President Barack Obama Talks to Bret Baier About Health Care Reform Bill

This is a rush transcript of "Special Report With Bret Baier" from March 17, 2010. This copy may not be in its final form and may be updated.

BRET BAIER, "SPECIAL REPORT" HOST: Welcome to Washington. I'm Bret Baier, and this is a special edition of "Special Report", beginning tonight in the Blue Room in the White House, mid-way through what many people are calling the most pivotal week of his presidency so far. We are interviewing President Barack Obama.

Mr. President, thank you for the time.

PRESIDENT BARACK OBAMA: Thank you for having me, Bret.

BAIER: You have said at least four times in the past two weeks: "the United States Congress owes the American people a final up or down vote on health care." So do you support the use of this Slaughter rule? The deem and pass rule, so that Democrats avoid a straight up or down vote on the Senate bill?

OBAMA: Here's what I think is going to happen and what should happen. You now have a proposal from me that will be in legislation, that has the toughest insurance reforms in history, makes sure that people are able to get insurance even if they've got preexisting conditions, makes sure that we are reducing costs for families and small businesses, by allowing them to buy into a pool, the same kind of pool that members of Congress have.

We know that this is going to reduce the deficit by over a trillion dollars. So you've got a good package, in terms of substance. I don't spend a lot of time worrying about what the procedural rules are in the House or the Senate.

(CROSS TALK)

OBAMA: What I can tell you is that the vote that's taken in the House will be a vote for health care reform. And if people vote yes, whatever form that takes, that is going to be a vote for health care reform. And I don't think we should pretend otherwise.

(CROSS TALK)

OBAMA: Bret, let me finish. If they don't, if they vote against, then they're going to be voting against health care reform and they're going to be voting in favor of the status quo. So Washington gets very concerned about these procedural issues in Congress. This is always an issue that's — whether Republicans are in charge or Democrats in charge — when Republicans are in charge, Democrats constantly complain that the majority was not giving them an opportunity, et cetera.

What the American people care about is the fact that their premiums are going up 25, 40, 60 percent, and I'm going to do something about it.

BAIER: Let me insert this. We asked our viewers to e-mail in suggested questions. More than 18,000 people took time to e-mail us questions. These are regular people from all over the country. Lee Johnson, from Spring Valley, California: "If the bill is so good for all of us, why all the intimidation, arm twisting, seedy deals, and parliamentary trickery necessary to pass a bill, when you have an overwhelming majority in both houses and the presidency?"

Sandy Moody in Chesterfield, Missouri: "If the health care bill is so wonderful, why do you have to bribe Congress to pass it?"

OBAMA: Bret, I get 40,000 letters or e-mails a day.

BAIER: I know.

OBAMA: I could read the exact same e-mail —

BAIER: These are people. It's not just Washington punditry.

OBAMA: I've got the exact same e-mails, that I could show you, that talk about why haven't we done something to make sure that I, a small business person, am getting as good a deal as members of Congress are getting, and don't have my insurance rates jacked up 40 percent? Why is it that I, a mother with a child with a preexisting condition, still can't get insurance?

So the issue that I'm concerned about is whether not we're fixing a broken system.

BAIER: OK, back to the original question.

OBAMA: The key is to make sure that we vote — we have a vote on whether or not we're going to maintain the status quo, or whether we're going to reform the system.

BAIER: So you support the deem and pass rule?

OBAMA: I am not —

BAIER: You're saying that's that vote.

OBAMA: What I'm saying is whatever they end up voting on — and I hope it's going to be sometime this week — that it is going to be a vote for or against my health care proposal. That's what matters. That's what ultimately people are going to judge this on.

If people don't believe in health care reform — and I think there are definitely a lot of people who are worried about whether or not these changes are, in some fashion, going to affect them adversely. And I think those are legitimate concerns on the substance — then somebody who votes for this bill, they're going to be judged at the polls. And the same is going to be true if they vote against it.

BAIER: Monday in Ohio, you called for courage in the health care debate. At the same time, House Speaker Pelosi was saying this to reporters about the deem and pass rule: "I like it, this scenario, because people don't have to vote on the Senate bill." Is that the kind of courage that you're talking about?

