Clinton Urges Americans to Sign Up for Health Care Exchanges

By Clinton Presidential Center

Bill Clinton Defends Affordable Care Act: The former president countered some common criticisms of President Obama's health care bill during a speech at the Clinton Presidential Center in Little Rock, Ark.

LITTLE ROCK, Ark. — He chose his home state as the venue, and did not refrain from ticking off several problems he saw with the law. But former President Bill Clinton on Wednesday made a meticulous, if wonkish, case for Americans of all political leanings to embrace the Obama health care law.

"The health of our people, the security and stability of our families, and the strength of our economy are all riding on getting health care reform right and doing it well," he said.

Less than a month before Americans can start shopping for insurance under the law, the speech comes at a pivotal time for the Obama administration, which needs millions of healthy Americans to buy insurance through new state-based markets in order for the law to work but faces an escalating campaign by Republicans to cut or eliminate the law's financing. Even supporters of the law have criticized the administration as having done too little to explain and sell it to the public.

Mr. Clinton made the speech at the request of the White House, but on his own terms. He chose to deliver it at the glass building in downtown Little Rock that houses his presidential library. The venue allowed him to lend a hand to Senator Mark Pryor, a Democrat who is facing a difficult re-election fight here, and to start wooing his home state should his wife, former Secretary of State Hillary Rodham Clinton, decide to make a presidential bid in 2016.

The former president avoided soaring rhetoric, even saying at the beginning of the 50-minute speech that he would "try to use very few adjectives" and instead just "explain how this works."

"I have agreed to give this talk today because I am still amazed at how much misunderstanding there is about the current system of health care, how it works, how it compares with what other people in other countries pay for health care," Mr. Clinton told the crowd assembled in a hall around the corner from a montage of black-and-white photographs of the 1992 presidential campaign. The audience of about 250 included Gov. Mike Beebe, a Democrat, and Speaker Davy Carter of the Legislature and Michael Lamoureux, president of the State Senate, both Republicans.

Despite the bipartisan show, health care is a contentious topic in Arkansas politics that conservatives have seized on in local campaigns. Mr. Pryor did not attend the event for risk of being too closely associated with the health care law, according to one person with knowledge of his plans, but who was not authorized to discuss them publicly. A campaign spokesman has said that Mr. Pryor had a scheduling conflict.

With the new insurance markets set to open on Oct. 1 for an initial six-month enrollment period, the White House has asked cabinet officers and other presidential appointees to step up efforts to promote the law. The administration has also recruited actors and entertainers and is seeking athletes and disc jockeys to whip up enthusiasm. Last week, the singer Katy Perry retweeted a Twitter post from President Obama encouraging young people to sign up for coverage. He responded, "Thanks for spreading the word."

Mr. Clinton's speech, which the White House broadcast live on its Web site, was not the first time that the former president, whose own attempt to sell a universal health care law failed drastically in his first term, has stepped into the debate over the new law. At the Democratic National Convention last September, Mr. Clinton delivered an endorsement of Mr. Obama that included concrete, well-received explanations of his policies, including on health care. That speech in particular signaled to the White House that Mr. Clinton could be an effective surrogate to sell the highly complicated Affordable Care Act.

On Wednesday, the former president carefully laid out Mr. Obama's plan without delving into politics. But his mere involvement in selling the law provides him with a platform to reframe the failed battles of "Hillarycare" from his own administration.

"It would not be in her interest to be running for president and have this be a huge controversial issue in 2016," said Robert J. Blendon, a professor of health policy at Harvard who closely follows public opinion of the law. "The Clintons have a lot of interest in getting this up and working and making it a legacy for the Democratic side."

Reading glasses perched on his nose, Mr. Clinton struck a professorial tone as he explained in extensive detail the intricacies of the act. He laid out who would qualify for federal subsidies to help pay for the cost of coverage through the new markets and even ticked off Web addresses and phone numbers where Americans could find information.

Calling the current system "unaffordable and downright unhealthy for millions of Americans," he emphasized that other prosperous countries "cover everybody and do it at far less cost," and bemoaned that the United States ranks "first by a country mile" in the percentage of income spent on health care.

Mr. Clinton said that last year's Supreme Court decision upholding the law created a "whopper" of a problem by allowing states to opt out of expanding Medicaid and covering more low-income people. Almost half the states subsequently refused to expand the program, which will leave far more people uninsured than Mr. Obama had planned.

But Mr. Clinton praised Mr. Beebe and the Republican-controlled State Legislature here for agreeing on a compromise. Under Arkansas's so-called "private option," federal money that was supposed to support an expansion of Medicaid will instead help eligible residents buy private insurance through the state's new online marketplace, or exchange.

Without mentioning Mrs. Clinton's efforts specifically, Mr. Clinton talked about the longtime opposition to universal coverage. Perhaps the most pointed criticism came in the 1990s when the health insurance lobby introduced the multimillion-dollar "Harry and Louise" television campaign to protest the Clintons' proposed health care overhaul.

"We'd all be better off working together to make it work as well as possible," Mr. Clinton said, "instead of to keep replaying the same old battles."

Mr. Clinton said the law did have some problematic provisions, including one that prohibits many people with modest incomes who cannot get insurance through their spouses' jobs from buying subsidized coverage through the new marketplaces. But he stressed that such problems could be fixed if opponents of the law in Congress and in state governments would drop their resistance.

"We've got to do this," Mr. Clinton said.

Robert Pear and Michael D. Shear contributed reporting from Washington.

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