para que el seguro sea más económico. (Aplausos.)

Así que vamos a eliminar los subsidios destinados a las aseguradoras que despilfarran el dinero de los contribuyentes. (Aplausos.) Y dado que las aseguradoras se beneficiarán de los millones de estadounidenses que podrán adquirir una póliza, estableceremos una nueva tarifa sobre estas aseguradoras. (Aplausos.) El asunto es éste: nuestra propuesta está pagada...
 
Bueno, lo tercero que hace esta legislación es que reducirá el costo del cuidado de salud para las familias, empresas y el gobierno federal. (Aplausos.) Los estadounidenses que compren cobertura individual comparable a la que tienen hoy verán que sus primas se reducirán entre 14 y 20 por ciento. (Aplausos.)  Para los estadounidenses que reciben seguro de su empleador, el costo se reducirá hasta en $3,000 por empleador en comparación con las primas sin reforma. Bueno, piensen en eso. Eso serían $3,000 que su empleador no tendría que pagar, lo que significa que pueden darles un aumento de sueldo...En total, nuestras medidas de reducción de costos significarán primas más bajas para la mayoría de las personas. Y este es el bono: reduce nuestro déficit por más de $1 billón en las próximas dos décadas...de acuerdo a la Oficina de Presupuesto del Congreso (Congressional Budget Office), el árbitro independiente de cuanto cuestan las cosas -- dice que nos ahorraremos $1 billón. No solo está al alcance de nuestros bolsillos hacer esto, no nos podemos dar el lujo de no hacerlo. (Aplausos.)

A final de cuentas, ésta es nuestra propuesta...Eso es sobre lo que el Congreso de Estados Unidos está a punto de votar este fin de semana.

Bueno, sería bueno si todos estuviéramos analizando la sustancia, si estuviéramos hablando de los detalles del plan, lo que significa para ustedes. Pero eso no es lo que le gusta discutir a las estaciones de cable. (Risas.) Lo que les gusta discutir es la política de la votación. ¿Qué significa para noviembre? ¿Qué significa para nuestros resultados en las encuestas? ¿Será una mayor ventaja para demócratas o republicanos? ¿Qué significará para Obama?

...
 
No sé las consecuencias políticas de esto. Nadie lo sabe en realidad...Pero esto es lo que sí sé. Sé  que este proyecto de ley, esta legislación, va a ser sumamente importante para el futuro de Estados Unidos. (Aplausos.) Sé el impacto en millones de estadounidenses que necesitan nuestra ayuda, y en millones más que pueden no necesitar ayuda ahora pero en un año o en cinco o en diez años, si tienen mala suerte...Sé lo que significa la reforma para una persona como Leslie Banks, una madre sola que conocí en Pensilvania. Ella está tratando de pagar la educación universitaria de su hija...Y su aseguradora le acaba de enviar una carta diciendo que planean aumentar sus primas al doble este año... al doble. Y ella no puede pagarlo. Entonces ahora está tratando de resolver, ¿voy a mantener mi seguro o voy a mantener a mi hija en la universidad? Leslie Banks necesita que aprobemos esta ley. (Aplausos.)

Sé lo que significa la reforma para una persona como Laura Klitzka. Conocí a Laura en Green Bay, Wisconsin, durante la campaña. Laura pensaba que había vencido al cáncer de ceno. Luego se enteró que se había propagado a los huesos. Ella y su seguro -- ella y su esposo, tenían la suerte de tener seguro, pero los gastos médicos los llevaron a endeudarse, y ahora se la pasa preocupada de la deuda y todo lo que quiere es aprovechar su tiempo con sus dos hijos. Laura necesita que aprobemos esta ley.  (Aplausos.)