OBAMA: Well, here's what's taking place — we both know what's going on. You've got a Senate bill that was passed, that had provisions that needed to be changed. Right? People were concerned about, for example, the fix that only fixed Nebraska, and didn't fix the rest of the states.

Now, a lot of the members of the House legitimately say, we want to vote on a package, as the president has proposed, that has those fixes embedded in it. Now that may mean they have to sequence the votes. But the ultimate vote they're taking is on whether or not they believe in the proposal that I put forward, to make sure that insurance reform is fixed, to make sure the deficits are reduced, and premiums go down, and small businesses are helped. That's what they're concerned about.

BAIER: Do you know which specific deals are in or out, as of today?

OBAMA: I am certain that we've made sure, for example, that any burdens on states are alleviated, when it comes to what they're going to have to chip in to make sure that we're giving subsidies to small businesses, and subsidies to individuals, for example.

BAIER: So the Connecticut deal is still in?

OBAMA: So that's not — that's not going to be something that is going to be in this final package. I think the same is true on all of these provisions. I'll give you some exceptions though.

Something that was called a special deal was for Louisiana. It was said that there were billions — millions of dollars going to Louisiana, this was a special deal. Well, in fact, that provision, which I think should remain in, said that if a state has been affected by a natural catastrophe, that has created a special health care emergency in that state, they should get help. Louisiana, obviously, went through Katrina, and they're still trying to deal with the enormous challenges that were faced because of that.

(CROSS TALK)

OBAMA: That also — I'm giving you an example of one that I consider important. It also affects Hawaii, which went through an earthquake. So that's not just a Louisiana provision. That is a provision that affects every state that is going through a natural catastrophe.

Now I have said that there are certain provisions, like this Nebraska one, that don't make sense. And they needed to be out. And we have removed those. So, at the end of the day, what people are going to be able to say is that this legislation is going to be providing help to small businesses and individuals, across the board, in an even handed way, and providing people relief from a status quo that's just not working.

BAIER: OK, the Florida deal, in or out?

OBAMA: The Florida deal —

BAIER: Paying for Medicare Advantage, exempting 800,000 Floridians from —

OBAMA: My understanding is that whatever is going to be done on Medicare is going to apply across the board to all states.

BAIER: Connecticut, Montana — there are a lot of deals in here, Mr. President, that people have issues about.

OBAMA: Bret, the core of this bill is going to be affecting every American family. If you have insurance, you're going to be able to keep it. If you don't have insurance, you're going to be able to buy into a pool, like members of Congress have. We're going to make sure that we have delivery system reforms that strengthen Medicare, that are going to make sure that doctors and hospitals are providing better service and better care, and this is going to reduce the deficit.

Now, there are going to be in this, as I just mentioned, on things like making sure that states who have gone through natural catastrophes and medical emergencies are getting help, but those are not going to ones that are driven by politics, they're going to be driven policy.

BAIER: Couple more process things, quickly.

You said a few times as Senator Obama that if a president has to eke out a victory of 50 plus one, that on something as important as health care, "you can't govern." But now you're embracing a 50 plus one reconciliation process in the Senate, so do you feel like you can govern after this?

OBAMA: Well, Bret, the — I think what we've seen during the course of this year is that we have come up with a bill that basically tracks the recommendations of Tom Daschle, former Democratic senator and leader, but also Bob Dole, former Republican leader, Howard Baker, former Republican leader. The ideas embodied in this legislation are not left, they're not right, they are — they are —

BAIER: I understand what you're — I know you don't like to talk about process, but there are a lot of questions in these 18,000 that talk about process.

OBAMA: I understand being —

(CROSSTALK)

BAIER: And there are a lot of people around America that have a problem with this process.

OBAMA: Bret, I —

BAIER: You called it an ugly process just last month.

OBAMA: I've got to tell — I've got to say to you, there are a lot more people who are concerned about the fact that they may be losing their house or going bankrupt because of health care.

BAIER: OK, so we have —

OBAMA: And so — so the — look —

BAIER: Deem and passed, Senate reconciliation and we don't know exactly what's in the fix bill. Do you still think —

OBAMA: No, we will — by the time the vote has taken place, not only I will know what's in it, you'll know what's in it because it's going to be posted and everybody's going to be able to able to evaluate it on the merits.

