Barack Obama: Passage of Health Care Marks a New Season in America

Today, after almost a century of trying; today, after over a year of debate; today, after all the votes have been tallied — health insurance reform becomes law in the United States of America. Today.

It is fitting that Congress passed this historic legislation this week. For as we mark the turning of spring, we also mark a new season in America. In a few moments, when I sign this bill, all of the overheated rhetoric over reform will finally confront the reality of reform.

And while the Senate still has a last round of improvements to make on this historic legislation — and these are improvements I’m confident they will make swiftly — the bill I’m signing will set in motion reforms that generations of Americans have fought for, and marched for, and hungered to see.

It will take four years to implement fully many of these reforms, because we need to implement them responsibly. We need to get this right. But a host of desperately needed reforms will take effect right away.

This year, we’ll start offering tax credits to about 4 million small businessmen and women to help them cover the cost of insurance for their employees. That happens this year.

This year, tens of thousands of uninsured Americans with preexisting conditions, the parents of children who have a preexisting condition, will finally be able to purchase the coverage they need. That happens this year.

This year, insurance companies will no longer be able to drop people’s coverage when they get sick. They won’t be able to place lifetime limits or restrictive annual limits on the amount of care they can receive.(continued)

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Home • Briefing Room • Speeches & Remarks

The White House

Office of the Press Secretary

For Immediate Release March 22, 2010
Remarks by the President on the House Vote on Health Insurance Reform

East Room

11:47 P.M. EDT

THE PRESIDENT: Good evening, everybody. Tonight, after nearly 100 years of talk and frustration, after decades of trying, and a year of sustained effort and debate, the United States Congress finally declared that America’s workers and America’s families and America’s small businesses deserve the security of knowing that here, in this country, neither illness nor accident should endanger the dreams they’ve worked a lifetime to achieve.

Tonight, at a time when the pundits said it was no longer possible, we rose above the weight of our politics. We pushed back on the undue influence of special interests. We didn’t give in to mistrust or to cynicism or to fear. Instead, we proved that we are still a people capable of doing big things and tackling our biggest challenges. We proved that this government — a government of the people and by the people — still works for the people.

I want to thank every member of Congress who stood up tonight with courage and conviction to make health care reform a reality. And I know this wasn’t an easy vote for a lot of people. But it was the right vote. I want to thank Speaker Nancy Pelosi for her extraordinary leadership, and Majority Leader Steny Hoyer and Majority Whip Jim Clyburn for their commitment to getting the job done. I want to thank my outstanding Vice President, Joe Biden, and my wonderful Secretary of Health and Human Services, Kathleen Sebelius, for their fantastic work on this issue. I want to thank the many staffers in Congress, and my own incredible staff in the White House, who have worked tirelessly over the past year with Americans of all walks of life to forge a reform package finally worthy of the people we were sent here to serve.

Today’s vote answers the dreams of so many who have fought for this reform. To every unsung American who took the time to sit down and write a letter or type out an e-mail hoping your voice would be heard — it has been heard tonight. To the untold numbers who knocked on doors and made phone calls, who organized and mobilized out of a firm conviction that change in this country comes not from the top down, but from the bottom up — let me reaffirm that conviction: This moment is possible because of you.

Most importantly, today’s vote answers the prayers of every American who has hoped deeply for something to be done about a health care system that works for insurance companies, but not for ordinary people. For most Americans, this debate has never been about abstractions, the fight between right and left, Republican and Democrat — it’s always been about something far more personal. It’s about every American who knows the shock of opening an envelope to see that their premiums just shot up again when times are already tough enough. It’s about every parent who knows the desperation of trying to cover a child with a chronic illness only to be told “no” again and again and again. It’s about every small business owner forced to choose between insuring employees and staying open for business. They are why we committed ourselves to this cause.

Tonight’s vote is not a victory for any one party — it’s a victory for them. It’s a victory for the American people. And it’s a victory for common sense.

Now, it probably goes without saying that tonight’s vote will give rise to a frenzy of instant analysis. There will be tallies of Washington winners and losers, predictions about what it means for Democrats and Republicans, for my poll numbers, for my administration. But long after the debate fades away and the prognostication fades away and the dust settles, what will remain standing is not the government-run system some feared, or the status quo that serves the interests of the insurance industry, but a health care system that incorporates ideas from both parties — a system that works better for the American people.