Sé lo que significa la reforma para una persona como Natoma Canfield. Cuando su aseguradora aumentó sus primas, se vio forzada a prescindir de su cobertura, a pesar de que había pagado miles de dólares en primas durante años, debido a que había vencido el cáncer 11 años atrás. Le subieron las primas, y le subieron las primas. Finalmente, temía que perdería su hogar. Temía que una enfermedad repentina la llevara a la ruina, pero no tuvo alternativa. En este momento está en una cama de hospital, enfrentando tener que pagar por esa enfermedad, luego de haber tenido que prescindir de su seguro médico. Está rezando que tendrá los recursos para recuperarse. Ella sabe que éste es el momento de la reforma.

George Mason, cuando escuchen a la gente que dice, bueno, ¿por qué no hacemos esto poco a poco? ¿por qué no hacemos esto por pedazos? ¿por qué no ayudamos a las personas que son más fáciles de ayudar? Mi respuesta es que éste es el momento de la reforma. Hemos esperado suficiente. (Aplausos.) Hemos esperado suficiente.

Y en apenas unos días, una lucha de un siglo culminará con un voto histórico...Y cuando tuvimos que enfrentar tales decisiones en el pasado, esta nación optó una y otra vez por extender su promesa a más de sus pobladores.  (Aplausos.)

Saben, los críticos argumentaron que el Seguro Social llevaría al socialismo. (Risas.) Pero los hombres y mujeres del Congreso permanecieron firmes y crearon un programa que ha sacado a millones de la pobreza. (Aplausos.)

Hubo cínicos que advirtieron que Medicare resultaría en una toma de control por el gobierno de todo nuestro sistema de salud, y no era muy popular en los sondeos. Pero demócratas y republicanos se rehusaron a rendirse y se aseguraron de que nuestros ciudadanos de la tercera edad tuvieran el cuidado de salud que necesitaban y pudieran tener cierta tranquilidad básica. (Aplausos.)

Varias generaciones, nuestros antepasados, tomaron la decisión de que nuestras personas mayores y los pobres, por medio del Medicaid, no se verían forzados a prescindir del cuidado de salud simplemente porque no podían pagarlo. Hoy, recae en esta generación decidir si les haremos la misma promesa a las familias de clase media y a las pequeñas empresas y a jóvenes estadounidenses como ustedes que recién empiezan. (Aplausos.)

A final de cuentas. Sé que ha sido una travesía difícil. Sé que será un voto difícil. Sé que en Washington todos están contando votos ahora mismo. Pero también recuerdo una cita que vi en una placa en la Casa Blanca el otro día. Está colgada en la misma sala donde exigí respuestas de los ejecutivos de las aseguradoras y solamente recibí excusas. Y es una cita de Teddy Roosevelt, quien propuso inicialmente la reforma del cuidado de salud -- ese Republicano -- hace tantos años. Dice, “La lucha enérgica por los derechos es el deporte más noble del mundo”.

Bueno, no sé qué pasará en términos políticos con la aprobación de la reforma de salud. Pero sé que es lo correcto. (Aplausos.) Teddy Roosevelt sabía que era lo correcto. Harry Truman sabía que era lo correcto. Ted Kennedy sabía que era lo correcto. (Aplausos.) Y si creen también que es lo correcto, necesito que nos ayuden a llevar a su fin la lucha que iniciaron. Necesito que me respalden. Así como cuando vine aquí hace tres años, que llamen por teléfono y toquen puertas, hablen con sus padres, hablen con sus amigos. No se rindan, no se den por vencidos, seguimos adelante. (Aplausos.) Vamos a logarlo. Vamos a hacer historia. Vamos a arreglar el cuidado de salud en Estados Unidos con su ayuda. (Aplausos.)

Que Dios los bendiga, que Dios bendiga a los Estados Unidos de Norteamérica. (Aplausos.)

FIN           11:56 A.M. EDT

Remarks by the President to the House Democratic Congress

Capitol Visitor Center Auditorium, Washington, D.C.

THE PRESIDENT:  Thank you.  Thank you.  Thank you.  Thank you.  Thank you.  Thank you, everybody.  Thank you.  Thank you very much.  Thank you.  Everybody, please have a set.

