By Jacqueline Klingebiel

Sep 10, 2009 4:01pm

Today’s Q’s for O’s WH – 9/10/2009

JAKE TAPPER:  The president yesterday, last night, said that the bills — the healthcare reform bills, whatever he signs, will be deficit-neutral and will bend the cost curve.  The Democratic bills that have been introduced in the House and Senate so far, at least according to the Congressional Budget Office, will not do that.  They will increase the deficit, according to Doug Elmendorf, and they will not bend the cost curve.  In fact, the cost curve will continue to go up. Does the White House accept what the CBO director says about these bills?  And if so, what pressure is the White House conveying or using on Congress and Democrats to improve these two elements that the president said were so important?

ROBERT GIBBS:  Well, let's — let me take these separately.  First and foremost, it's not up to us to judge.  Obviously, we take at face value whatever the CBO says about — about legislation, as we've discussed in here.  The proposal that the president outlined last night is obviously in some ways different than what we discussed — what has been discussed on Capitol Hill thus far. I think the CBO would one of the first to tell you that one way to bend that cost curve is to go after and discuss how to prevent what the president called "Cadillac health insurance plans" last night, that tend to make steeper that curve going upwards. I think one of the things that the CBO has said is addressing that will put that downward pressure on costs, and obviously the president, as part of his plan last night, outlined a fee on insurance companies that offer these Cadillac plans after — at a certain rate. So I think that, first and foremost, is one of the things that the president outlined. 

And I think, secondly, the president outlined a trigger, a deficit trigger that would — would evaluate whether or not savings have been achieved.  And if savings haven't been achieved, before moving forward, how that savings can be achieved before the plan is fully implemented in 2013.  I think those are two ways that the president outlined last night to address those concerns. But you heard him, I think, say pretty clearly that this was — this has to change the direction of our — or our — of government spending on health care, and this has to not add a dime to the deficit.  And the president is — is very serious about keeping those promises.
  
TAPPER:  How firm is he being with Democratic leaders?  Because they — I mean, we've heard that — from Harry Reid and Nancy Pelosi that they're 90 percent there.  You guys have said that there's 80 percent agreement.  Seems to be — I understand…

(CROSSTALK)

GIBBS:  … the proposal the president outlined and that's (inaudible) 10 to 20 percent range.

TAPPER:  Well, is it going to be that significant?  I mean — I mean, are these major steps that are actually going to change the impacts of these bills, according to the CBO (inaudible)?

GIBBS:  Well, actually, I mean, again, the — I think the CBO has evaluated a number of cost-cutting mechanisms that have been outlined, and the one that they think has the greatest ability is to — deals with these Cadillac health insurance plans, which the president talked about last night. So I do think the president believes that will have a — will have an impact on the cost curve.

**

Later in the briefing, Gibbs asserted that despite what was in other legislation, last night “the president outlined a plan that doesn't cover illegal immigrants.” This reference to a “plan” is a reference to the President Obama’s outline of what he wants to sign, which was posted on the White House website last night.

JONATHAN WEISMAN, WALL STREET JOURNAL:  In his plan, would he say that an illegal immigrant could not take money out of his pocket, go on the federal exchange, and buy an insurance policy with his money?

GIBBS:  The policy would not cover — the plan would not cover illegal immigrants.

TAPPER:  I think the question is that the House bill, for instance, 3200, explicitly says that none of the subsidies can go people who in this country illegally.

GIBBS:  Right.

TAPPER:  Right, but some of the criticism — and what the Congressional Research Service analysis says of it is that people who are illegal, as Jon points out, are able to buy insurance, as they already do…

GIBBS:  I can't speak for somebody that's here illegally, but I would think it would be somewhat of a bad course of events if you're here illegally to alert people that you are here illegally and sign up for a government program.

TAPPER:  Just to — just to put the dot on it, I mean there are illegal immigrants who are — who are covered by emergency Medicaid all the time — millions.

GIBBS:  As a result of I think a 1986 law that was signed by President Reagan…

TAPPER:  Right.  So — but the House bill…

GIBBS:  …that might be the last time Congress took up immigration reform, in 1986.