If you have health insurance, this reform just gave you more control by reining in the worst excesses and abuses of the insurance industry with some of the toughest consumer protections this country has ever known — so that you are actually getting what you pay for.

If you don’t have insurance, this reform gives you a chance to be a part of a big purchasing pool that will give you choice and competition and cheaper prices for insurance. And it includes the largest health care tax cut for working families and small businesses in history — so that if you lose your job and you change jobs, start that new business, you’ll finally be able to purchase quality, affordable care and the security and peace of mind that comes with it.

This reform is the right thing to do for our seniors. It makes Medicare stronger and more solvent, extending its life by almost a decade. And it’s the right thing to do for our future. It will reduce our deficit by more than $100 billion over the next decade, and more than $1 trillion in the decade after that.

So this isn’t radical reform. But it is major reform. This legislation will not fix everything that ails our health care system. But it moves us decisively in the right direction. This is what change looks like.

Now as momentous as this day is, it’s not the end of this journey. On Tuesday, the Senate will take up revisions to this legislation that the House has embraced, and these are revisions that have strengthened this law and removed provisions that had no place in it. Some have predicted another siege of parliamentary maneuvering in order to delay adoption of these improvements. I hope that’s not the case. It’s time to bring this debate to a close and begin the hard work of implementing this reform properly on behalf of the American people. This year, and in years to come, we have a solemn responsibility to do it right.

Nor does this day represent the end of the work that faces our country. The work of revitalizing our economy goes on. The work of promoting private sector job creation goes on. The work of putting American families’ dreams back within reach goes on. And we march on, with renewed confidence, energized by this victory on their behalf.

In the end, what this day represents is another stone firmly laid in the foundation of the American Dream. Tonight, we answered the call of history as so many generations of Americans have before us. When faced with crisis, we did not shrink from our challenge — we overcame it. We did not avoid our responsibility — we embraced it. We did not fear our future — we shaped it.

Thank you, God bless you, and may God bless the United States of America.

END
11:55 P.M. EDT

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Home • Briefing Room • Speeches & Remarks

The White House

Office of the Press Secretary

For Immediate Release March 23, 2010
Remarks by the President and Vice President at Signing of the Health Insurance Reform Bill

East Room

11:29 A.M. EDT

THE VICE PRESIDENT: Thank you all. (Applause.)

AUDIENCE: Fired up! Ready to go! Fired up! Ready to go!

THE VICE PRESIDENT: Thank you.

Mr. President, I think we got a happy room here. (Laughter.) It seems ridiculous to say thank you all for being here. (Laughter.) Ladies and gentlemen, to state the obvious, this is a historic day. (Applause.)

In our business you use that phrase a lot, but I can’t think of a day in the 37 years that I’ve been a United States senator and the short time I’ve been Vice President that it is more appropriately stated. This is a historic day.

And history — history is not merely what is printed in textbooks. It doesn’t begin or end with the stroke of a pen. History is made. History is made when men and women decide that there is a greater risk in accepting a situation that we cannot bear than in steeling our spine and embracing the promise of change. That’s when history is made. (Applause.)

History is made when you all assembled here today, members of Congress, take charge to change the lives of tens of millions of Americans. Through the efforts of those of us lucky enough to serve here in this town, that’s exactly what you’ve done. You’ve made history.

History is made when a leader steps up, stays true to his values, and charts a fundamentally different course for the country. History is made when a leader’s passion — passion — is matched with principle to set a new course. Well, ladies and gentlemen, Mr. President, you are that leader. (Applause.)

Mr. President, your fierce advocacy, the clarity of purpose that you showed, your perseverance — these are in fact — it is not hyperbole to say — these are the reasons why we’re assembled in this room together, today. But for those attributes we would not be here. Many, many men and women are going to feel the pride that I feel in watching you shortly, watching you sign this bill, knowing that their work — their work has helped make this day possible. But, Mr. President, you’re the guy that made it happen. (Applause.)