To Leader Reid, to Steny Hoyer, John Larson, Xavier Becerra, Jim Clyburn, Chris Van Hollen, to an extraordinary leader and extraordinary Speaker of the House, Nancy Pelosi, and to all the members here today, thank you very much for having me.  (Applause.)  Thanks for having me and thanks for your tireless efforts waged on behalf of health insurance reform in this country. 

I have the great pleasure of having a really nice library at the White House.  And I was tooling through some of the writings of some previous Presidents and I came upon this quote by Abraham Lincoln:  “I am not bound to win, but I’m bound to be true.  I’m not bound to succeed, but I’m bound to live up to what light I have.”

This debate has been a difficult debate.  This process has been a difficult process.  And this year has been a difficult year for the American people.  When I was sworn in, we were in the midst of the worst recession since the Great Depression.  Eight hundred thousand people per month were losing their jobs.  Millions of people were losing their health insurance.  And the financial system was on the verge of collapse.

And this body has taken on some of the toughest votes and some of the toughest decisions in the history of Congress.  Not because you were bound to win, but because you were bound to be true.  Because each and every one of you made a decision that at a moment of such urgency, it was less important to measure what the polls said than to measure what was right.

A year later, we’re in different circumstances.  Because of the actions that you’ve taken, the financial system has stabilized.  The stock market has stabilized.  Businesses are starting to invest again.  The economy, instead of contracting, is now growing again.  There are signs that people are going to start hiring again.  There’s still tremendous hardship all across the country, but there is a sense that we are making progress -- because of you.

But even before this crisis, each and every one of us knew that there were millions of people across America who were living their own quiet crises.  Maybe because they had a child who had a preexisting condition and no matter how desperate they were, no matter what insurance company they called, they couldn’t get coverage for that child.  Maybe it was somebody who had been forced into early retirement, in their 50s not yet eligible for Medicare, and they couldn’t find a job and they couldn’t find health insurance, despite the fact that they had some sort of chronic condition that had to be tended to.

     Every single one of you at some point before you arrived in Congress and after you arrived in Congress have met constituents with heart-breaking stories.  And you’ve looked them in the eye and you’ve said, we’re going to do something about it -- that’s why I want to go to Congress. 

And now, we’re on the threshold of doing something about it.  We’re a day away.  After a year of debate, after every argument has been made, by just about everybody, we’re 24 hours away. 

As some of you know, I’m not somebody who spends a lot of time surfing the cable channels, but I’m not completely in the bubble.  I have a sense of what the coverage has been, and mostly it’s an obsession with “What will this mean for the Democratic Party?  What will this mean for the President’s polls?  How will this play out in November?  Is this good or is this bad for the Democratic majority?  What does it mean for those swing districts?” 

And I noticed that there’s been a lot of friendly advice offered all across town.  (Laughter.)  Mitch McConnell, John Boehner, Karl Rove -- they’re all warning you of the horrendous impact if you support this legislation.  Now, it could be that they are suddenly having a change of heart and they are deeply concerned about their Democratic friends.  (Laughter.)  They are giving you the best possible advice in order to assure that Nancy Pelosi remains Speaker and Harry Reid remains Leader and that all of you keep your seats.  That’s a possibility.  (Laughter.)

But it may also be possible that they realize after health reform passes and I sign that legislation into law, that it’s going to be a little harder to mischaracterize what this effort has been all about. 

Because this year, small businesses will start getting tax credits so that they can offer health insurance to employees who currently don’t have it.  (Applause.)  Because this year, those same parents who are worried about getting coverage for their children with preexisting conditions now are assured that insurance companies have to give them coverage -- this year.  (Applause.) 

Because this year, insurance companies won’t suddenly be able to drop your coverage when you get sick -- (applause) -- or impose lifetime limits or restrictive limits on the coverage that you have.  Maybe they know that this year, for the first time, young people will be able to stay on their parents’ health insurance until they’re 26 years old and they’re thinking that just might be popular all across the country.  (Applause.)