But here's the thing, Bret, I mean, the reason that I think this conversation ends up being a little frustrating is because the focus entirely is on Washington process. And yes, I have said that is an ugly process. It was ugly when Republicans were in charge, it was ugly were in Democrats were in charge.

BAIER: This is one-sixth of the U.S. economy, though, sir. One-sixth.

OBAMA: And, Bret, let me tell you something, the fact of the matter is that for the vast majority of people, their health care is not going to change because right now they're getting a better deal. The only thing that is going to change for them is is that they're going to have more security under their insurance and they're going to have a better situation when it comes to if they lose their job, heaven forbid, or somebody gets sick with a preexisting condition, they'll have more security. But, so — so —

BAIER: So how can you —

OBAMA: — the notion that —

BAIER: — guarantee that they're not going to —

OBAMA: — so but —

BAIER: — they're going to be able to keep their doctor —

OBAMA: Bret, you've got to let me finish my answers —

BAIER: Sir, I know you don't like to filibuster, but —

OBAMA: Well, I'm trying to answer your question and you keep on interrupting. So let me be clear.

Now, you keep on repeating the notion that it's one-sixth of the economy. Yes, it's one-sixth of the economy, but we're not transforming one-sixth of the economy all in one fell swoop. What we're saying is is that for the vast majority of people who have health care, they're going to be able to keep it. But what we are saying is that we should have some basic protections from insurance company abuses and that in order for us to do that, we are going to have to make some changes in the status quo that we've been debating for a year.

This notion that this has been not transparent, that people don't know what's in the bill, everybody knows what's in the bill. I sat for seven hours with —

BAIER: Mr. President, you couldn't tell me what the special deals are that are in or not today.

OBAMA: I just told you what was in and what was not in.

BAIER: Is Connecticut in?

OBAMA: Connecticut — what are you specifically referring to?

BAIER: The $100 million for the hospital? Is Montana in for the asbestos program? Is — you know, listen, there are people — this is real money, people are worried about this stuff.

OBAMA: And as I said before, this — the final provisions are going to be posted for many days before this thing passes, but —

BAIER: Let me get to some of the specifics on substance not process.

OBAMA: The only thing —

(CROSSTALK)

BAIER: (INAUDIBLE)

OBAMA: — the only thing I want to say, just to close up, is that when you talk about one-sixth of the economy, this is one-sixth of the economy that right now is a huge drag on the economy. Now, we can fix this in a way that is sensible, that is centrist. I have rejected a whole bunch of provisions that the left wanted that are — you know, they were very adamant about because I thought it would be too disruptive to the system. But what we can't do is perpetuate a system in which millions of people day in and day out are having an enormously tough time and small businesses are sending me letters constantly saying that they are seeing their premiums increase 40, 50 percent.

BAIER: Mr. President, you said Monday that you praised the Congressional Budget Office numerous times. You also said this, this proposal makes Medicare stronger — and you just said it to me here —

OBAMA: Right.

BAIER: — it makes coverage better, it makes its finances more secure, and anyone who says otherwise is misinformed or is trying to misinform you.

OBAMA: Right.

BAIER: The CBO has said specifically that the $500 billion that you say that you're going to save from Medicare is not being spent in Medicare. That this bill spends it elsewhere outside of Medicare. So you can't have both.

OBAMA: Right.

BAIER: You either spend it on expenditures or you make Medicare more solvent. So which is it?

OBAMA: Here's what it does. On the one hand what you're doing is you're eliminating insurance subsidies within Medicare that aren't making anybody healthier but are fattening the profits of insurance companies. Everybody agrees that that is not a wise way to spend money. Now, most of those savings go right back into helping seniors, for example, closing the donut hole.

When the previous Congress passed the prescription drug bill, what they did was they left a situation which after seniors had spent a certain amount of money, suddenly they got no help and they were stuck with the bill. Now that's a pretty expensive proposition fixing that. It wasn't paid for at the time that that bill was passed. So that money goes back into Medicare, both to fix the donut hole, lower premiums.

