Today’s Q’s for O’s WH – 9/10/2009

By Jacqueline Klingebiel

Sep 10, 2009 4:01pm

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…


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…


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


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