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Obama Outlines Health Ideas In Prime-Time Speech


It's MORNING EDITION from NPR News. Good morning. I'm Renee Montagne.


And I'm Steve Inskeep.

President Obama reframed his arguments last night in a speech to Congress. He asked lawmakers to expand health coverage and protect the coverage Americans have now.

MONTAGNE: The president was speaking to a sharply divided Congress. To diffuse that opposition, the president argued that he's embracing Republican ideas. He also tried to finesse the concerns of Democrats who are themselves divided.

INSKEEP: At different points in this morning's program, we're hearing responses from Congress and across the nation. Right now, we'll put an ear to the speech itself.

Here's NPR national political correspondent Mara Liasson.

MARA LIASSON: The president began by acknowledging the century-old fight to reform the nation's health care system. I'm not the first president to take up this cause, he said, but I am determined to be the last.

President BARACK OBAMA: Our collective failure to meet this challenge, year after year, decade after decade, has led us to the breaking point.

LIASSON: The president described the problem, as he has many times before, but he also did something new. Instead of sticking to broad principles and leaving the details up to Congress, he outlined his own plan, starting with what it would do for the largest and most important constituency in the health care fight: the hundreds of millions of Americans with health insurance.

Pres. OBAMA: Under this plan, it will be against the law for insurance companies to deny you coverage because of a preexisting condition.

(Soundbite of applause)

LIASSON: And the president said it would be illegal for insurers to drop coverage.

Pres. OBAMA: They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime.

(Soundbite of applause)

LIASSON: For those without insurance, he offered a new marketplace called an insurance exchange and subsidies for those who couldn't afford it. Until the exchange is set up, he called for a high-risk insurance pool in which people with preexisting conditions could get low-cost coverage. This is an idea borrowed from his opponent in the presidential race, John McCain. And it wasn't the only Republican idea the president embraced. In a nod to the bipartisanship that voters want to see in Washington, Mr. Obama said he would set up demonstration projects on medical malpractice reform. And he said he would try to limit expensive health care policies that many employers currently give their workers as a tax-free perk.

Pres. OBAMA: This reform will charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money - an idea which has the support of Democratic and Republican experts. And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long run.

LIASSON: He repeated his promise not to sign a bill that added one dime to the federal deficit.

Pres. OBAMA: And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.

LIASSON: He embraced an individual insurance mandate, something he had campaigned against last year in the Democratic primary.

Pres. OBAMA: Individuals will be required to carry basic health insurance, just as most states require you to carry auto insurance.

(Soundbite of applause)

LIASSON: Businesses would have to offer their workers health care or pay a fee, but the president said 95 percent of small businesses would be exempt. On the most divisive issue, whether there should be a government-run alternative to private insurance, the president offered an eloquent defense of such a public option. But then he made it clear he would be happy to sign a bill without the robust Medicare-style public option that so many liberals in Congress hold dear.

Pres. OBAMA: To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage available for those without it.

(Soundbite of applause)

Pres. OBAMA: The public option is only a means to that end, and we should remain open to other ideas that accomplish our ultimate goal.

LIASSON: Other ideas the president suggested might work as a compromise. He mentioned a fall back triggered public option or nonprofit co-ops that could provide choice and competition in the insurance market. White House officials acknowledged those proposals have a better chance of getting the 60 votes in the Senate that would be needed to defeat a Republican filibuster.

The president tried to rekindle a sense of optimism about the health care effort after a summer of acrimonious town hall meetings and sagging poll numbers.

(Soundbite of applause)

Pres. OBAMA: I still believe that we can act when it's hard. I still believe we can replace acrimony with civility and gridlock with progress. I still believe we can do great things, and that here and now we will meet history's test.

LIASSON: It was a rousing conclusion, but if the speech does help the president recapture the initiative, it won't be the soaring rhetoric so much as the practical blueprint he laid out for Congress to follow.

Mara Liasson, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

Mara Liasson
Mara Liasson is a national political correspondent for NPR. Her reports can be heard regularly on NPR's award-winning newsmagazine programs Morning Edition and All Things Considered. Liasson provides extensive coverage of politics and policy from Washington, DC — focusing on the White House and Congress — and also reports on political trends beyond the Beltway.
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