And so, Mr. President, all of us, press and elected officials, assembled in this town over the years, we’ve seen some incredible things happen. But you know, Mr. President, you’ve done what generations of not just ordinary, but great men and women, have attempted to do. Republicans as well as Democrats, they’ve tried before. Everybody knows the story, starting with Teddy Roosevelt. They’ve tried. They were real bold leaders.
But, Mr. President, they fell short. You have turned, Mr. President, the right of every American to have access to decent health care into reality for the first time in American history. (Applause.)

Mr. President, I’ve gotten to know you well enough. You want me to stop because I’m embarrassing you. (Laughter.) But I’m not going to stop for another minute, Mr. President, because you delivered on a promise — a promise you made to all Americans when we moved into this building.

Mr. President, you are — to repeat myself — literally about to make history. Our children and our grandchildren, they’re going to grow up knowing that a man named Barack Obama put the final girder in the framework for a social network in this country to provide the single most important element of what people need — and that is access to good health — (applause) — and that every American from this day forward will be treated with simple fairness and basic justice.

Look, the classic poet, Virgil, once said that “The greatest wealth is health.” The greatest wealth is health. Well, today, America becomes a whole lot wealthier because tens of millions of Americans will be a whole lot healthier from this moment on.

Ladies and gentlemen, the President of the United States of America, Barack Obama. (Applause.)

THE PRESIDENT: Thank you, everybody. Thank you. (Applause.) Thank you. Thank you, everybody. Thank you. Thank you everybody. Thank you so much. Thank you. Thank you. (Applause.) Thank you, everybody. Please, have a seat.

Thank you, Joe. (Laughter.)

THE VICE PRESIDENT: Good to be with you, Mr. President. (Laughter.)

THE PRESIDENT: Today, after almost a century of trying; today, after over a year of debate; today, after all the votes have been tallied –- health insurance reform becomes law in the United States of America. (Applause.) Today.

And while the Senate still has a last round of improvements to make on this historic legislation — and these are improvements I’m confident they will make swiftly — (applause) — the bill I’m signing will set in motion reforms that generations of Americans have fought for, and marched for, and hungered to see.

This year, we’ll start offering tax credits to about 4 million small businessmen and women to help them cover the cost of insurance for their employees. (Applause.) That happens this year.

This year, insurance companies will no longer be able to drop people’s coverage when they get sick. (Applause.) They won’t be able to place lifetime limits or restrictive annual limits on the amount of care they can receive. (Applause.)

This year, all new insurance plans will be required to offer free preventive care. And this year, young adults will be able to stay on their parents’ policies until they’re 26 years old. That happens this year. (Applause.)

And this year, seniors who fall in the coverage gap known as the doughnut hole will start getting some help. They’ll receive $250 to help pay for prescriptions, and that will, over time, fill in the doughnut hole. And I want seniors to know, despite what some have said, these reforms will not cut your guaranteed benefits. (Applause.) In fact, under this law, Americans on Medicare will receive free preventive care without co-payments or deductibles. That begins this year. (Applause.)

Once this reform is implemented, health insurance exchanges will be created, a competitive marketplace where uninsured people and small businesses will finally be able to purchase affordable, quality insurance. They will be able to be part of a big pool and get the same good deal that members of Congress get. That’s what’s going to happen under this reform. (Applause.) And when this exchange is up and running, millions of people will get tax breaks to help them afford coverage, which represents the largest middle-class tax cut for health care in history. That’s what this reform is about. (Applause.)

This legislation will also lower costs for families and for businesses and for the federal government, reducing our deficit by over $1 trillion in the next two decades. It is paid for. It is fiscally responsible. And it will help lift a decades-long drag on our economy. That’s part of what all of you together worked on and made happen. (Applause.)

That our generation is able to succeed in passing this reform is a testament to the persistence –- and the character -– of the American people, who championed this cause; who mobilized; who organized; who believed that people who love this country can change it.

It’s also a testament to the historic leadership -– and uncommon courage –- of the men and women of the United States Congress, who’ve taken their lumps during this difficult debate. (Laughter.)

AUDIENCE MEMBER: Yes, we did. (Laughter.)

THE PRESIDENT: You know, there are few tougher jobs in politics or government than leading one of our legislative chambers. In each chamber, there are men and women who come from different places and face different pressures, who reach different conclusions about the same things and feel deeply concerned about different things.

