The Affordable Care act is here to stay, and so today i want to speak plainly, clearly, honestly about what it means for you and for the people you care about. Now lets start with the fact that even before the Affordable Care act fully takes effect, about 85 of americans already have Health Insurance either through their job or through medicare or through the individual market. So if youre one of these folks, its reasonable that you might worry whether Health Care Reform is going to create changes that are a problem for you especially when youre bombarded with all sort of fearmongering. So the first thing you need to know is this, if you already have health care you dont have to do anything. In fact, from the past few years since i signed the Affordable Care act, a lot of you have been enjoying new benefits and protections that you didnt have before even if you didnt know they were coming from obama care. Let me just give you a few examples, because of the Affordable Care act more than 100 million americans have gotten free mammograms and contraceptive care with no copays. Because of the Affordable Care act 3 million young adults under age 26 have gained coverage by staying on their parents plan. Because of the Affordable Care act millions of seniors on medicare have saved hundreds of dollars on their prescription medicine. Theyve been getting their Prescription Drugs cheaper. Because of the Affordable Care act just this year 8. 5 million families actually got an average of 100 back from their Insurance Companies because the Insurance Companies spent too much on things like overhead and not enough on actual medicare medical care. Because of the Affordable Care act, Insurance Companies can no longer put lifetime limits on the care your family needs or discriminate with children with preexisting conditions. And starting on january 1st they wont charge them more just because theyre women. Thats a good thing. So tens of millions of americans are already better off buzz of the benefits and protections provided by the Affordable Care act. Like i said, they may not know why that rebate check came in the mail. They may not notice that theyre not having a copay for some Preventive Care that they received, but theyre getting those benefits. Thats already happening and thats in place and has been going on for several years. Those are the benefits of obama care, the law that republicans want to repeal. Although its interesting, when you ask republicans whether theyd repeal the benefits i just mention, when you say to them, well, do you think its the right thing to do to let young people stay on their parents plan so they can keep insurance . Do you want to prevent seniors from getting more discounts on their Prescription Drugs and then theyll say no, no, no. We like those. Those things are okay. So they dont like obama care in theory, but some of the Component Parts at least, those that poll well, they dont mind, but thats already in place. Now heres the second thing you need to know. If youre one of over 40 million americans who dont have Health Insurance including hundreds of thousands of folks right here in maryland, starting on tuesday, five days from now, youll finally have the same chance to buy quality, Affordable Health care as everybody else. And i want to i want to break this down for you. I want you to know exactly how it works. The major reason why people dont have Health Insurance is either they dont have a job or they do have a job, but their employer doesnt offer Health Insurance or theyre selfemployed. If youve ever troyed to buy Health Insurance on your own, you know it is really, really expensive. Its even worse if you have a preexisting condition and up to all americans, they have a preexisting condition, part of why youre not buying it on your own is because youre not part of a big group and not buying it as a group plan and what groups do they spread risk between sick and healthy people, between older and younger people and groups because Insurance Companies want the business of groups, thats a lot of customers, theyll negotiate a better deal with a group than they will with an individual. So if youre on your own youre out there trying to negotiate with an Insurance Company and theyre looking and saying, well, you know, you take it or leave it. Im going to charge you a whole lot of money and if you have a preexisting condition, theyll say we dont even want to insure you because we think you might get sick and we dont really want to pay. We just want to take in premiums. So if youre not part of a group, youre either uninsurable or you need to spend a small fortune on insurance that often times is not very good. Thats whats with happening right now. The Affordable Care was designed to solve that problem. Starting on tuesday, every american can visit health carry. Gov to fiend out the insurance marketplace for your state and i actually call it Maryland Health connection. Gov. Maryland health connection. Com, but if you go to health care. Gov you can look and theyll tell you where to go. Theyll link to your state. Now, this is real simple. Its a website where you can compare and purchase affordable Health Insurance plans side by side the same way you shop for a plane ticket on kayak, the same way