TAPPER:  …the House bill would expand Medicaid, and that could lead to an expansion of emergency Medicaid that would cover, possibly…

GIBBS:  Again…

(CROSSTALK)

TAPPER:  …so when you say that illegal immigrants will not be covered, does that mean they can't be covered by any expansion in emergency Medicaid, they can't — they can't buy into the health exchange…

GIBBS:  Well, again, again, again, let me check with the health care guys on how this would affect the 1986 law.  But they would not be covered under the health care exchange in the proposal…
 
TAPPER:  And they can't — and they can't — they would be prohibited from buying…
  
GIBBS:  As I understand it…
 
TAPPER:  … insurance through the exchange?
 
GIBBS: …yes

-jpt

User Comments

Good questions, Jake. Thanks for trying and keep at it, please.
Cadillac health insurance plans are not only expensive in and of themselves, but their very existence encourages overutilization and drives up costs. Unfortunatly, “accepatable health care coverage” as defined by HR3200 is of a cadillac variety, and will continue the spiral of out of control spending.

Posted by: Bridget | September 10, 2009, 4:11 pm 4:11 pm

Hmmm. Must get my glasses so I can see my typos before posting.

Posted by: Bridget | September 10, 2009, 4:12 pm 4:12 pm

Jake,
How ’bout some follow up on Van Jones? Does PBO agree he does not belong in his administration? If not, how far out does one have to get before he is too far out? If yes, how did he get in the administration in the first place–was his background known, but dismissed as no big deal, or (unlikely) was it missed?

Posted by: jpfred | September 10, 2009, 4:14 pm 4:14 pm

“I think the CBO would one of the first to tell you that one way to bend that cost curve is to go after and discuss how to prevent what the president called “Cadillac health insurance plans” last night, that tend to make steeper that curve going upwards.”
Seems Obama and his crew are staking collection of a significant amount of ObamaCare funds by taxing “Cadillac” plans. Do these geniuses realize that “by taxing something, you’ll get less of it (i.e., when taxes go up enrollment in “Cadillac” plans will drop, decreasing expected tax revenues)?
Obama does not have a sound way to pay for his plans. Taxing “Cadillac” plans will not significantly “bend” cost curve.
Are these guys really this incompetent or are they simply dishonest? I go back-and-forth on this everyday…

Posted by: tjp612 | September 10, 2009, 4:26 pm 4:26 pm

Are people really concerned that illegals may pay their own money to buy unsubsidized insurance? Seems like the least they could do, in addition to paying taxes, to makes sure they don’t burden our country further.

Posted by: jhw539 | September 10, 2009, 4:29 pm 4:29 pm

To prove that they aren’t illegal immigrants, will they have to have a birth certificate?

Posted by: DontGet818OnMeNow | September 10, 2009, 4:36 pm 4:36 pm

“Seems like the least they could do, in addition to paying taxes, to makes sure they don’t burden our country further.”
How about we start with gaining entrance to the country LEGALLY? Too much to ask?

Posted by: tjp612 | September 10, 2009, 4:43 pm 4:43 pm

Hmmm… I wonder about this Cadillac plan plan.
The people I know with the most Cadillacy plans are UAW workers. Unions negotiate hard for plans that are much more generous than many in the private sector. At GM, the union retirees got better health insurance benefits than white-collar workers- who were eventually converted to MediCare.
Who are the people with “Cadillac” plans?

Posted by: MayBee | September 10, 2009, 4:55 pm 4:55 pm

… it’s obvious… the people who assemble Cadillacs.. please…….

Posted by: DontGet818OnMeNow | September 10, 2009, 4:57 pm 4:57 pm

The other issue with illegal immigrants getting HC coverage in many of the proposed bills is that there is no mechanism to determine if someone is an illegal immigrant.
It isn’t enough to say “they won’t be” if there is no way to legally ensure they won’t be.
That’s aside from the many people who actually and actively do want illegal immigrants to be covered by Health Care Reform.

Posted by: MayBee | September 10, 2009, 4:58 pm 4:58 pm

There are STILL way too many questions that need to be answered on this bill. He did not say anymore last night than has been said for the past few months. For example, exactly WHAT does the “public option” cover? Will the person being covered have to go to only government sponsored doctors and hospitals? How are they going to control the fraud that PEOPLE put on insurance companies? All we hear is complaints about how insurance companies do horrible things to the people they insure, but what about the people who go to the doctor every time they have a paper cut just because they have medicaid and they can? There’s many more where that came from, but that’s just the beginning. I think the main question the American people have is how this monster is going to be paid for without any extra deficit? REALLY?

