Did Obama Change His Line on Health Care Today?

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The Associated Press does a “fact check” on a passage from Obama’s presser today that also caught my ear:

President Barack Obama told voters repeatedly during the health care debate that the overhaul legislation would bring down fast-rising health care costs and save them money. Now, he’s hemming and hawing on that….

[Obama said] he never expected to extend insurance coverage to an additional 31 million people “for free.” He added that “we’ve made huge progress” if medical inflation could be brought down to the level of overall inflation, or somewhere slightly above that.

THE FACTS: Those claims may be supported in the fine print of the plan he pitched to Congress and a skeptical public months ago. But they were rarely heard back then. “My proposal would bring down the cost of health care for millions—families, businesses and the federal government,” he declared in March.

Last August he predicted: “The American people are going to be glad that we acted to change an unsustainable system so that more people have coverage, we’re bending the cost curve, and we’re getting insurance reforms.”

On Friday, he conceded: “Bending the cost curve on health care is hard to do.” The goal: “Slowly bring down those costs.”

But does this represent a true shift? Admittedly it was odd to hear Obama say that the new health coverage would not be “free,” because in selling his health care plan Obama did tend to describe it as a cost-saver. If you read his words in more context, though, I’m not sure Obama really conceded much on the substance. Here’s his response to a question from ABC’s Jake Tapper about a new estimate from the Centers for Medicare and Medicaid Services showing that health care reform is going to raise costs:

Q    — the CMS study from February predicted a 6.1 percent increase, and now, post-health care, 6.3 percent.  So it seems to have bent it up.

THE PRESIDENT:  No, as I said, Jake, the — I haven’t read the entire study.  Maybe you have.  But if you — if what — the reports are true, what they’re saying is, is that as a consequence of us getting 30 million additional people health care, at the margins that’s going to increase our costs, we knew that.  We didn’t think that we were going to cover 30 million people for free, but that the long-term trend in terms of how much the average family is going to be paying for health insurance is going to be improved as a consequence of health care.

And so our goal on health care is, if we can get, instead of health care costs going up 6 percent a year, it’s going up at the level of inflation, maybe just slightly above inflation, we’ve made huge progress.  And by the way, that is the single most important thing we could do in terms of reducing our deficit.  That’s why we did it.  That’s why it’s important, and that’s why we’re going to implement it effectively.

You can read Ezra Klein for the details (avec useful chart). But it seems that what Obama is trying to say is that his plan will incur short term costs as we add millions to the payroll. But if its structural reforms pan out over the longer term (which is hardly guaranteed) health care will wind up costing the government substantially less–and reduce the deficit as a result. So I’m not sure Obama truly committed the foul that the AP has called here.