By necessity, leaders have to speak to those different concerns. It isn’t always tidy; it is almost never easy. But perhaps the greatest –- and most difficult –- challenge is to cobble together out of those differences the sense of common interest and common purpose that’s required to advance the dreams of all people — especially in a country as large and diverse as ours.

And we are blessed by leaders in each chamber who not only do their jobs very well but who never lost sight of that larger mission. They didn’t play for the short term; they didn’t play to the polls or to politics: One of the best speakers the House of Representatives has ever had, Speaker Nancy Pelosi. (Applause.)

AUDIENCE: Nancy! Nancy! Nancy! Nancy!

THE PRESIDENT: One of the best majority leaders the Senate has ever had, Mr. Harry Reid. (Applause.)

To all of the terrific committee chairs, all the members of Congress who did what was difficult, but did what was right, and passed health care reform — not just this generation of Americans will thank you, but the next generation of Americans will thank you.

And of course, this victory was also made possible by the painstaking work of members of this administration, including our outstanding Secretary of Health and Human Services, Kathleen Sebelius — (applause) — and one of the unsung heroes of this effort, an extraordinary woman who led the reform effort from the White House, Nancy-Ann DeParle. Where’s Nancy? (Applause.)

Today, I’m signing this reform bill into law on behalf of my mother, who argued with insurance companies even as she battled cancer in her final days.

I’m signing it for Ryan Smith, who’s here today. He runs a small business with five employees. He’s trying to do the right thing, paying half the cost of coverage for his workers. This bill will help him afford that coverage.

I’m signing it for 11-year-old Marcelas Owens, who’s also here. (Applause.) Marcelas lost his mom to an illness. And she didn’t have insurance and couldn’t afford the care that she needed. So in her memory he has told her story across America so that no other children have to go through what his family has experienced. (Applause.)

I’m signing it for Natoma Canfield. Natoma had to give up her health coverage after her rates were jacked up by more than 40 percent. She was terrified that an illness would mean she’d lose the house that her parents built, so she gave up her insurance. Now she’s lying in a hospital bed, as we speak, faced with just such an illness, praying that she can somehow afford to get well without insurance. Natoma’s family is here today because Natoma can’t be. And her sister Connie is here. Connie, stand up. (Applause.)

I’m signing this bill for all the leaders who took up this cause through the generations — from Teddy Roosevelt to Franklin Roosevelt, from Harry Truman, to Lyndon Johnson, from Bill and Hillary Clinton, to one of the deans who’s been fighting this so long, John Dingell. (Applause.) To Senator Ted Kennedy. (Applause.) And it’s fitting that Ted’s widow, Vicki, is here — it’s fitting that Teddy’s widow, Vicki, is here; and his niece Caroline; his son Patrick, whose vote helped make this reform a reality. (Applause.)

I remember seeing Ted walk through that door in a summit in this room a year ago — one of his last public appearances. And it was hard for him to make it. But he was confident that we would do the right thing.

Our presence here today is remarkable and improbable. With all the punditry, all of the lobbying, all of the game-playing that passes for governing in Washington, it’s been easy at times to doubt our ability to do such a big thing, such a complicated thing; to wonder if there are limits to what we, as a people, can still achieve. It’s easy to succumb to the sense of cynicism about what’s possible in this country.

But today, we are affirming that essential truth -– a truth every generation is called to rediscover for itself –- that we are not a nation that scales back its aspirations. (Applause.) We are not a nation that falls prey to doubt or mistrust. We don’t fall prey to fear. We are not a nation that does what’s easy. That’s not who we are. That’s not how we got here.

We are a nation that faces its challenges and accepts its responsibilities. We are a nation that does what is hard. What is necessary. What is right. Here, in this country, we shape our own destiny. That is what we do. That is who we are. That is what makes us the United States of America.

And we have now just enshrined, as soon as I sign this bill, the core principle that everybody should have some basic security when it comes to their health care. (Applause.) And it is an extraordinary achievement that has happened because of all of you and all the advocates all across the country.

So, thank you. Thank you. God bless you, and may God bless the United States. (Applause.) Thank you. Thank you.

All right, I would now like to call up to stage some of the members of Congress who helped make this day possible, and some of the Americans who will benefit from these reforms. And we’re going to sign this bill.