All those things are important, but what's also happening is each year we're spending less on Medicare overall and as consequence, that lengthens the trust fund and it's availability for seniors.

BAIER: Your chief actuary for Medicare said this, that cuts in Medicare: "cannot be simultaneously used to finance other federal outlays and extend the trust fund." That's your guy.

OBAMA: No — and what is absolutely true is that this will not solve our whole Medicare problem. We're still going to have to fix Medicare over the long term.

BAIER: But it's $38 trillion in the hole.

OBAMA: Absolutely, and that's the reason that we're going to have to — that's the reason I put forward a fiscal commission based on Republicans and Democratic proposals, to make sure that we have a long-term fix for the system. The key is that this proposal doesn't weaken Medicare, it makes it stronger for seniors currently who are receiving it. It doesn’t solve that big structural problem, Bret. Nobody's claiming that this piece of legislation is going to solve every problem that's been there for decades. What it does do is make sure that the trust fund is not going to be going bankrupt in seven years, according to their accounting rules —

BAIER: So you don't buy —

OBAMA: — and in the meantime —

BAIER: — the CBO or the actuary that you can't have it both ways?

OBAMA: No —

BAIER: That you can't spend the money twice?

OBAMA: — no, what is absolutely true and what I do agree with is that you can't say that you are saving on Medicare and then spend the money twice. What you can say is that we are going to take these savings, put them back to make sure that seniors are getting help on the prescription drug bill instead of that money going to, for example, insurance reform, and —

BAIER: And you call this deficit neutral, but you also set aside the doctor fix, more than $200 billion. People look at this and say, how can it be deficit neutral?

OBAMA: But the — as you well know, the doctors problem, as you mentioned, the "doctors fix," is one that has been there four years now. That wasn't of our making, and that has nothing to do with my health care bill. If I was not proposing a health care bill, right — let's assume that I had never proposed health care.

BAIER: But you wanted to change Washington, Mr. President. And now you're doing it the same way.

OBAMA: Bret, let me finish my — my answers here. Now, if suddenly, you've got, over the last decade, a problem that's been built up. And the suggestion is somehow that, because that's not fixed within this bill, that that's a reason to vote against the bill, that doesn't make any sense. That's a problem that I inherited. That was a problem that should have been solved a long time ago. It's a problem that needs to be solved, but it's not created by my bill. And I don't think you would dispute that.

BAIER: We're getting the wrap-up sign here.

OBAMA: Yes.

BAIER: Can you be a transformative president if health care does not pass?

OBAMA: Well, I think that — look, I came in at a time when we probably had the toughest economic challenges since the Great Depression. A year later, we can say that, although we're still a long way from where we need to be, that we have made the economy stronger. It's now growing again. We have created a financial situation that is vastly better than it was before.

And so we're now in a situation in which the economy is growing, moving. We're reforming areas like education. We're taking steps on energy. We're doing a whole bunch of things out there that are going to create the foundation for long-term economic growth.

BAIER: So if it doesn't pass, does that diminish your presence?

OBAMA: Well, if it doesn't pass, I'm more concerned about what it does to families out there who right now are getting crushed by rising health care costs and small businesses who were having to make a decision, "Do I hire or do I fix health care?" That's the reason I make these decisions.

BAIER: Mr. President, I'm getting wrapped up, and I don't want to interrupt you, but to finish up, do you think this is going to pass?

OBAMA: I do. I'm confident it will pass. And the reason I'm confident that it's going to pass is because it's the right thing to do. Look, on a whole host of these measures, whether it's health care, whether it was fixing the financial system, whether it's making sure that we passed the Recovery Act, I knew these things might not be popular, but I was absolutely positive that they were the right thing to do and that, over time, we would be vindicated in having made those tough decisions.

I think health care is exactly the same thing. We — I've got a whole bunch of portraits of presidents around here, starting with Teddy Roosevelt, who tried to do this and didn't get it done. The reason that it needs to be done is not its affect on the presidency. It has to do with how it's going to affect ordinary people who right now are desperately in need of help.

BAIER: I apologize for interrupting you, sir. I tried to get the most for our buck here.

(CROSSTALK)

BAIER: Thank you very much for your time.

OBAMA: Thank you very much. I appreciate it. Thank you.

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