Remarks With Former President Barack Obama on the Patient Protection and Affordable Care Act

Vice President Kamala D. Harris. Good afternoon. Indeed, it is a good afternoon. Good afternoon. Please have a seat, everybody. Please have a seat. Thank you. It feels good, doesn't it? [Laughter]

President Biden, President Obama, Members of Congress, and my fellow Americans: On March 23d, 2010, the Affordable Care Act was signed into law.

In the 12 years since, the ACA has delivered high-quality, affordable health care to more than 30 million Americans—[applause]. Yes. [Laughter] And those Americans are working parents and young children, college students and older Americans—millions of people who had never been able to afford coverage before or who had been denied coverage altogether, often because of a category of denial called "preexisting conditions," conditions such as cancer, diabetes, hypertension, or even asthma.

The ACA is the most consequential health care legislation passed in generations in our country. And it is something more. The ACA is a statement of purpose; a statement about the Nation we must be, where all people—no matter who they are, where they live, or how much they earn—can access the health care they need, no matter the cost.

You know, when I served as attorney general of California, it was that purpose that led our office and 10 other State attorneys general to submit a brief to the United States Supreme Court in defense of the ACA.

And it is that purpose that brings us all together today: to continue to expand affordable health care and its coverage to families across our Nation and to call on Congress to take action to pass legislation that simply allows Medicare to directly negotiate prescription drug prices with pharmaceutical companies.

And if there's any question why, I'll explain. [Laughter] More than 60 million Americans are enrolled in Medicare. That would give Medicare significant bargaining power to negotiate prices for all those Americans. So, instead of forcing individual patients to negotiate by themselves, to require them to pay whatever price the drug companies set, they would have that kind of representation to stand there with their fellow Americans and negotiate those prices so that they would just simply be fair.

So today we also call on Congress to make permanent the ACA subsidies that are included in the American Rescue Plan—[applause]—subsidies that are currently lowering insurance premiums for millions of Americans and which are set to expire in December. And more must be done.

Currently, there are 12 States in our Nation that refuse to expand Medicaid for no reason other than petty partisan obstruction. As a result, 4 million people in our country are locked out of coverage, and that comes at a cost.

For example, women who do not have health care coverage and are, therefore, less likely to have access during pregnancy, or before or after, to pelvic exams or vaccinations, prenatal checkups, postpartum depression screenings, and all the other essential care they need to be safe and healthy before, during, and after birth.

We know that expanding Medicaid coverage significantly reduces the number of mothers who die as a result of pregnancy. So the sooner coverage is expanded in those 12 States, the more lives we will save.

Protecting the health and well-being of the people of our Nation should not be a partisan issue. Every person in our Nation should be able to access and afford the health care they need to thrive, not as a privilege, but as a right. And that is why our administration will continue to use every tool at our disposal to strengthen the ACA.

And with that—[applause]—it is now my great pleasure to introduce the man whose vision and leadership led us to this day, whose unwavering commitment to the people of our Nation laid the foundation for this groundbreaking legislation; a leader who showed us the way forward on this important issue.

Please welcome President Barack Obama.

Former President Obama. Thank you. Thank you, everybody. Thank you. Thank you very much. Thank you, everybody. Have a seat. Have a seat. Thank you.

Vice President Biden, Vice President—[laughter]—that was a joke.

[At this point, former President Obama hugged President Biden.]

Former President Obama. That was all set up. [Laughter]

My President, Joe Biden; Vice President Harris; our dear friend, Madam Speaker, Nancy Pelosi; all the Members of Congress who are in attendance today, the members of the Cabinet: It is good to be back in the White House. It's been a while.

I confess I heard some changes have been made—[laughter]—by the current President, since I was last here. Apparently, Secret Service agents have to wear aviator glasses now. [Laughter] The Navy Mess has been replaced by a Baskin-Robbins. [Laughter] And there's a cat running around—[laughter]—which, I guarantee you, Bo and Sunny would have been very unhappy about. [Laughter]

But coming back—even if I have to wear a tie, which I very rarely do these days—[laughter]—gives me a chance to visit with some of the incredible people who serve this White House and who serve this country every single day, a lot of times out of the limelight. They make this Government function, and they help people in ways big and small.

