The Last Word   |  November 21, 2012

Spreading the word about Obamacare benefits

President Obama won re-election and Obamacare is the law of the land. Now the work to implement it and make sure Americans know of its benefits is starting. And the Affordable Care Act could be even bigger and better than predicted. MSNBC analyst Ezra Klein talks with Families USA executive director Ron Pollack, who is spearheading a major public education campaign.

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This content comes from Closed Captioning that was broadcast along with this program.

>> you, too. you know what i am thankful for this thanksgiving? i am thankful elections, they have consequences.

>> the time for bickering is over. the time for games has passed. now is the time to deliver on health care .

>> have you read the bill? hell, no, you haven't.

>> the supreme court has upheld president obama 's health care law .

>> the health care law .

>> the signature achievement of barack obama 's presidency.

>> now they're trying to drag it into the negotiations over the fiscal cliff.

>> we have a new message from congressman boehner .

>> we can't afford it, we can't afford it and we can't afford to leave it in tact. that's not a new message.

>> can you say it was done openly?

>> that is not a new message.

>> they have been defeated three times.

>> we had an election.

>> the american people have spoken.

>> elections have consequences.

>> we're not going to change anybody's mind.

>> they need to move on.

>> we had an election and they lost.

>> i want to thank everyone who participated in this election.

>> the presidential pardon .

>> the winning turkey can thank his stellar campaign team.

>> turkey pardon at the white house .

>> these birds are moving forward.

>> a very happy thanksgiving.

>> a very happy thanksgiving.

>> happy thanksgiving.

>> and happy thanksgiving. presidential campaigns, they usually focus on, well, you might say hope and change. the candidates promise big grand new policies and how everything will be different and they get elected and go to congress and congress usually says no. this time, though, this time is different. candidate obama in 2008 promised universal health care . shockingly, unlike the many, many presidents who had run for office and been elected promising that before him, president obama was pretty much able to get it passed into law. though the affordable care act became law in 2010 , it wasn't scheduled to actually begin until 2014 . and that right there, that is the single most important fact about the election we have just been through. you may have heard that elections have consequences. this election had real completely life changing consequences for the 30 million uninsured people and maybe millions more who will get health care coverage because president obama is re-elected and that means the affordable care act will take effect. that is not just change you can believe in or change you can hope for. it is change that is actually happening. it is happening even as we speak right now. it doesn't need another vote in congress or to clear another challenge before the supreme court . it is law and even john boehner knows it.

>> you had said next year that you would repeal the health care vote. that still your mission?

>> i think the election changes that. it is pretty clear that the president was re-elected and obama care is the law of the land .

>> that was boehner less than two weeks ago. it was pretty clear that mission repeal obama care had failed. the voters had spoken and obama care as speaker boehner said is the law of the land . republicans weren't super happy about that message. they thought boehner was getting a little squishy, giving up a fight. that election we just had. the one where voters re-elected the obama care guy, the one that had obama in his name, that was but a flesh wound. today boehner wrote an op-ed to the cincinnati inquirer which begins with, quote, president obama has won re-election but as was the case before the election, obama care has to go. if you read on in his op-ed, things get a little strange. boehner went on to share the big plan which is, quote, over the past couple of years i have noted there are essentially three major routes to repeal of the president's law. the courts, the presidential election process and the congressional oversight process. with two of those three routes having come up short, the third and final one becomes more important than ever. vigor us oversight of the health care law by the house can be expected and in fact is already under way. one of these things is not like the other. the courts and the presidential election process, they can actually stop obama care from happening. you get supreme court ruling against it, the president works to repeal it and that can matter. congressional oversight hearings? that is not an accepted avenue for repeal. it is actually a little pathetic. if you think john boehner has any chance of repealing the health care law through vigorous oversight from the house's oversight committees, what have they been doing for the past two years? why isn't it gone now? boehner is a realist. this is not wishful thinking on his part. it is lazy comforting and it is here, republicans, don't you worry, it is all part of the plan, we're on track, but there is no plan. the country is moving forward. it is moving forward regardless of the house republicans. on tuesday the department of health and human services issued new regulations that explained the health care law in practical terms like what will a deductible actually be able to go up to and can your insurer jack up the price when you hit your 30th birthday or 50th birthday and this one is for you, john boehner . what is the policy for smokers anyway? the answers there just so you know are in order, a deductible can in the cheapest plans be $2,000 or more in some cases. insurers can't hit you with a huge new bill when you hit a new decade. increases due to your age have to be gradual and smokers can be charged 1.5 times as many as non-smokers but not if they enter a program to help them quit smoking. as a nation's near universal shelt care system is being defined in washington there is a campaign right now to make sure people around the country know about it, understand it and become part of it. if this campaign succeeds, it could make the affordable care act bigger and better than we thought. you have probably heard that the law will cover 30 million people. what you probably don't know is what is behind that guesstimate. roughly 49 people in the united states currently don't have health insurance . the congressional budget office estimates that 30 million of them will gain coverage under the affordable care act . that leaves 19 million uninsured. about 5 million of that 19 million are illegal immigrants not eligible for the law of subsidies. they project another 2 million live in states that will opt out of the medicaid expansion. that leaves 12 million people. the cbo estimates at least 6 million of them are actually going to be eligible for medicaid . they just won't sign up and won't know about it. even more will be eligible for private insurance. the cbo is in effect assuming a lot of people won't participate in the bill not because it wouldn't help them but because all government programs have a serious non- participation rate . a lot of people don't know about them. a recent poll found that 83% of people likely to qualify for the medicaid expansion in the law are completely unaware. they have no idea they can suddenly get health care . some who do know about it are so beaten down by the current system they don't believe it. " washington post " colleague sara cliff visited a focus group where the uninsured were asked about the health care bill and it was searing. one woman in a genuinely heartbreaking moment of honesty said, quote, if it was doable, by that meaning giving people like her health care , it would have been done by now. i just don't think it is possible. think about that. if you could get to 100% participation or even just near to it, this bill could easily cover 40 million people a full 33% more than we were expecting and you don't need to pass a new law to get the people on the books. you need to tell people the bill is there and convince them it can help them, and right now a ban of very strange bed fellows teamed up to do just that to run a public education campaign that will get these people the information they need to sign up. the big health care players, insurers and pharmaceutical companies are working with liberal health care advocacy groups to make sure people know about and understand the health care law and what they can get from it. they're going to spend millions of dollars to tell people about the law. the insurers and the drug makers, if they want to do it because more people in the system means more profit for them and the health care advocates because more people being covered means more people with health care coverage and you don't have to go through the dangerous experience of being uninsured and while all of this is happening and hammering out regulations and trying to tell people that are depressed and discouraged that finally at long last we have an answer for them and we can help them, as we're moving forward and changing health care in this country entirely, the republicans are going to be chasing their tails in oversight hearings pretending they can repeal the bill. come on, guys. the campaign is over. the election is over. it is now time to govern. obama care is the law of the land . it is the law by the way that could have been different had republicans chosen to participate in its construction, chosen to trade their votes for more of a say in the final policy, but they didn't. they made an all-in bet on killing the bill and then an all-in bet on repealing the bill and now both of those bets have gone bad. it is over. health care reform is happening. the only question is whether republicans will choose to be part of it. joining me now is ron paul , the executive director of families usa , a national organization that advocates on behalf of health care consumers and the chairman of the enroll america , the aforementioned strange bed fellows coalition working to bring people into the coverage of the law. ron, it is great to have you here.

