the president: hello, miami! (applause) thank you so much. well, everybody have a seat. have a seat. it is good tosee all of you! it's good to beback at miami-dade! one of my favoriteinstitutions! love this school.
i want to thank yourlongtime president and great friend, eduardo j. padrã³n. and to all the faculty andstaff, and of course, most importantly, the students,for hosting me -- i want to say how grateful i am. i want to thank thewonderful elected officials who are here today. i'm going to just point outtwo outstanding members of congress -- debbiewasserman schultz --
-- and ted deutch. so this is one of my lastvisits here as president. now, once i'mnot president -- audience member: nooo -- the president: no, no, thegood news is, once i'm no longer president ican come more often. right now, usually i canonly come to florida when i'm working. but when i'm out of office,i can come here for fun.
(laughter) but the first thing i wantto say is thank you for your support, and thank you forthe opportunity and the privilege you've given meto serve these past eight years. i remember standing just afew blocks north of here in the closing days ofthe 2008 campaign. and at that point, we werealready realizing that we were in the midst of theworst economic crisis
of our lifetimes. we didn't know wherethe bottom would be. we were still in themiddle of two wars. over 150,000 of ourtroops were overseas. but thanks to the hard workand the determination of the american people, when i comehere today the story is different. working together, we've cutthe unemployment rate in florida by more than half.
across the country, weturned years of job losses into the longest streak ofjob creation on record. we slashed our dependenceon foreign oil, doubled our production ofrenewable energy. incomes are rising again --they rose more last year than any time ever recorded. poverty is falling -- fellmore last year than any time since 1968. our graduation rates fromhigh school are at
record highs. college enrollment issignificantly higher than it was when we cameinto office. marriage equality is areality in all 50 states. so we've been busy. this is why i'vegot gray hair. but we did one other thing. we fought to make sure thatin america, health care is not just a privilege, buta right for every
single american. and that's what i wantto talk about today. that's what i want totalk about here today. you've heard a lot aboutobamacare, as it's come to be known. you heard a lot about it inthe six and a half years since i signed it into law. and some of the things youheard might even be true. but one thing i want tostart with is just reminding
people why it is that wefought for health reform in the first place. because it was one ofthe key motivators in my campaign. and it wasn't just becauserising health costs were eating into workers'paychecks and straining budgets for businessesand for governments. it wasn't just because,before the law was passed, insurance companies couldjust drop your coverage
because you got sick, rightat the time you needed insurance most. it was because of you. it was because of thestories that i was hearing all around the country, andright here in florida -- hearing from people whohad been forced to fight a broken health care system atthe same time as they were fighting to get well. it was about children likezoe lihn, who needed heart
surgery when she was just 15hours old -- just a baby, just a infant. and she was halfway tohitting her lifetime insurance cap before shewas old enough to walk. her parents had no idea howthey could possibly make sure that she continuedto make progress. and today, because of theaffordable care act, zoe is in first grade and she'sloving martial arts. and she's got a brightfuture ahead of her.
we fought so hard for healthreform because of women like amanda heidel, who liveshere in south florida. as a girl, she was diagnosedwith diabetes -- and that's a disease with costs thatcan add up quickly if you don't have insurance, caneat away at your dreams. but thanks to the affordablecare act, amanda got to stay on her parents'plan after college. when she turned 26, amandawent online, she shopped for an affordable healthinsurance plan that covered
her medications. today, she's pursuing adoctorate in psychology. and amanda said that theaffordable care act "has given me the security andfreedom to choose how i live my life." the freedom and security tochoose how i live my life. that's what thiswas all about. zoe and amanda, the peoplewho i get letters from every single day describing whatit meant not to fear that if
they got sick, or a memberof their family got sick, if they, heaven forbid, were inan accident, that somehow they could lose everything. so because of this law,because of obamacare, another 20 million americansnow know the financial security ofhealth insurance. so do another 3 millionchildren, thanks in large part to the affordable careact and the improvements, the enhancements that wemade to the children's
health insurance program. and the net result is thatnever in american history has the uninsured rate beenlower than it is today. never. and that's trueacross the board. it's dropped among women. it's dropped among latinosand african americans, every other demographic group. it's worked.
now, that doesn't meanthat it's perfect. no law is. and it's true that a lot ofthe noise around the health care debate, ever since wetried to pass this law, has been nothing morethan politics. but we've also always known-- and i have always said -- that for all the good thatthe affordable care act is doing right now -- for asbig a step forward as it was -- it's stilljust a first step.
it's like building a starterhome -- or buying a starter home. it's a lot better than nothaving a home, but you hope that over time youmake some improvements. and in fact, since we firstsigned the law, we've already taken a numberof steps to improve it. and we can do even more --but only if we put aside all the politics rhetoric, allthe partisanship, and just be honest about what'sworking, what needs fixing
and how we fix it. so that's what iwant to do today. this isn't kind ofa rah-rah speech. i might get intothe details. i hope you don't mind. so let's startwith a basic fact. the majority of americans donot -- let me repeat -- do not get health care throughthe affordable care act. eighty percent or so ofamericans get health care on
the job, through theiremployer, or they get health care through medicaid, orthey get health care through medicare. and so for most americans,the affordable care act, obama, has not affected yourcoverage -- except to make it stronger. because of the law, you nowhave free preventive care. insurance companies haveto offer that in whatever policy they sell.