And from the outside, sometimes people don't understand just how grueling this is and how many sacrifices people make, because those of us who are in front of the cameras oftentimes get the credit. But it's a lot of people who are devoted day in, day out to making this country better that matter, and a lot of them are represented here. And that's not just in the West Wing, by the way. It's also in the Residence. There were a lot of people who looked after our families that I will always be grateful to.

So it's wonderful to be back to say thank you to all of you. But most of all, coming back here gives me a chance to say thank you and spend some time with an extraordinary friend and partner who was by my side for 8 years.

Joe Biden and I did a lot together. We helped save the global economy, made record investments in clean energy. We put guardrails on our financial system. We helped turn the auto industry around, repealed "don't ask, don't tell." But nothing made me prouder than providing better health care and more protections to millions of people across this country.

So—[applause]—so when President Biden said he was not going to just celebrate the ACA, but also announce actions that would make it even better, I had to show up. [Laughter]

I think it's been well documented just how difficult it was to pass the ACA. [Laughter] There—there's—you can get a lot of testimony here, in case folks haven't heard.

As a country, we had been talking about reforming health care for a hundred years. Unlike almost every other advanced economy on Earth, we didn't have a system that guaranteed access to health care for all of its citizens. Millions of people didn't have health insurance, often because their employers didn't provide it or because it was too expensive.

But despite the fact that our health care system didn't work well, it was hard to change. Health care represents about one-fifth of our economy; that's trillions of dollars that are involved. So there were a lot of different economic interests that were vying to maintain the status quo.

And because the majority of Americans did have health care, some people naturally worried that they'd lose what they had. The media was skeptical of past failures. There was a lot of misinformation, to say the least, flying around. [Laughter] And it's fair to say that most Republicans showed little interest in working with us to get anything done. [Laughter] That's fair to say.

But despite great odds, Joe and I were determined, because we'd met too many people on the campaign trail who'd shared their stories, and our own families had been touched by illness.

And as I said to our dear friend Harry Reid, who is missed—wish he was here today, because he took great pride in what we did—I intended to get health care passed even if it cost me reelection, which, for a while, it looked like it might. [Laughter]

But for all of us—for Joe, for Harry, for Nancy Pelosi, for others—the ACA was an example of why you run for office in the first place, why all of you sign up for doing jobs that pay you less than you can make someplace else; why you're away from home sometimes and you miss some soccer practices or some dance recitals.

Because we don't—we're not supposed to do this just to occupy a seat or to hang on to power. But we're supposed to do this because it's making a difference in the lives of the people who sent us here.

And because of so many people, including a lot of people who are here today, made enormous sacrifices; because Members of Congress took courageous votes, including some who knew that their vote would likely cost them their seat; because of the incredible leadership of Nancy and Harry, we got the ACA across the finish line together.

And the night we passed the ACA—I've said it before—it was a high point of my time here, because it reminded me and it reminded us of what is possible.

But of course, our work was not finished. Republicans tried to repeal what we had done—again and again and again. [Laughter] And they filed lawsuits that went all the way to the Supreme Court three times. I see Don Verrilli here who had to defend—[laughter]—a couple of them.

They tried explicitly to make it harder for people to sign up for coverage. And let's face it: It didn't help that when we first rolled out the ACA, the website didn't work. [Laughter] That was not one of my happiest moments. [Laughter]

So, given all the noise and the controversy and the skepticism, it took a while for the American people to understand what we had done. But lo and behold, a little later than I'd expected, a lot of folks, including many who had initially opposed health care reform, came around. And today, the ACA hasn't just survived, it's pretty darn popular. And the reason is because it's done what it was supposed to do. It's made a difference.