you shop for a tv on amazon. You just go on and you start looking and here are all of the options. Its buying insurance on the private market, but because now youre part of a big group plan and everybody in maryland is all logging in and taking a look at the prices and youve got new choices and now youve got new competition because insurers want your business and that means you will have cheaper prices. So you enter in some basic information about yourself, what level of coverage youre looking for. After that youll be presented with a list of quality, affordable plans that area available in your area and it will say clearly what each plan cover, what each plan costs and the price will be right there, it will be fully transparent and before this law, only a handful of states required Insurance Companies to offer you instant price quote, but because this law insures in all 50 states well have to offer you instant price quotes, and so if youve ever tried to buy insurance on your own, i promise you, this is a lot easier. Its like booking a hotel or plane ticket. And heres another thing about these new plans. If youre one of those folks who have a preexisting condition, these plans have to offer you coverage. They cant use your medical history to charge you more than anybody else. If you couldnt afford coverage for your child because he had asthma and he was not covered. If you couldnt afford coverage because you were told heartburn with was a preexisting condition, youre covered. If youre one of the 45 million americans with a mental illness, you are covered. If youre a young adult or entrepreneur striking out on your own, youre covered. If if youre a young couple who previously had insurance that didnt include maternity benefits and now suddenly you need some maternity benefits, youre covered. If you lose your job and your health care with it it, youre covered. [ cheers and applause ] so all those things that were denying you coverage in the past that were the the cruelties of a broken Health Care System on january 1st, when these plans take effect no, no, no, no. Hold on. Hold on, i know what im talking about. You sign up starting on tuesday. The plan will take effect on january 1st, and when the federal government helps run these marketplaces, the average american will have more than 50 dint plans to choose from with Different Levels of coverage and because Insurance Companies are competing against one another for your business a lot of americans will pay significantly less for their insurance than they do now. Premiums will be different in different parts of the country depending on how much coverage you buy, but 95 of uninsured americans will see their premiums cost less than was expected and many families, including more than twothirds of all young adults who buy health care through these Online Marketplaces will also be eligible for tax credits that bring the costs down even further. So so let me be specific. Right here in maryland average 25yearold, have we got any 25yearolds here . All right. So weve got a few. Some of you raised your hand, im not sure. All right. Here in maryland, average 25yearold making 25,000 a year could end up getting covered for as little as 80 a month. 80 a month. Here in maryland, a family of four making 60,000 a year could get covered for 164 a month. Its the same story across the country. In texas, average betweenyearold making 25,000 could get covered for as little as 83 a month. In florida, a family of four could get covered for as little as 104 a month and keep in mind, the government didnt set these prices, the Insurance Companies, they proposed these prices because they want to get in with these big groups, with all these new customers. The Insurance Companies are saying these marketplaces, this law will work. Theyre putting money on the line because they think it will work. Competition, choice, transparency, all these things are keeping costs down. And knowing you can offer the security of health care is priceless. Now you can do it for the cost of your cable bill, probably less than your cell phone bill. Think about that. Good Health Insurance for the price of your cell phone bill or less. And say youre a young woman, im interested in this because ive got two daughters, right . Say you just turned 26. Say you cant stay on your parents plan anymore. If you buy health care through the marketplace your plan has to cover free checkups, flu shots, contraceptive care, so you might end up getting more health care each month than youre paying for the premiums. All told, nearly six in ten americans without Health Insurance today will be able to get covered for 100 or less. It would actually be eight in ten if every governor were working as hard as governor omalley to make the Affordable Care act work for their citizen. [ cheers and applause ] unfortunately, weve still got a few republican governors who are so opposed to the very idea of the law or at least theyre doing it for the politics, that they havent lifted a finger to help cover more people. Some of them have actually tried to harm the law before it it ta takes effect, but a lot of republican governors are putting politics aside and doing the right thing. And they deserve congratulations for that. It wasnt easy