Posted by: Shoe | September 10, 2009, 5:02 pm 5:02 pm

Shoe..
this was all answered by the Comedian in Chief..
there are still a few details to be fleshed out… no pun intended..
..biggest laugh of the evening..

Posted by: DontGet818OnMeNow | September 10, 2009, 5:05 pm 5:05 pm

“Conveniently enough, the union negotiated plans are exempt from Obamacare.”
Also, the House version of health care, that has made it out of committee, has a $10 billion provision tucked into it for the unions.
Cadillacs, indeed.

Posted by: Independent voter | September 10, 2009, 5:33 pm 5:33 pm

“Conveniently enough, the union negotiated plans are exempt from Obamacare.”
Also, the House version of health care, that has made it out of committee, has a $10 billion provision tucked into it for the unions.
Cadillacs, indeed.

Posted by: Independent voter | September 10, 2009, 5:36 pm 5:36 pm

“The other issue with illegal immigrants getting HC coverage in many of the proposed bills is that there is no mechanism to determine if someone is an illegal immigrant.”
MayBee | Sep 10, 2009 4:58:19 PM
“Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.” – HR3200
There is no mechanism defined to verify they aren’t actually lizard men from Atlantis either, and I doubt another 1000 pages of minutia would change your opinion.
I find it interesting that when Republicans were in power they didn’t have the slightest urge to complain about illegal aliens explicitly being covered by Medicaid.

Posted by: jhw539 | September 10, 2009, 5:38 pm 5:38 pm

“Conveniently enough, the union negotiated plans are exempt from Obamacare.”
Also, the House version of health care, that has made it out of committee, has a $10 billion provision tucked into it for the unions.
Cadillacs, indeed.

Posted by: Independent voter | September 10, 2009, 5:41 pm 5:41 pm

The only way President Obama has any possibility of passing health care reform, is a commitment to remove illegal immigrants from gaining entrance to any public option? In the health care bill they must–PROVE–to the majority of the American People that–NO ILLEGAL FOREIGN NATIONAL–will be able to bleed the government extension in the package. An amendment to the 1000 page reform bill, must guarantee–IN THE WORDING– that a very thorough background identity check is performed on any applicant who applies? E-Verify would be a progressive identifier, with an initial examination of Social Security number in conjunction with Homeland Security Databases.
To complete the operation of E-Verification this PC application, must branch out across the country as a permanent tool in business and industry for every worker newly hired or long time employee. Thousands or even millions of illegal workers could be hiding in plain site in the workplace, as they have never been checked as a citizen or legal residency compliance? It also seems that the auditing of 1-9 forms around the country, that the federal authorities forget to mention that irregularities by employers only allows them to dismiss the applicant? The fact is that ICE raids have trailed off, so that any illegal workers–ARE NOT DEPORTED–they can move onto yet another workplace. Anybody who is suspected of being in this sovereign nation illegally should be detained and held for ICE inspection, not released into the public mainstream?
We all know that Fraudulent ID is so prevalent, that all security systems have been compromised, with even al-Qaeda murderers who brought down three passenger jets. On 9/11 these terrorists had in their possession numerous authentic drivers’ licenses and other picture ID. E-Verify is not perfect and can be cheated, but as it’s modified, collecting more tools to compliment the enforcement program it success rate will become exemplary. Those hired workers who then find themselves under suspicion, can have errors resolved through any Social Security agency. That special interest groups have remained silent about this matter, doesn’t need any explanation? most Americans want enforcement at our borders, the workplace, so contact your reluctant politician at 202-224-3121 MORE HONEST INFORMATION AT NUMBERSUSA & JUDICIAL WATCH. REMEMBER NO MORE BLANKET AMNESTIES!

Posted by: Brittancus | September 10, 2009, 5:41 pm 5:41 pm

“How about we start with gaining entrance to the country LEGALLY? Too much to ask?”
tjp612 | Sep 10, 2009 4:43:21 PM
Too much to enforce apparently. If it didn’t happen with a hard right Republican President and a fully Republican Congress that gave him almost anything he wanted (what, 2 vetos and a failed Supreme Court nominee over 6 years?) it’s not happening now.
You can stick with your fantasy of literally millions of people being rounded up and shipped out in the largest civilian detention program since WW2 internment, but for those of us who live in reality the reality is it saves us money if illegals buy themselves insurance.