First, 20 million and now 30 million people have gotten covered thanks to the ACA. It's—[applause]—it's prevented insurance companies from denying people coverage based on a preexisting condition. It's lowered prescription drug costs for 12 million seniors. It's allowed young people to stay on their parent's plan until they're 26. It's eliminated lifetime limits on benefits that often put people in a jam. So we are incredibly proud of that work.

But the reason we're here today is because President Biden, Vice President Harris, everybody who has worked on this thing understood from the start that the ACA wasn't perfect. To get the bill passed, we had to make compromises. We didn't get everything we wanted. That wasn't a reason not to do it. If you can get millions of people health coverage and better protection, it is—to quote a famous American—a pretty "big deal." [Laughter] That's what it is.

[President Biden made the sign of the cross.]

[Laughter] A big deal.

But there were gaps to be filled. Even today, some patients still pay too much for their prescriptions. Some poor Americans are still falling through the cracks. In some cases, health care subsidies aren't where we want them to be, which means that some working families are still having trouble paying for their coverage.

Here's the thing: That's not unusual when we make major progress in this country. The original Social Security Act left out entire categories of people, like domestic workers and farm workers. That had to be changed. In the beginning, Medicare didn't provide all the benefits that it does today. That had to be changed.

Throughout history, what you see is that it's important to get something started, to plant a flag, to lay a foundation for further progress. The analogy I've used about the ACA before is that: In the same way that was true for early forms of Social Security and Medicare, it was a starter home. [Laughter] It secured the principle of universal health care, provided help immediately to families. But it required us to continually build on it and make it better.

And President Biden understands that. And that's what he's done since the day he took office. As part of the American Rescue Plan, he lowered the cost of health care even further for millions of people. He made signing up easier. He made outreach to those who didn't know they could get covered—make sure that they knew; made that a priority.

And as a result of these actions, he helped a record 14.5 million Americans get covered during the most recent enrollment period. That, ladies and gentlemen, is what happens when you have an administration that's committed to making a program work.

And today—[applause]—today the Biden-Harris administration is going even further by moving to fix a glitch in the regulations that will lower premiums for nearly 1 million people who need it and allow 200,000 more uninsured Americans get access to coverage.

I'm a private citizen now, but I still take more than a passing interest in the course of our democracy. [Laughter] But I'm outside the arena, and I know how discouraged people can get with Washington—Democrats, Republicans, Independents. And I—everybody feels frustrated sometimes about what takes place in this town. Progress feels way too slow sometimes. Victories are often incomplete. And in a country as big and as diverse as ours, consensus never comes easily.

But what the Affordable Care Act shows is that if you are driven by the core idea that, together, we can improve the lives of this generation and the next, and if you're persistent—if you stay with it and are willing to work through the obstacles and the criticism and continually improve where you fall short, you can make America better; you can have an impact on millions of lives. You can help make sure folks don't have to lose their homes when they get sick, that they don't have to worry whether a loved one is going to get the treatment they need.

President Joe Biden understands that. He has dedicated his life to the proposition that there's something worthy about public service and that the reason to run for office is for days like today.

So I could not be more honored to be here with him as he writes the next chapter in our story of progress. I'm grateful for all the people who have been involved in continuing to make the ACA everything it can be.

And it is now my great privilege to introduce the 46th President of the United States, Joe Biden.

President Biden. Thank you. [Applause]

President Obama. Hey!

President Biden. Thank you, thank you, thank you. Please. Thank you. Thank you. Thank you, thank you, thank you. Please. Please. Thank you. Thank you very much. Please.

My name is Joe Biden, and I'm Barack Obama's Vice President. [Laughter] And I'm Jill Biden's husband. [Laughter] By the way, the only reason Jill is not here today, she's working. [Laughter] She's teaching. [Laughter]

Former President Obama. I hear you.

President Biden. And so I just want you to know that's why she's not here. Good afternoon, everyone.

President Obama. Good afternoon.

Vice President Harris. Good afternoon.

