WEEKLY ADDRESS: Calling on Congress to Prevent Student Interest Rates from Doubling

WASHINGTON, DC—In this week’s address, President Obama called on Congress to act before student loan interest rates double for more than 7.4 million students, adding an average of $1000 to their debt. Having a college education has never been more important, but it’s also never been more expensive.  While the Obama administration has taken historic steps to provide Americans with a fair shot at an affordable college education, Republicans in Congress have instead prioritized huge new tax cuts for millionaires and billionaires.  Congress has a chance to take action on what should be an area of bipartisan agreement to prevent this unnecessary and damaging increase in interest rates and give our young people a chance to succeed in the jobs of today and tomorrow.

Remarks of President Barack Obama
Weekly Address
The White House
Saturday, April 21, 2012

Hi.  This week, I got the chance to sit down with some impressive students at Lorain County Community College in Ohio.  One of them was a woman named Andrea Ashley.  Two years ago, Andrea lost her job as an HR analyst.  Today, she’s getting certified in the fast-growing field of electronic medical records.  Before enrolling at Lorain, Andrea told me she was looking everywhere trying to find a new job.  But without a degree, she said that nobody would hire her.

Andrea’s story isn’t unique.  I’ve met so many Americans who are out there pounding the pavement looking for work only to discover that they need new skills.  And I’ve met a lot of employers who are looking for workers, but can’t find ones with the skills they’re looking for.

So we should be doing everything we can to put higher education within reach for every American – because at a time when the unemployment rate for Americans with at least a college degree is about half the national average, it’s never been more important.  But here’s the thing: it’s also never been more expensive.  Students who take out loans to pay for college graduate owing an average of $25,000.  For the first time, Americans owe more debt on their student loans than they do on their credit cards.  And for many working families, the idea of owing that much money means that higher education is simply out of reach for their children.

In America, higher education cannot be a luxury.  It’s an economic imperative that every family must be able to afford.  That’s why next week I’ll be visiting colleges across the country, talking to students about how we can make higher education more affordable – and what’s at stake right now if Congress doesn’t do something about it.  You see, if Congress doesn’t act, on July 1st interest rates on some student loans will double.  Nearly seven and half million students will end up owing more on their loan payments.  That would be a tremendous blow.  And it’s completely preventable. 

This issue didn’t come out of nowhere.  For some time now, I’ve been calling on Congress to take steps to make higher education more affordable – to prevent these interest rates from doubling, to extend the tuition tax credit that has saved middle-class families millions of dollars, and to double the number of work-study jobs over the next five years.

Instead, over the past few years, Republicans in Congress have voted against new ways to make college more affordable for middle-class families, and voted for huge new tax cuts for millionaires and billionaires – tax cuts that would have to be paid for by cutting things like education and job-training programs that give students new opportunities to work and succeed.

We cannot just cut our way to prosperity.  Making it harder for our young people to afford higher education and earn their degrees is nothing more than cutting our own future off at the knees.  Congress needs to keep interest rates on student loans from doubling, and they need to do it now.

This is a question of values.  We cannot let America become a country where a shrinking number of people do really well, while a growing number of people struggle to get by.  We’ve got to build an economy where everyone gets a fair shot, everyone does their fair share, and everyone plays by the same set of rules.  That’s how the middle class gets stronger.  That’s an economy that’s built to last.  And I’m not only going to take that case to college campuses next week – I’m going to take it to every part of the country this year.  Thanks, and have a great weekend.

FACT SHEET: Creating Health Care Jobs by Addressing Primary Care Workforce Needs

Primary care providers are critical for ensuring better coordinated care and better health outcomes for all Americans. To meet the health needs of Americans, the Obama Administration has made the recruitment, training and retention of primary care professionals a top priority. 

Expanding the Primary Health Care Workforce

Together, the Affordable Care Act, the American Recovery and Reinvestment Act of 2009 (Recovery Act), and ongoing federal investments in the health care workforce have led to significant progress in training new primary care providers – including physicians, nurse practitioners and physician assistants – and encouraging primary care providers to practice in underserved areas, including:

• Nearly Tripling the National Health Service Corps in Three Years:  By 2011, more than 10,000 doctors, nurses and other health care providers were caring for Americans in communities nationwide, thanks to investments over the past three years in the National Health Service Corps (NHSC) through the Affordable Care Act, the Recovery Act and annual appropriations. The NHSC has awarded nearly $900 million in scholarships and loan repayment to health care professionals to help expand the country’s primary care workforce and meet the health care needs of communities across the country. In 2008, approximately 3.7 million patients were provided service by 3,600 National Health Service Corps providers.  In 2011, with field strength of more than 10,000 clinicians, the NHSC provided health care services to about 10.5 million patients.
• Training New Primary Care Providers: The Affordable Care Act invests in the training of new primary care providers, including providing nearly $230 million to increase the number of medical residents, nurse practitioners and physician assistants trained in primary care.  With these investments, by 2015, more than 1,700 new primary care providers will have been trained and enter primary care practice. The President’s Fiscal Year 2013 budget includes $677 million, an increase of $49 million over FY 2012, within the Health Resources and Services Administration to expand the capacity and improve the training and distribution of primary care, dental, and pediatric health providers. The Budget will support the placement of more than 1,500 new primary care providers in underserved areas and begin investments that expand the capacity of institutions to train 2,800 additional primary care providers over five years.
• Training Physicians in Community-Based Settings: The Affordable Care Act created the Teaching Health Center Program to help move primary care training into community-based settings. The five-year investment in this program is expected to supportthe community-based training of over 600 new primary care physician residents by 2015. 
• Supporting Mental Health Training: Mental health issues rank in the top five chronic illnesses in the United States. In Fiscal Year 2012, the Affordable Care Act will invest $10 million to support training to help close the gap in access to mental and behavioral health care services by increasing the number of adequately prepared mental and behavioral health providers.
• Expanding Residency Slots for Primary Care: To encourage more medical residents to pursue careers in primary care, the Affordable Care Act redistributes unused residency positions and directs those slots for the training of primary care physicians. In distributing the residency slots, priority for awarding residents is given to hospitals that have rural training tracks, train residents in geriatrics, use the additional slots to create or expand a primary care program, demonstrate focus in training residents to pursue careers in primary care, or are located in a primary care health professional shortage area.
• Expanding Training of Advanced Practice Nurses: The Affordable Care Act allows up to five hospitals to receive $50 million each year, for fiscal years 2012 to 2015, to train advanced practice nurses, including nurses in community-based settings through the Centers for Medicare and Medicaid Services. 

Modernizing Primary Care Training and Practice

Implementation of the Affordable Care Act provisions is strengthening the primary care training infrastructure, creating new primary care clinical training opportunities, and supporting primary care practice. These efforts include:

• Encouraging Physician Training in the Community: The Affordable Care Act provides incentives for hospitals to train primary care physicians in the community by providing flexibility in Medicare residency training requirements. Prior to the law, hospitals had to bear the cost of education in non-hospital sites, often by paying both the resident’s and teaching physician’s salary. This requirement discouraged training in community settings, which encourages primary care practice. The Affordable Care Act changed this policy and requires hospitals to only pay the resident salaries.
• Encouraging Health Homes:  Under the Affordable Care Act, States are incentivized to create Medicaid “health homes” for individuals with chronic health conditions. Health homes encourage the use of primary care providers to provide integrated care to help patients better manage their health. States that create health homes will receive enhanced federal matching funds for care coordination services for the first eight quarters a health home state plan amendment is in effect.

Modernizing Payment and Improving Financial Incentives for Coordinated Care

• Creating Primary Care Payment Incentives:  The Affordable Care Act authorizes a ten percent Medicare payment bonus from 2011 to 2015 for physicians who specialize in family medicine, internal medicine, geriatric medicine, or pediatric medicine, nurse practitioners, clinical nurse specialists, or physician assistants for whom primary care services account for at least 60 percent of their Medicare allowed charges. The Affordable Care Act also increases primary care physician payment rates in the Medicaid program to match Medicare payment levels in 2013 and 2014. 
• Realigning financial incentives in Accountable Care Organizations (ACOs):Under old payment systems, care coordination – the hallmark of effective primary care – wasn’t rewarded financially. Medicare’s shared savings program changes that model by rewarding physicians and other primary care practitioners for high-quality care and preventing the need for care in the first place. Already, 27 ACOs have joined the program and over 150 more potential ACOs have submitted an application. CMS has also created two demonstration programs to supplement the shared savings program: the Pioneer ACO initiative for 32 large and experienced health systems ready to move into accountable care quickly; and the Advanced Payment ACO, for smaller practices that need help with startup costs. Together, these initiatives are improving primary care for 1.1 million people with Medicare.
• Innovation Center: The Center for Medicare & Medicaid Innovation has launched 16 initiatives involving over 50,000 health care providers that will touch the lives of Medicare and Medicaid beneficiaries in all 50 States. Many of those are explicitly designed to promote primary care.
  • Comprehensive Primary Care Initiative Demonstration: A public-private partnership to enhance access to primary care services by establishing medical homes supported by multiple payers. Funding of up to $322 million is available to support 75 practices in 5-7 States starting this year.
  • Federal Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration: This initiative makes almost $50 million available to support 500 FQHCs in 44 States with care coordination payments that will allow the Centers to become medical homes, the hub of a patient’s primary care needs. This initiative started in 2011.
  • Multi-payer Advanced Primary Care Practice Demonstration: This initiative, launched in 2011, is a State-led, multi-payer collaboration to help primary care practices transform into medical homes. It makes $283 million available in 8 States.
  • Independence at Home: This initiative supports home-based care for patients with multiple chronic conditions that would benefit from primary care coordination. It provides up to $15 million to support up to 50 practices and will launch later this year.