This is going to take a little while. I’ve got to use every pen, so it’s going to take a really long time. (Laughter.) I didn’t practice. (Laughter.)

(The bill is signed.)

We are done. (Applause.)

END
11:56 A.M. EDT

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Home • Briefing Room • Speeches & Remarks

The White House

Office of the Press Secretary

For Immediate Release March 23, 2010
Remarks by the President and Vice President on Health Insurance Reform at the Department of the Interior

Department of Interior, Washington, D.C.

12:39 P.M. EDT

THE VICE PRESIDENT: Thank you all. (Applause.)

AUDIENCE: Yes, we can! Yes, we can! Yes, we can!

THE VICE PRESIDENT: Yes, he did. (Applause.) Thank you all for being here, ladies and gentlemen. Please be seated.

Ladies and gentlemen, to state the obvious, this is truly a historic day. But as all of you know, history is not merely what’s printed in our textbooks. It doesn’t begin or end with a stroke of a pen. History is made. History is made when men and women decide that there’s a greater risk in accepting the situation we cannot bear than in steeling our spines and embracing the promise of change. History is made when a leader’s passion is matched with his principle in service of his country.

Mr. President, your passion to make the lives of ordinary Americans better has been on display. And the principles that guided your public service, beginning when you were a community organizer, have led this nation to this moment. Mr. President, 30 minutes ago, by the stroke of your pen, you began the process of making life better for tens of millions of Americans today and for evermore. (Applause.)

For much too long, for much too long, Americans have been denied what every human being is entitled to — decent, affordable health care. Starting with Teddy Roosevelt straight through to you, Mr. President, everyone else tried. They were great men, they gave it their best, but they came up short. But you succeeded, Mr. President, and we owe you for that. (Applause.)

As I said just before the President signed the health care bill, I quoted Virgil, the classic Greek poet, who once said, “The greatest wealth is health.” The greatest wealth is health. Mr. President, you’ve made us a nobler and wealthier nation by providing for the health of your fellow citizens.

Ladies and gentlemen, the President of the United States of America, Barack Obama. (Applause.)

THE PRESIDENT: Thank you, everybody. Thank you. (Applause.) Thank you, everybody. Please have a seat.

We wanted to do this twice — (laughter) — because there are so many people we have to thank. And as I look around the room, we’ve got leaders of labor who helped to make this happen. We’ve got ordinary folks who knocked on doors and made phone calls at the last minute to get this thing over the top. My extraordinary members of my Cabinet — we’ve still got some additional members of Congress who helped lead the charge on this. There’s my staff, who I see are still here. (Laughter.) At any given moment I thought they were going to quit — (laughter) — but they just stuck it out with me.

So the main purpose here is to say thank you, and thank you on behalf of the American people.

After a century of striving, after a year of debate, after a historic vote, health care reform is no longer an unmet promise. It is the law of the land. It is the law of the land. (Applause.)

And although it may be my signature that’s affixed to the bottom of this bill, it was your work, your commitment, your unyielding hope that made this victory possible. When the special interests deployed an army of lobbyists, an onslaught of negative ads, to preserve the status quo, you didn’t give up. You hit the phones and you took to the streets. You mobilized and you organized. You turned up the pressure and you kept up the fight.

When the pundits were obsessing over who was up and who was down, you never lost sight of what was right and what was wrong. You knew this wasn’t about the fortunes of a party — this was about the future of our country. (Applause.)

And when the opposition said this just wasn’t the right time, you didn’t want to wait another year, or another decade, or another generation for reform. You felt the fierce urgency of now.

You met the lies with truth. You met cynicism with conviction. Most of all, you met fear with a force that’s a lot more powerful — and that is faith in America. You met it with hope. (Applause.)

Despite decades in which Washington failed to tackle our toughest challenges, despite the smallness of so much of what passes for politics these days, despite those who said that progress was impossible, you made people believe that people who love this country can still change it.

So this victory is not mine — it is your victory. It’s a victory for the United States of America. (Applause.)

For two years on the campaign trail, and for the past year as we’ve worked to reform our system of health insurance, it’s been folks like you who have propelled this movement and kept us fixed on what was at stake in this fight. And rarely has a day gone by that I haven’t heard from somebody personally — whether in a letter, or an email, or at a town hall — who’s reminded me of why it was so important that we not give up; who reminded me why we could not quit.