President Biden. Mr. President, welcome back to the White House, man. It feels like the good old days. Being here with you brings back so many good memories. We just had lunch together, and we weren't sure who was supposed to sit where. [Laughter]

Look, it's fitting that the first time you return to the White House is to celebrate a law—a law—that's transforming millions of lives because of you. And I say "because of you." We had a lot of help—the staff and I helped a little bit—but it was because of you. A law that shows hope leads to change. And you did that. You did it.

Let's be honest: The Affordable Care Act has been called a lot of things, but "Obamacare" is the most fitting. [Laughter] Obamacare. It's true.

I can tell you all how much Barack Obama cared about getting this done. Throughout the countless hours of negotiations and the relentless political attacks, he never, ever, ever gave up. And I guarantee you that.

If I had time, I could tell you all the times when he'd say, "Should we compromise, should we do"—and I'd say, "Well, we ought to think about that." "No, if I do that, then so and so won't get covered. This group of people won't get covered."

And whether it was after meeting our—or during our weekly lunch—and we met every single day—he'd remind me of what—why we were doing this in the first place.

We were doing this, in the first place, for people who needed it and deserved to be treated with dignity. Dignity. The idea that when you can't afford health insurance for your children, for your spouse, male or female—it doesn't matter—not only are they in trouble, but you're deprived of your dignity.

Barack, you talked about the idea that it was important that we make sure that you couldn't outrun your insurance. I can remember there with—with Beau, thinking to myself, "What would I do if they walked in and said, 'You've outrun your time here,' and there was still 35 days to live?" The things that change people's lives.

We both understood the Affordable Care Act wasn't about a single President or the Presidency. It was about the countless—countless—Americans lying in bed at night, staring at the ceiling, wondering: "My God—my God—what if I get really sick? What am I going to do? What is my family going to do? Will I lose the house?" Discussions we had in my house with my dad when he lost his health insurance: "Who's going to pay for it? Who's going to take care of my family?"

You know, in America, health care—as we all three said, will have now said—health care should be a right, not a privilege. And with—[applause]—with the help of Members of Congress, especially Nancy, and the advocates for families who are here today, 12 years ago last month—12 years ago—we made a good effort toward that proposition, that it should be a right.

When—and, Barack, when you signed the Affordable Care Act into law, it became the most consequential piece of health insurance—most consequential piece of legislation, in my view—since the creation of Medicare and Medicaid in 1965. It made a difference in people's lives every day.

You just talked about where we were before the Affordable Care Act and what happened in the past 12 years to make life a lot better for people. Well, I'd like to talk about where we go from here, because we knew back then, as Barack—as the President said, we knew that we had to keep strengthening this legislation.

Look, that's why I ran for President and I promised to protect and build upon the Affordable Care Act. As soon as I entered office, that's exactly what Kamala and I did and what our administration and the Democrats in Congress here today did. We passed the landmark American Rescue Plan, which not only helped us on the COVID-19—get it under control and our economy back on track, it got millions more people insured under the Affordable Care Act.

It made it easier for people to sign up for coverage in the middle of a pandemic. It opened a special enrollment people [period]* and gave millions and millions of Americans more time to enroll. It quadrupled the number of navigators out there in the communities helping people to sign up for coverage, because it was confusing to people. It's confusing.

The President has heard me say when we worked together—you know how they'd say, "Well, Biden and Obama are doing great on foreign policy." I said: "You want to do something difficult? Try health care." [Laughter] Not a joke. Not a joke.

So we continue to expand Medicaid. Missouri and Oklahoma became the 37th and 38th States to expand Medicaid under the Affordable Care Act. And as has been mentioned, over 31 million people now have health insurance through the Affordable Care Act. Four out of five Americans can find quality coverage for under $10 a month.

The average family—[applause]—the average family is saving $2,400 a year on their premiums. That's $200 every single month available for other needs in their lives—from gas to groceries, to other basic necessities. The bottom line is this: The Affordable Care Act is stronger now than it has ever been.

And today—[applause]—and I'm not even talking about what your former Chief of Staff is doing to make sure health care is available to all our veterans in the way he is.

Former President Obama. Yes.

President Biden. And today we're strengthening it even further. In a moment, I'm going to sign an Executive order building on one of those that I signed last year.