>> it is great to be with you again.

>> tell me, what are you doing? how are you going to do this and the in under the circumstances and bolts and mechanics of it? how are you going to try to get people signed up?

>> enroll america , the task is to make sure as many people know about this as possible, so there will be a huge public education campaign. there will be advertising. and the various groups that are in touch with people who can benefit from this are going to help out. so people go to community health centers because they can get free care. people in the community health centers will have informed people about the possibility they can get health coverage. when you go to a hospital, you can learn that you can get coverage. the hospitals want you covered because they don't want to provide care for you for free. when you go to a pharmacy, the pharmacy can handout information to you about how you get enrolled. what enroll america is going to do is galvanize all of these different folks, people of goodwill, to get people enrolled and as you said, some of these interest groups , they can do well by doing good and so our hope is that this is going to be a really robust effort. there is going to have to be a really big advertising campaign as well.

>> right on that, this is not the first time in this country we have had to try to sign up people for a law like this. it happened in massachusetts and i want to play one of the ads they used to get people signed onto the bill.

>> four years after i graduated college i felt a lump in my left breast and i waited a whole year and then i finally got health insurance and i went to my new doctor who said i should get it checked out, and so i did and it was breast cancer . if i didn't have health insurance i might not be around today to tell my story. basically saved my life.

>> jackie's story is one example of how important it is for everyone to have health insurance . in massachusetts we're leading the way. the state's health connector has affordable plans, lots to choose from and easy sign up. in massachusetts even if you lose your job, you can still get coverage. visit the health connector today.

>> so that guy you just heard from, tim wakefield , in massachusetts he is a very big deal . he is a member of the red sox and that campaign worked. massachusetts had a very, very high sign up rate. what have you learned from that? what have you learned from what happened in mitt romney 's state?

>> we have learn add lot in terms of what messages work and actually we're doing a great deal of research now in terms of what kind of ways do we need to communicate to people who should not best communicators and so that there are people who are believable and one of the things that is very important is in addition to providing information either through an advertisement or some other process like that, people want to have personal contact with individuals because some of them want to get help, try to figure out which plan they should sign up for, make sure they understand what their obligations are going to be, what's going to be covered, what the deductibles are going to be and so in addition to the advertising and using athletes and others, it is going to be very important to have people on the ground who can help people.

>> what do you think the president's role is in all of this? obviously he is not directly affiliated with your group. what do you think will be coming out of the public sector and the federal government to try to get people engaged in the bill?

>> ezra, you know, this is a legacy for the president. so this has got to be a high priority for this administration. it is our hope that the white house directly will play a significant role. we would love to see the first lady play a significant role. i think she is an eloquent spokesperson and remember we're going to have to really target those groups that are more likely to be uninsured and they happen to be the same people targeted during the elections, people from communities of color, young adults , so i think the white house can play a very effective role.

>> thank you so much for joining me and have a happy thanksgiving.

>> you, too, ezra.

>> coming up, the science behind the victory, obama 's victory and what the administration can do with all of that data. and later why i have come to hate the movie mr. smith goes to washington. and the unusual mystical connection between the 47% and star trek . nobody said an inkjet had to be slow. or that printing in color had to cost a fortune. nobody said an all-in-one had to be bulky. or that you had to print from your desk. at least, nobody said it to us. introducing the