And what they also know is what won’t happen.  They know that after this legislation passes and after I sign this bill, lo and behold nobody is pulling the plug on Granny.  (Laughter.)  It turns out that in fact people who like their health insurance are going to be able to keep their health insurance; that there’s no government takeover.  People will discover that if they like their doctor, they’ll be keeping their doctor.  In fact, they’re more likely to keep their doctor because of a stronger system.

It’ll turn out that this piece of historic legislation is built on the private insurance system that we have now and runs straight down the center of American political thought.  It turns out this is a bill that tracks the recommendations not just of Democrat Tom Daschle, but also Republicans Bob Dole and Howard Baker; that this is a middle-of-the-road bill that is designed to help the American people in an area of their lives where they urgently need help.

Now, there are some who wanted a single-payer government-run system.  That’s not this bill.  The Republicans wanted what I called the “foxes guard the henhouse approach” in which we further deregulate the insurance companies and let them run wild, the notion being somehow that that was going to lower costs for the American people.  I don’t know a serious health care economist who buys that idea, but that was their concept.  And we rejected that, because what we said was we want to create a system in which health care is working not for insurance companies but it’s working for the American people, it’s working for middle class families.

So what did we do?  What is the essence of this legislation?  Number one, this is the toughest insurance reforms in history.  (Applause.)  We are making sure that the system of private insurance works for ordinary families.  A prescription -- this is a patient’s bill of rights on steroids.  So many of you individually have worked on these insurance reforms -- they are in this package -- to make sure that families are getting a fair deal; that if they’re paying a premium, that they’re getting a good service in return; making sure that employers, if they are paying premiums for their employees, that their employees are getting the coverage that they expect; that insurance companies are not going to game the system with fine print and rescissions and dropping people when they need it most, but instead are going to have to abide by some basic rules of the road that exemplify a sense of fairness and good value.  That’s number one.

The second thing this does is it creates a pool, a marketplace, where individuals and small businesses, who right now are having a terrible time out there getting health insurance, are going to be able to purchase health insurance as part of a big group -- just like federal employees, just like members of Congress.  They are now going to be part of a pool that can negotiate for better rates, better quality, more competition. 

And that’s why the Congressional Budget Office says this will lower people’s rates for comparable plans by 14 to 20 percent. That’s not my numbers -- that’s the Congressional Budget Office’s numbers.  So that people will have choice and competition just like members of Congress have choice and competition.

Number three, if people still can’t afford it we’re going to provide them some tax credits -- the biggest tax cut for small businesses and working families when it comes to health care in history.  (Applause.)

And number four, this is the biggest reduction in our deficit since the Budget Balance Act -- one of the biggest deficit reduction measures in history -- over $1.3 trillion that will help put us on the path of fiscal responsibility.  (Applause.)

And that’s before we count all the game-changing measures that are going to assure, for example, that instead of having five tests when you go to the doctor you just get one; that the delivery system is working for patients, not just working for billings.  And everybody who’s looked at it says that every single good idea to bend the cost curve and start actually reducing health care costs are in this bill.

So that’s what this effort is all about.  Toughest insurance reforms in history.  A marketplace so people have choice and competition who right now don’t have it and are seeing their premiums go up 20, 30, 40, 50 percent.  Reductions in the cost of health care for millions of American families, including those who have health insurance.  The Business Roundtable did their own study and said that this would potentially save employers $3,000 per employee on their health care because of the measures in this legislation. 

And by the way, not only does it reduce the deficit -- we pay for it responsibly in ways that the other side of the aisle that talks a lot about fiscal responsibility but doesn’t seem to be able to walk the walk can’t claim when it comes to their prescription drug bill.  We are actually doing it.  (Applause.)  This is paid for and will not add a dime to the deficit -- it will reduce the deficit.  (Applause.)

Now, is this bill perfect?  Of course not.  Will this solve every single problem in our health care system right away?  No.  There are all kinds of ideas that many of you have that aren’t included in this legislation.  I know that there has been discussion, for example, of how we’re going to deal with regional disparities and I know that there was a meeting with Secretary Sebelius to assure that we can continue to try to make sure that we’ve got a system that gives people the best bang for their buck.  (Applause.)

