Thursday, September 10, 2009


Many have questioned in recent months Obama's oft-stated claim that if people like their insurance, they would not have to change it after reform. "If you like your health-care plan, you'll be able to keep your health-care plan, period," he liked to say. Obama has retained that basic notion, but possibly in response to those criticisms, he tweaked his claim to say that reform will not "require" people or companies to change their plans. The subtle but crucial shift puts the president on slightly firmer ground,

The fact is, there are several likely scenarios under which some people who are now insured will find themselves with different coverage -- possibly better coverage, but still, different coverage.

Thus Obama's rhetorical sleight of hand: His promise is slightly less definitive and slightly more accurate.

-- Alec MacGillis


Here Obama is embracing one of the primary sources of funding proposed by Senate Finance Committee Chairman Max Baucus (D-Mont.). The president has in the past refused to support the idea because he campaigned vigorously against a variant of it during the 2008 presidential election.

In essence, the proposal to fine insurance companies for selling high-cost plans amounts to a tax on the most generous employer-provided policies in America. Many of those policies are held by union workers, who helped Obama win the election last year. But many are held by workers with the highest incomes, and the benefit is currently tax-free.

Many economists hope that the funds employers no longer spend on gold-plated health plans would be shifted into workers' wages -- a move that would improve the nation's economic stability.

-- Lori Montgomery


This is a shift in the terms that Obama uses to address the problem of the uninsured. He and other reform proponents have talked previously about the 46 million or so uninsured, a census-based number that many reform opponents have called overstated. Among other things, opponents have argued that a large chunk of that number is made up of illegal immigrants.

In a seeming concession to that sort of rhetoric, Obama narrowed the number of uninsured who would be helped by reform to 30 million citizens -- a figure that is roughly in line with expert estimates. About 9.7 million of the uninsured are not citizens, according to the estimates, including about 6 million illegal immigrants. (The last, Obama reiterated Wednesday, would not be covered under universal health care.)

Obama's "citizen" framing does raise the question of whether he intends his plan to cover legal immigrants who are not citizens. Until this point, he and congressional leaders had given no indication that their plans would not cover legal immigrants. But in Massachusetts, budget troubles have forced lawmakers to trim benefits offered to legal immigrants.

-- Alec MacGillis

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