What Has Health Care Reform Changed?

On its second anniversary, an Obama official shares the law's achievements, setbacks and evolution.


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CM: The Supreme Court is going to hear six hours of argument, and there hasn’t been that lengthy an argument in the Supreme Court in many years. It recognizes that this is a historic, important moment. At the end of the day, we are confident that the Supreme Court is going to uphold the law. That will give us the opportunity to build on the strong record that we’ve already built over two years of implementing this law, and get to the point where everybody has access to insurance coverage that’s affordable.

TR: In the event that the mandate is stripped out, what is the administration’s plan?

CM: We’re not thinking about or planning for a moment when those provisions are not in the law. We really are quite confident that the Supreme Court is going to uphold it. So we’re full speed ahead implementing the law and making sure that we can finish this job.

TR: A recent Washington Post-ABC poll found that a majority of Americans want the Supreme Court to strike down at least some of the law. Why do you think so many people have doubts about this legislation, and does that doubt concern the administration?

CM: This is certainly true in the congressional debate, and it continues to be true otherwise. There are a lot of misconceptions about the law, and a lot of exaggerated and overheated rhetoric that people use. But when you talk about its specific provisions — like the protections against discrimination for people with pre-existing conditions, like the notion that insurance companies have to spend 80 cents of every dollar that they get in premiums on actual health care, as opposed to profits or bonuses — by and large the public supports those things.

When you talk about the actual pieces of the law, you do a lot better than if you talk about the law as a whole, because that’s when you get into the land of these misperceptions and exaggerated rhetoric that have really dominated this debate.

TR: Why has it been so difficult to get Americans to connect with the law as a whole?