I heard from Ryan Smith, who’s here today, and runs a small business with five employees. He is trying to do the right thing, paying for half of the cost of coverage for his workers. But as his premiums keep on going up and up and up, he’s worried he’s going to have to stop offering health care for his people. But because of this bill he is now going to be getting tax credits that allow him to do what he knows is the right thing to do — and that’s going to be true for millions of employers all across America. (Applause.)

I heard the story of 11-year-old Marcelas Owens, who’s right here — looking sharp — (applause.) He and I made sure to coordinate our ties today. (Laughter.) Yes, it looks good. (Laughter.)

Marcelas is a wonderful young man, and he lost his mom to illness. And she didn’t have insurance and couldn’t afford the care that she needed. So in her memory, Marcelas, 11 years old, has told her story across America so that no other children have to go through what his family has experienced. (Applause.) That’s why we don’t quit. (Applause.)

I heard from folks like Natoma Canfield, who had to give up her health coverage after her rates were jacked up by more than 40 percent. She was terrified that an illness would mean she’d lose the house that her parent built, but she also knew that if she was burdened by these huge premiums, that she wouldn’t be able to pay the mortgage. So she finally decided not to — not to keep her health insurance. And she’s now lying in a hospital bed, as we speak, faced with just such an illness, and she’s praying that she can somehow afford to get well. And her sister Connie is here today. (Applause.) And it’s because of Natoma’s family that we could not quit. (Applause.)

I’ve met people like Ashley Baia, who worked for my campaign. Where’s Ashley? She’s around here somewhere. I know she is. There she is, right in front. She just doesn’t like waving. (Laughter.) Ashley decided to get involved with our campaign a couple of years ago because her own mother lost her job, and with it, her health insurance when she got sick. And they had to file bankruptcy. And so Ashley worked tirelessly, not to get me elected, but to solve a problem that millions of families across the country were facing.

Each of these Americans made their voices heard. It’s because of them, and so many others, so many of you, that real, meaningful change is coming to the United States of America. (Applause.) It is because of you that we did not quit. It’s because of you that Congress did not quit. It’s because of you that I did not quit. It’s because of you. (Applause.)

Now, let me tell you what change looks like — because those fighting change are still out there, still making a lot of noise — (laughter) — about what this reform means. So I want the American people to understand it. And look it up for yourself. Go on our Web site, whitehouse.gov, or go to any credible news outlet’s Web site, and look in terms of what reform will mean for you. (Laughter.)

I said this once or twice, but it bears repeating: If you like your current insurance, you will keep your current insurance. No government takeover; nobody is changing what you’ve got if you’re happy with it. If you like your doctor, you will be able to keep your doctor. In fact, more people will keep their doctors because your coverage will be more secure and more stable than it was before I signed this legislation.

And now that this legislation is passed, you don’t have to take my word for it. You’ll be able to see it in your own lives. I heard one of the Republican leaders say this was going to be Armageddon. Well, two months from now, six months from now, you can check it out. We’ll look around –- (laughter) — and we’ll see. (Applause.) You don’t have to take my word for it. (Applause.)

So what works in our system won’t change. And a lot of people are happy with the health care that they’ve got and that won’t change because of this legislation. Here’s what will change, and here’s what will change right away:

This year, we’ll start offering tax credits to about 4 million small businesses to help them cover the cost of coverage. And that means that folks like Ryan will immediately get a tax break so that he can better afford the coverage he’s already providing for his employees. And who knows, because of that tax break, he may decide to hire a couple more folks in his small business — because of this legislation. (Applause.)

This year, tens of thousands of uninsured Americans with a preexisting condition and parents whose children have a preexisting condition will finally be able to purchase the coverage they need. And that means folks like Natoma Canfield will have access to affordable insurance. That happens this year. (Applause.)

This year, insurance companies will no longer be able to drop people’s coverage when they get sick, or place lifetime limits or restrictive annual limits on the amount of care they can receive. This year, all new insurance plans will be required to offer free preventive care. And this year, young adults will be able to stay on their parents’ policies until they’re 26 years old. That all happens this year. (Applause.)