WEEKLY ADDRESS: Passing the Buffett Rule so that Everyone Pays Their Fair Share

WASHINGTON, DC— In this week’s address, President Obama calls on Congress to pass the Buffett Rule, a principle of fairness that ensures that millionaires and billionaires do not pay less in taxes as a share of their income than middle class families pay.  The President believes our system must ask the wealthiest to pay their fair share, while protecting 98 percent of Americans from seeing their taxes go up at all. That is why the President proposed the Buffett Rule, which will help make our system reflect our values so that all Americans get a fair shot, play by the same rules, and pay their fair share.

Remarks of President Barack Obama
Weekly Address
The White House
March 31, 2012

Hello. 

Over the last few months, I’ve been talking about a choice we face as a country.  We can either settle for an economy where a few people do really well and everyone else struggles to get by, or we can build an economy where hard work pays off again – where everyone gets a fair shot, everyone does their fair share, and everyone plays by the same rules.  That’s up to us.

Today, I want to talk to you about the idea that everyone in this country should do their fair share.

Now, if this were a perfect world, we’d have unlimited resources.  No one would ever have to pay any taxes, and we could spend as much as we wanted.  But we live in the real world.  We don’t have unlimited resources.  We have a deficit that needs to be paid down.  And we also have to pay for investments that will help our economy grow and keep our country safe: education, research and technology, a strong military, and retirement programs like Medicare and Social Security. 

That means we have to make choices.  When it comes to paying down the deficit and investing in our future, should we ask middle-class Americans to pay even more at a time when their budgets are already stretched to the breaking point?  Or should we ask some of the wealthiest Americans to pay their fair share?

That’s the choice.  Over the last decade, we’ve spent hundreds of billions of dollars on what was supposed to be a temporary tax cut for the wealthiest two percent of Americans.  Now we’re scheduled to spend almost a trillion more. Today, the wealthiest Americans are paying taxes at one of the lowest rates in 50 years.  Warren Buffett is paying a lower rate than his secretary.  Meanwhile, over the last 30 years, the tax rates for middle class families have barely budged.

That’s not fair.  It doesn’t make any sense.  Do we want to keep giving tax breaks to the wealthiest Americans like me, or Warren Buffett, or Bill Gates – people who don’t need them and never asked for them?  Or do we want to keep investing in things that will grow our economy and keep us secure?  Because we can’t afford to do both.

Now, some people call this class warfare.  But I think asking a billionaire to pay at least the same tax rate as his secretary is just common sense.  We don’t envy success in this country.  We aspire to it.  But we also believe that anyone who does well for themselves should do their fair share in return, so that more people have the opportunity to get ahead – not just a few.

That’s the America I believe in.  And in the next few weeks, Members of Congress will get a chance to show you where they stand.  Congress is going to vote on what’s called the Buffett Rule: If you make more than $1 million a year, you should pay at least the same percentage of your income in taxes as middle class families do.  On the other hand, if you make under $250,000 a year – like 98 percent of American families do – your taxes shouldn’t go up.  You’re the ones struggling with the rising cost of everything from college tuition to groceries.  You’re the ones who deserve a break.

So every Member of Congress is going to go on record.  And if they vote to keep giving tax breaks to people like me – tax breaks our country can’t afford – then they’re going to have to explain to you where that money comes from.  Either it’s going to add to our deficit, or it’s going to come out of your pocket.  Seniors will have to pay more for their Medicare benefits.  Students will see their interest rates go up at a time when they can’t afford it.  Families who are scraping by will have to do more because the richest Americans are doing less.

That’s not right.  That’s not who we are.   In America, our story has never been about what we can do by ourselves – it’s about what we can do together.  It’s about believing in our future and the future of this country.  So tell your Members of Congress to do the right thing.  Call them up, write them a letter, pay them a visit, and tell them to stop giving tax breaks to people who don’t need them and start investing in the things that will help our economy grow and put people back to work.

That’s how we’ll make this country a little fairer, a little more just, and a whole lot stronger.  Thank you.