Posted by: jhw539 | September 10, 2009, 5:42 pm 5:42 pm

“In the health care bill they must–PROVE–to the majority of the American People that–NO ILLEGAL FOREIGN NATIONAL–will be able to bleed the government extension in the package.”
Oh please, a portion of the American people don’t even think Obama has proven his own citizenship. There is nothing, literally nothing, they could do to stop the Right from whining and whipping up fear amongst their followers.
“Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.”
Now why isn’t there the same blind rage about a real case of subsidizing illegals – Reagan explicitly extending Medicaid coverage to illegals? Why didn’t the Right do anything about that all the years they held Congress and the White House?

Posted by: jhw539 | September 10, 2009, 5:52 pm 5:52 pm

“TAPPER: Right, but some of the criticism — and what the Congressional Research Service analysis says of it is that people who are illegal[sic], as Jon points out, are able to buy insurance, as they already do…”
Jake, name one person who has criticized this legislation under the framework you describe here.
People do criticize the fact that people come here without permission, thus breaking the law. Some misinformed people also criticize government benefits going to people here illegally. Until you brought it up just now, I have never heard anyone complain about someone here illegally spending their own money to buy something.

Posted by: Flash Override | September 10, 2009, 5:53 pm 5:53 pm

It sounds to me like the media is trying to stretch as much as they can to cover for their utter failure on the Wilson story. ABC reported it as a he said/he said story without noting that Wison was not only out of line, but wrong.

Posted by: Flash Override | September 10, 2009, 5:59 pm 5:59 pm

“Now why isn’t there the same blind rage about a real case of subsidizing illegals – Reagan explicitly extending Medicaid coverage to illegals? Why didn’t the Right do anything about that all the years they held Congress and the White House?”
The Republicans are kissing the Hispanic vote good bye.
Not because they are against illegal immigration.
But because too many Republicans politicians and those in the base fail to distinguish between the illegal immigrant and the Hispanic immigrant.

Posted by: Ryan C | September 10, 2009, 6:03 pm 6:03 pm

Gibbsy says: ” I think the CBO would one of the first to tell you that one way to bend that cost curve is to go after and discuss how to prevent what the president called “Cadillac health insurance plans” last night, that tend to make steeper that curve going upwards.”
What kind of morons do they think we are? The “cadillac health insurance plans” are what help subsidize the uninsured the most. The definition of a “cadillac health plan” at least in the private world is one where the premiums are higher and the payments to Doctors and hospitals are higher, thus doing more to help than hurt when subsidizing the uninsured. Now, on the other hand a “cadillac health plan” provided to government employees and representatives could do more harm than good as we all have to pay for them, so if they got rid of those, the cost of overall health care would go down some, probably not much, but some. Either way we are talking a few billion dollars when the deficit is going to be over a trillion dollars, so it is pretty stupid to cite this as a major contributor to bending the cost curve in any direction.

Posted by: Jason | September 10, 2009, 7:55 pm 7:55 pm

jhw395 asks: “Are people really concerned that illegals may pay their own money to buy unsubsidized insurance? Seems like the least they could do, in addition to paying taxes, to makes sure they don’t burden our country further.”
Dude, the point is that they will not be unsubsidized as their income is so low. They will not be able to afford an unsubsidized health insurance plan. The taxpayers will be paying the majority of the cost. This is why it is important to verify citizenship before allowing people to buy plans in this marketplace they want to set up.

Posted by: Jason | September 10, 2009, 7:58 pm 7:58 pm

“The Republicans are kissing the Hispanic vote good bye.”
And the Democrats are insulting legal hispanic immigrants by kissing the butts of illegal aliens to get their illegal votes.

Posted by: Peppah | September 10, 2009, 9:02 pm 9:02 pm

Obama apparently had a teachable moment
last night. Millions of liberals had
orgasms, but there was no appreciable
conception. That means no big bump in
Dem voters 18 years from now….unless
they sneak across the border to take
advantage of the health care benefits
that Obama is promising, are NOT there.

Posted by: Trajan | September 10, 2009, 10:35 pm 10:35 pm

The whole thing about immigrants, even those who are here legally, can not buy insurance from the exchange is absurd. Those who are here legally pay taxes, ss, and contribute to the country. WH said that legal immigrants (including green card holders) are required to buy insurance but can not buy from the exchange. So, I guess when you are immigrants, they all fall under leeches category regardless.
So much for HOPE Obama..it turns out you are spineless…we should have elected Hillary Clinton instead. The woman is a fighter.

Posted by: sad | September 12, 2009, 7:57 am 7:57 am

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