Caught between nervous Democrats and emboldened Republicans, President Obama on Friday stepped up the sales pitch on his health care overhaul as the final elements of his top domestic achievement go into effect. With his legacy and the law's success at stake, Obama said: "The law is here to stay."
Behind the scenes, the White House readied a campaign-style effort to get healthy young people to sign up for the insurance "exchanges" in order to keep premium costs from skyrocketing. On Capitol Hill, House Republicans are planning yet another vote to try to try to repeal the law.
The insurance exchanges are the centerpiece of the landmark overhaul of the nation's health insurance system and the White House mobilization is crucial to the success of the health care law and, by extension, to Obama's place in history as the first president in decades to expand health care coverage.
"There's a lot that this law is already doing for Americans with insurance," Obama said during a Mother's Day-themed event at the White House. "There's a lot more that's going to happen for folks who don't have insurance."
But he cautioned: "We still have a lot of work to do in the coming months to make sure more Americans can buy affordable health coverage."
And he urged the public not to be swayed by what he said were scare tactics from critics of the law who might blame it for rising premiums.
"Don't be bamboozled," he said.
Underscoring the policy and political consequences, the White House plans to employ both the resources of government as well as those of his reconfigured political operation as it aimed to enroll 7 million people in health insurance exchanges between Oct. 1 and the end of March. The goal is to get 30 million people to sign up within five years.
However, the composition of those signing up for the new exchanges matters just as much as the overall totals. In order to keep premium costs down, officials say they must register 2.7 million healthy people between the ages of 18 and 35 in order to counteract the costs of ensuring seniors and people with health problems.
The effort comes as the public remains divided over the health care law. As a result, the White House is planning an election-like campaign to target those uninsured or individually insured young people, an effort reminiscent of the sophisticated voter outreach that helped Obama win twice win the White House. The administration has identified where many of the healthy and uninsured young live and will be working with health clinics, hospitals, churches and other groups to sign them up for the exchanges.
Organizing for Action, an outside political group supporting Obama, will also be involved in the effort to promote the exchanges.
Administration officials say one-third of the young people they need to sign up for the exchanges live in California, Texas and Florida. Just over 50 percent are minorities and 57 percent are men.
The administration's challenge is to overcome both confusion and lack of awareness about the law. A new poll from the Kaiser Family Foundation showed more than 4 in 10 Americans didn't know the Affordable Health Care Act was still law or was being implemented, and about half feel they don't have enough information about the law to know how it will affect them.
However, the officials said they expect some of those views to shift after the exchanges are fully operational, in part because many Americans will realize their health didn't change and those that are uninsured will see the benefits of the law.
Besides enrolling needed participants, the White House effort is designed to rally the public around the health care law to stave off yet another challenge from Republicans. Three years after it became law, the health care overhaul remains a target of GOP lawmakers determined to overturn it.
"Women and families don't need Obamacare's higher costs, 20,000 pages of red tape and regulations, or to be forced off plans they currently have and like, in order to get cancer screenings or other preventive care," Senate Minority Leader Mitch McConnell, R-Ky., said in a statement ahead of Obama's remarks. "As implementation draws closer, the president owes it to these women and all Americans to be straight about those consequences. Rather than another campaign-style event, the President has an obligation to warn all Americans about the train wreck that's headed our way."