So this is not -- there are all kinds of things that many of you would like to see that isn’t in this legislation.  There are some things I’d like to see that’s not in this legislation.  But is this the single most important step that we have taken on health care since Medicare?  Absolutely.  Is this the most important piece of domestic legislation in terms of giving a break to hardworking middle class families out there since Medicare?  Absolutely.  Is this a vast improvement over the status quo?  Absolutely.

Now, I still know this is a tough vote, though.  I know this is a tough vote.  I’ve talked to many of you individually.  And I have to say that if you honestly believe in your heart of hearts, in your conscience, that this is not an improvement over the status quo; if despite all the information that’s out there that says that without serious reform efforts like this one people’s premiums are going to double over the next five or 10 years, that folks are going to keep on getting letters from their insurance companies saying that their premium just went up 40 or 50 percent; if you think that somehow it’s okay that we have millions of hardworking Americans who can’t get health care and that it’s all right, it’s acceptable, in the wealthiest nation on Earth that there are children with chronic illnesses that can’t get the care that they need -- if you think that the system is working for ordinary Americans rather than the insurance companies, then you should vote no on this bill.  If you can honestly say that, then you shouldn’t support it.  You’re here to represent your constituencies and if you think your constituencies honestly wouldn’t be helped, you shouldn’t vote for this.

But if you agree that the system is not working for ordinary families, if you’ve heard the same stories that I’ve heard everywhere, all across the country, then help us fix this system.  Don't do it for me.  Don’t do it for Nancy Pelosi or Harry Reid.  Do it for all those people out there who are struggling. 

Some of you know I get 10 letters a day that I read out of the 40,000 that we receive.  Started reading some of the ones that I got this morning.  “Dear President Obama, my daughter, a wonderful person, lost her job.  She has no health insurance.  She had a blood clot in her brain.  She’s now disabled, can’t get care.”  “Dear President Obama, I don’t yet qualify for Medicare.  COBRA is about to run out.  I am desperate, don't know what to do.”

Do it for them.  Do it for people who are really scared right now through no fault of their own, who’ve played by the rules, who’ve done all the right things, and have suddenly found out that because of an accident, because of an ailment, they’re about to lose their house; or they can’t provide the help to their kids that they need; or they’re a small business who up until now has always taken pride in providing care for their workers and it turns out that they just can’t afford to do it anymore and they’ve having to make a decision about do I keep providing health insurance for my workers or do I just drop their coverage or do I not hire some people because I simply can’t afford it -- it’s all being gobbled up by the insurance companies.

Don’t do it for me.  Don’t do it for the Democratic Party.  Do it for the American people.  They’re the ones who are looking for action right now.  (Applause.)

I know this is a tough vote.  And I am actually confident -- I’ve talked to some of you individually -- that it will end up being the smart thing to do politically because I believe that good policy is good politics.  (Applause.)  I am convinced that when you go out there and you are standing tall and you are saying I believe that this is the right thing to do for my constituents and the right thing to do for America, that ultimately the truth will out.

I had a wonderful conversation with Betsy Markey.  I don't know if Betsy is around here.  There she is right there.  (Applause.)  Betsy is in a tough district.  The biggest newspaper is somewhat conservative, as Betsy described.  They weren’t real happy with health care reform.  They were opposed to it.  Betsy, despite the pressure, announced that she was in favor of this bill.  And lo and behold, the next day that same newspaper runs an editorial saying, you know what, we’ve considered this, we’ve looked at the legislation, and we actually are pleased that Congresswoman Markey is supporting the legislation.  (Applause.) 

When I see John Boccieri stand up proud with a whole bunch of his constituencies -- (applause) -- in as tough a district as there is and stand up with a bunch of folks from his district with preexisting conditions and saying, you know, I don’t know what is going on Washington but I know what’s going on with these families -- I look at him with pride.

