Former President Bill Clinton campaigns for his wife, Democratic presidential candidate Hillary Clinton on May 20, 2016, in Sioux Falls, S.D.
Photo by James Nord/AP

What Bill Clinton said (and didn’t say) about ‘Obamacare’

Health care didn’t play too big a role in the vice presidential debate last night, but Indiana Gov. Mike Pence (R) did make a point to say, “Even former President Bill Clinton calls Obamacare a ‘crazy’ plan.” On the campaign trail yesterday, Donald Trump said something similar.

But what exactly did the former president say about the Affordable Care Act?
“The current system works fine if you’re eligible for Medicaid, if you’re a lower income working person. If you’re already on Medicare or if you get enough subsidies on a modest income that you can afford your healthcare,” he said in Flint, Michigan, while speaking at a campaign rally on behalf of his wife.

Clinton continued: “But the people that are getting killed in this deal is small business people and individuals who make just a little too much to get any of these subsidies… So you’ve got this crazy system where all of a sudden 25 million more people have healthcare and then the people are out there busting it sometimes 60 hours a week wind up with their premiums doubled and their coverage cut in half.”
The rhetoric wasn’t exactly on-message, and the former president tried to clarify matters in Ohio yesterday. The ACA, Clinton said, “did a world of good, and the 50-something efforts to repeal it that the Republicans have staged were a terrible mistake. We, for the first time in our history, at least are providing insurance to more than 90 percent of our people.”

Part of the problem here is that the former president was sharing overly simplified thoughts on a complex issue, which is never a good idea during a political campaign.

His reference to a “crazy” system, for example, didn’t appear to reference the Affordable Care Act specifically, but rather, the overall patchwork of the American health care system. And by any fair measure, Clinton’s point about the broader system is certainly fair.

As Vox’s Sarah Kliff explained, “We have a health care system where access to coverage depends on where you live, where you work, how old you are, and how much you earn. When any of those variables change – you get older, move states, switch jobs – you switch to a new type of coverage with its own co-payments, doctor networks, and paperwork. You can’t really compare any of the different programs because they’re all structured so differently. And most of them offer very little transparency about how much health care will actually cost you after you sign up. So, in a nutshell, yes! Our current system is confusing and complex – it was before Obamacare passed, and it still is afterward.”

That’s obviously different from what Pence and Trump said yesterday, when they argued that Clinton had called the ACA itself “crazy.”

But what about the former president’s comments about “small business people and individuals who make just a little too much” to get ACA subsidies “getting killed in this deal”? This was a rather candid assessment, but as the Huffington Post’s Jeffrey Young added:
Hillary Clinton campaign’s platform calls for several enhancements to the Affordable Care Act, like creating a government-run “public option” that would compete with private insurers and allowing near-retirees to buy into Medicare instead of purchasing private coverage. Clinton would also provide tax credits to families who face extraordinarily high health care costs, among other things.

Despite its characterization in the CNN report, Bill Clinton’s assessment of the health care system and the Affordable Care Act mirrors Hillary Clinton’s and Obama’s own.
It’s something to keep in mind as the debate continues.