It directs Federal agencies to continue doing everything in their power—everything in their power—to expand quality and affordable health care coverage: making it easier for people to enroll in and keep their coverage; helping people better understand their coverage options and to pick—to be able to pick the best option for that family; taking steps to strengthen benefits, lower costs, and expand eligibility; protecting Americans from low-quality coverage that can lead to a mountain of medical debt.

And, folks—and separately, it's time to fix what we refer to as the "family glitch." Now, the family glitch, to all—everybody in this room probably knows what it is. [Laughter] But it's a common issue facing 5 million Americans who can't get financial help to get coverage under the Affordable Care Act.

And here's the problem: Under the current rules, a working mom is told: As long as she can afford employer-based coverage for herself, she can't qualify for premium subsidies to afford coverage for her family. It will cover her, but not her family.

But we're going to change that. Once today's proposed rule is finalized, starting next year, working families in America will get the help they need to afford full family coverage—everyone in the family.

As a result, families will be saving hundreds of dollars a month. With this change, it's estimated that 200,000 presently uninsured Americans are going to gain coverage. Nearly 1 million Americans will see their coverage become more affordable. This is considered one of the biggest things my administration can do: lower costs and expand coverage. And we're taking steps today to get that done.

So, look, folks—but we need—we need to keep up the fight. Our Republican colleagues, as they say in southern Delaware, "They haven't changed a whole hell of a lot." [Laughter] Good folks, but they haven't changed a lot. They continue to attack the Affordable Care Act. They're unrelenting. Unrelenting. They haven't stopped.

Mr. President, since you signed the law, they haven't stopped for 1 second. Multiple court challenges, you mentioned. Sabotage from the previous administration. Over 70 attempts to repeal the law by Republicans in Congress.

In fact, just last month, the distinguished Senator from Wisconsin said: If Republicans get back in power, they should try to repeal the Affordable Care Act again—again try. Today, 12 years later, Republicans have not stopped their attacks on this lifesaving law.

So pay very close attention, folks: If Republicans have their way, it means 100 million Americans with preexisting conditions can once again be denied health care coverage by their insurance companies. That's what the law was before Obamacare.

In addition, tens of millions of Americans could lose their coverage, including young people who will no longer be able to stay on their parent's insurance policy until age 26. Premiums are going to go through the roof.

Well, I've got a better idea: Instead of destroying the Affordable Care Act, let's keep building on it. Let's extend it. Extend.

And because of all the folks in this room, the Members of Congress, the American Rescue Plan subsidies—subsidizes that are lowering premiums—subsidies are lowering premiums and extending coverage.

And I got a little practice when you gave me that other act, you know, when we were President—when you were President and I was with you. [Laughter]

Look, close the Medicaid coverage gap that locks nearly 4 million Americans out of coverage just because their States refused to expand Medicaid. Lower prescription drug costs, which was mentioned already, by allowing Medicare to negotiate prices for drugs that are on the market. We can do this. We should do this. We have to do this.

But let me close with this: Twelve years ago, at a bill signing of the Affordable Care Act, President Obama said, quote, "We're a nation that does what is hard, what is necessary, and what is right." That's exactly what he did. Exactly what he did.

And, folks, that's what we have to do. It's what we do as Americans. You know, it's what all of you did here in making the Affordable Care Act possible. I really mean it.

We just keep it—we just got to keep it going and keep building on it. We need to keep the faith. And we need to remember: We're the United States of America, and there's simply—literally—nothing beyond our capacity when we're united and do it together.

So God bless you all, and may God protect our troops. And now I'm going to sign an Executive order.

And, Barack, let me remind you: It's a hot mike. [Laughter]

Hey, Jim, how are you, pal? Can you see everybody?

Audience member. I can see.

The President. I have to admit one thing I haven't gotten down: Barack Obama could sign his name using nine different pens. [Laughter] But I'm going to use one.

[President Biden signed the Executive order titled, "Continuing To Strengthen Americans' Access to Affordable, Quality Health Coverage."]