Now, I can’t guarantee that this is good politics.  Every one of you know your districts better than I do.  You talk to folks.  You’re under enormous pressure.  You’re getting robocalls.  You’re getting e-mails that are tying up the communications system.  I know the pressure you’re under.  I get a few comments made about me.  I don’t know if you’ve noticed.  (Laughter.)  I’ve been in your shoes.  I know what it’s like to take a tough vote.

But what did Lincoln say?  “I am not bound to win, but I am bound to be true.”  Two generations ago, folks who were sitting in your position, they made a decision -- we are going to make sure that seniors and the poor have health care coverage that they can count on.  And they did the right thing. 

And I’m sure at the time they were making that vote, they weren’t sure how the politics were either, any more than the people who made the decision to make sure that Social Security was in place knew how the politics would play out, or folks who passed the civil rights acts knew how the politics were going to play out.  They were not bound to win, but they were bound to be true.

And now we’ve got middle class Americans, don’t have Medicare, don’t have Medicaid, watching the employer-based system fray along the edges or being caught in terrible situations.  And the question is, are we going to be true to them? 

Sometimes I think about how I got involved in politics.  I didn’t think of myself as a potential politician when I get out of college.  I went to work in neighborhoods, working with Catholic churches in poor neighborhoods in Chicago, trying to figure out how people could get a little bit of help.  And I was skeptical about politics and politicians, just like a lot of Americans are skeptical about politics and politicians are right now.  Because my working assumption was when push comes to shove, all too often folks in elected office, they’re looking for themselves and not looking out for the folks who put them there; that there are too many compromises; that the special interests have too much power; they just got too much clout; there’s too much big money washing around.

And I decided finally to get involved because I realized if I wasn’t willing to step up and be true to the things I believe in, then the system wouldn’t change.  Every single one of you had that same kind of moment at the beginning of your careers.  Maybe it was just listening to stories in your neighborhood about what was happening to people who’d been laid off of work.  Maybe it was your own family experience, somebody got sick and didn’t have health care and you said something should change. 

Something inspired you to get involved, and something inspired you to be a Democrat instead of running as a Republican.  Because somewhere deep in your heart you said to yourself, I believe in an America in which we don’t just look out for ourselves, that we don’t just tell people you’re on your own, that we are proud of our individualism, we are proud of our liberty, but we also have a sense of neighborliness and a sense of community -- (applause) -- and we are willing to look out for one another and help people who are vulnerable and help people who are down on their luck and give them a pathway to success and give them a ladder into the middle class.  That’s why you decided to run.  (Applause.)

And now a lot of us have been here a while and everybody here has taken their lumps and their bruises.  And it turns out people have had to make compromises, and you’ve been away from families for a long time and you’ve missed special events for your kids sometimes.  And maybe there have been times where you asked yourself, why did I ever get involved in politics in the first place?  And maybe things can’t change after all.  And when you do something courageous, it turns out sometimes you may be attacked.  And sometimes the very people you thought you were trying to help may be angry at you and shout at you.  And you say to yourself, maybe that thing that I started with has been lost. 

But you know what?  Every once in a while, every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises that you made in all those town meetings and all those constituency breakfasts and all that traveling through the district, all those people who you looked in the eye and you said, you know what, you’re right, the system is not working for you and I’m going to make it a little bit better. 

And this is one of those moments.  This is one of those times where you can honestly say to yourself, doggone it, this is exactly why I came here.  This is why I got into politics.  This is why I got into public service.  This is why I’ve made those sacrifices.  Because I believe so deeply in this country and I believe so deeply in this democracy and I’m willing to stand up even when it’s hard, even when it’s tough.

Every single one of you have made that promise not just to your constituents but to yourself.  And this is the time to make true on that promise.  We are not bound to win, but we are bound to be true.  We are not bound to succeed, but we are bound to let whatever light we have shine.  We have been debating health care for decades.  It has now been debated for a year.  It is in your hands.  It is time to pass health care reform for America, and I am confident that you are going to do it tomorrow. 

Thank you very much, House of Representatives.  Let’s get this done.  (Applause.)

END          
4:24 P.M. EDT