This year, seniors who fall in the coverage gap known as the doughnut hole will get some help to help pay for prescription drugs. And I want seniors to know, despite what some have said, these reforms will not cut your guaranteed benefits. Let me repeat that: They will not cut your guaranteed benefits. Period. I’d be wary of anybody who claimed otherwise.

So these are the reforms that take effect right away. These reforms won’t give the government more control over your health care. They certainly won’t give the insurance companies more control over your health care. (Applause.) These reforms give you more control over your health care. And that’s only the beginning. (Applause.)

That’s only the beginning. After more than a decade, we finally renewed the Indian Health Care Improvement Act. (Applause.) And the other changes I’m signing into law will take several years to implement fully, but that’s because this is a difficult, complex issue and we want to get it right.

One of these reforms is the creation of a health insurance exchange. This is one of the most important reforms — and by the way, originally, I should point out, a Republican idea. Imagine that. (Laughter.)

The idea is, is that right now there are a lot of people out there buying health insurance on their own, or small businesses buying health insurance on their own. They don’t work for a big company, they’re not part of a big pool, so they have no leverage; they’ve got no bargaining power with insurance companies. But now what we’re going to do is create exchanges all across the country where uninsured people — small businesses — they’re going to be able to purchase affordable, quality insurance. They will be part of a big pool, just like federal employees are part of a big pool. They’ll have the same choice of private health insurance that members of Congress get for themselves. That’s going to happen as a consequence of this legislation. (Applause.)

And when this exchange is up and running, not only because of better bargaining power will they see their premiums reduced, will people get a better deal, but millions of people who still can’t afford it are going to get tax breaks so they can afford coverage. And this represents the largest middle-class tax cut for health care in our history. (Applause.) And it’s going to mean that millions of people can get health care that don’t have it currently.

Now, for those of us who fought so hard for these reforms, and believe in them so deeply, I have to remind you our job is not finished. We’re going to have to see to it that these reforms are administered fairly and responsibly. And this includes rooting out waste and fraud and abuse in the system. That’s how we’ll extend the life of Medicare and bring down health care costs for families and businesses and governments. And in fact, it is through these reforms that we achieve the biggest reduction in our long-term deficits since the Balanced Budget Act of the 1990s.

So for all those folks out there who are talking about being fiscal hawks and didn’t do much when they were in power — (applause) — let’s just remind them that according to the Congressional Budget Office, this represents over a trillion dollars of deficit reduction that is being done in a smart way.

And for those who’ve been suspicious of reform — and there are a lot of wonderful folks out there who, with all the noise, got concerned — because of the misinformation that has marred this debate, I just repeat, don’t take my word for it. Go to our Web site, whitehouse.gov; go to the Web sites of major news outlets out there; find out how reform will affect you. And I’m confident that you will like what you see — a common-sense approach that maintains the private insurance system but makes it work for everybody; makes it work not just for the insurance companies, but makes it work for you.

So that’s what health reform is all about. Now, as long a road as this has been, we all know our journey is far from over. There’s still the work to do to rebuild this economy. There’s still work to do to spur on hiring. There’s work to do to improve our schools and make sure every child has a decent education. There’s still work to do to reduce our dependence on foreign oil. There’s more work to do to provide greater economic security to a middle class that has been struggling for a decade.

So this victory does not erase the many serious challenges we face as a nation. Those challenges have been allowed to linger for years, even decades, and we’re not going to solve them all overnight.

But as we tackle all these other challenges that we face, as we continue on this journey, we can take our next steps with new confidence, with a new wind at our backs — because we know it’s still possible to do big things in America — (applause) — because we know it’s still possible to rise above the skepticism, to rise above the cynicism, to rise above the fear; because we know it’s still possible to fulfill our duty to one another and to future generations. (Applause.)

So, yes, this has been a difficult two years. There will be difficult days ahead. But let us always remember the lesson of this day — and the lesson of history — that we, as a people, do not shrink from a challenge. We overcome it. (Applause.) We don’t shrink from our responsibilities. We embrace it. We don’t fear the future. We shape the future. That’s what we do. That’s who we are. That makes us the United States of America. (Applause.)

God bless you. And God bless the United States of America. Thank you. (Applause.)

END
1:01 P.M. EDT

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