for them, but you have conservative governors in ohio, michigan and pennsylvania and arizona, about eight republican governors in all theyve decided to expand medicaid through the Affordable Care act to cover more people in their states. And millions of americans without insurance will get coverage through these programs. So thats what the aed forable care act is. Thats what all of the fuss is about. Were giving more benefits and protections for folks who already have Health Insurance and weve created a new market, basically a big group plan, for folks without Health Insurance so that they get a better deal and then were providing tax credits to help folks afford it. You would think that would not be so controversial. You would think people would say, okay, lets go ahead and lets do this so everybody has Health Insurance coverage. The result is more choice, more competition, Real Health Care security, and one question people ask, how is it possible to do all of this and keep costs down . Well, part of what we did was build into the law all sorts of measures to assure that the growth of Health Care Costs would start slowing down and it has. See, under the old system doctors and hospital, they were rewarded not for the quality of care, but for the quantity of care. Theyd get paid for the number of procedures that they did instead of whether they were working or not. Now there are penalties for hospitals with high readmission rates and last year, surprisingly enough, for the First Time Ever hospital readmission rates for medicare patients actually fell. All right . [ applause ] that means fewer taxpayer dollars go to providers that dont serve their patients well. Over the past five years weve more than doubled the adoption of Electronic Health records for physicians. So that means they can track whats going on better and make fewer mistakes. New Technology Startup companies are coming up with new inventions to monitor patient health, prevent infects. Theres innovation going on all across the country. As a consequence, today medicare costs per enrollee are rising at the slowest rate in years. Employerbased Health Care Costs are growing at about onethird the rate of a decade ago. All told, since i signed the Affordable Care act into law, we have seen the slowest growth in healthcare costs on record. [ cheers and applause ] so lets think about this, if youve got Health Insurance, youre Getting Better protections, better benefits. If you dont have Health Insurance, you will now be a part of a group plan and Health Care Costs overall are rising much more slowly than they did before we signed the law. So far so good. So whats all the fuss about . Why what is it that everybody what is it that these republicans are just so mad about . No, no, no. Look, i want to be honest. There are parts of the bill that some folks dont like. To help pay for the program the wealthiest americans, families who make more than 250,000 a year will have to pay a little bit more. Extremely costly Health Insurance plans will no longer qualify for unlimited tax breaks, and most people who can afford Health Insurance now have to take responsibility to buy Health Insurance or pay a penalty. Right . Now the reason we do that is when uninsured people who can afford to get Health Insurance dont and then they get sick or they get hit by a car and they show up at the emergency room, who do you think pays for that . You do. In the form of higher premiums because the hospitals, theyve got to get their money back somehow. So if theyre treating someone that doesnt have Health Insurance they jack up premiums for everybody who has Health Insurance. Its like a hidden tax of 1,000 per family every year whos got Health Insurance. So were saying thats not fair. If you can afford to have Health Insurance dont dump the cost on us. The law also requires employers with more than 50 employees to either provide Health Insurance for your workers or pay a penalty. Some folks say well, thats not fair, but if you are an employer, you can afford to provide Health Insurance, you dont, your employees get sick. They go to the emergency room or they end up on medicaid because youre not doing what youre doing you should be doing, why is it everybody else should be bearing those costs . There are some folks who disagree with me, that violates peoples liberty telling them they have to get Health Insurance. I disagree, so did congress when it passed this bill into law. It is unfair for folks to game the system and make the rest of us pay for it. It is unfair [ cheers and applause ] its unfair for responsible employers who are doing the right thing giving their employees Health Insurance to get undercut by some operator thats not providing Health Insurance for their employees. That puts the employer who is doing the right thing at a disadvantage, right . So this idea that youve got responsibility, everybody, thats what massachusetts did when they passed their Health Care Plan a few years ago. By the way, today in massachusetts, almost everybodys covered and the system works pretty well. So [ applause ] all right. Let me just wrap up by saying this, like any law, like any big Product Launch there are going to be some glitches as this thing unfolds. Folks in different parts o