because of the law, younow have free checkups for women. because of the law, youget free mammograms. because of the law, itis harder for insurance companies to discriminateagainst you because you're a woman when you gethealth insurance. because of the law, doctorsare finding better ways to perform heart surgeries anddelivering healthier babies, and treating chronicdisease, and reducing the
number of people that, oncethey're in the hospital, end up having to returnto the hospital. so you're getting betterquality even though you don't know thatobamacare is doing it. audience member:thanks, obama. the president:thanks, obama. (laughter and applause) because of the law, yourannual out-of-pocket spending is capped.
seniors get discounts ontheir prescription drugs because of the law. young people can stay ontheir parents' plan -- just like amanda did --because of the law. and amanda was able to stayon her parents' plan and then get insurance after sheaged out, even though she has what used to be calleda preexisting condition -- because we made it illegalto discriminate against people with preexistingconditions.
by the way, before this law,before obamacare, health insurance rates foreverybody -- whether you got your insurance on the job,or you were buying it on your own -- health insurancerates generally were going up really fast. this law has actually sloweddown the pace of health care inflation. so, every year premiums havegone up, but they've gone up the slowest in 50 yearssince obamacare was passed.
in fact, if your family getsinsurance through your job, your family is paying, onaverage, about $3,600 less per year than you would beif the cost trends that had existed before the lawwere passed had continued. think about that. that's money in your pocket. now, some people may say,well, i've seen my copays go up, or my networkshave changed. but these are decisions thatare made by your employers.
it's not becauseof obamacare. they're not determined bythe affordable care act. so if the affordable careact, if obamacare hasn't changed the coverage of the80 percent of americans who already had insurance,except to make it a better value, except to make itmore reliable, how has the law impacted the other 15 or20 percent of americans who didn't have health insurancethrough their job, or didn't qualify for medicaid, ordidn't qualify for medicare?
well, before the affordablecare act, frankly, you were probably out of luck. either you had to buy healthinsurance on your own, because you weren't gettingit through the job, and it was wildly expensive, andyour premiums were going up all the time, and if youhappened to get sick and use the insurance, the insurerthe next year could drop you. and if you had had anillness like cancer or diabetes, or some otherchronic disease, you
couldn't buy new insurancebecause the insurance company's attitude was, youknow what, this is just going to cost us money, wedon't want to insure you. so if you were trying to buyhealth insurance on your own, it was either hugelyexpensive or didn't provide very effective coverage. you might buy a policythinking that it was going to cover you. it was sort of like when iwas young and i bought my
first car, i had tobuy car insurance. and i won't name theinsurance company, but i bought the insurance becauseit was the law, and i got the cheapest one i couldget, because i didn't have any money -- and it wasa really beat-up car. and i remember somebodyrear-ends me, and i call up the insurance company,thinking maybe i can get some help, andthey laughed at me. they're all like,what, are you kidding?
it didn't provide anycoverage other than essentially allowingme to drive. well, that's what it waslike for a lot of people who didn't have healthinsurance on the job. so that meant that a lot ofpeople just didn't bother getting healthinsurance at all. and when they got sick,they'd have to go to the emergency room. audience member: (inaudible)
the president: well,that's true, too. and so you're relying onthe emergency room, but the emergency room is the mostexpensive place to get care. and because you weren'tinsured, the hospital would have to give you the carefor free, and they would have to then make up forthose costs by charging everybody else more money. so it wasn'tgood for anybody. so what the affordable careact is designed to do is to
help those people who werepreviously either uninsured or underinsured. and it worked to helpthose people in two ways. first, we gave statesfunding to expand medicaid to cover more people. in d.c. and the 31 statesthat took us up on that, more than 4 million peoplehave coverage who didn't have it before. they now havehealth insurance.
second, for people who madetoo much to qualify for medicaid even after weexpanded it, we set up what we call marketplaces onhealthcare.gov, so you could shop for a plan that fitsyour needs, and then we would give you tax creditsto help you buy it. and most people today canfind a plan for less than $75 a month at thehealthcare.gov marketplace when you include the taxcredits that government is giving you.
that means it's less thanyour cellphone bill -- because i know you guysare tweeting a lot -- -- and texting and selfies. and the good news is, isthat most people who end up buying their coveragethrough the marketplaces, using these tax credits, aresatisfied with their plans. so not only did obamacaredo a lot of good for the 80-plus percent of americanswho already had health care, but now it gave a newaffordable option to a lot
of folks who neverhad options before. all told, about another 10percent of the country now have coverage. the affordable care act hasdone what it was designed to do: it gave usaffordable health care. so what's the problem? why is therestill such a fuss? well, part of the problem isthe fact that a democratic president named barackobama passed the law.
and that's just the truth. i mean, i worked really,really hard to engage republicans; took republicanideas that originally they had praised; said, let'swork together to get this done. and when they just refusedto do anything, we said, all right, we're going to haveto do it with democrats. and that's what we did. and early on, republicansjust decided to oppose it. and then they tried to scarepeople with all kinds of
predictions -- that it wouldbe a job-killer; that it would force everyone intogovernment-run insurance; that it would lead torationing; that it would lead to death panels; thatit would bankrupt the federal government. you remember all this. and despite the fact thatall the bad things they predicted have not actuallyhappened -- despite the fact that we've created more jobssince the bill passed in
consecutive months than any time on record -- -- despite the fact that theuninsured rate has gone down to its lowest levels ever,despite that fact that it's actually cost less thananybody anticipated and has shown to be much lessdisruptive on existing plans that people get throughtheir employers, despite the fact that it saved medicareover $150 billion -- which makes that program moresecure -- despite all this, it's been hard, if notimpossible, for any
republican to admit it. they just can't admit thata lot of good things have happened and the bad thingsthey predicted didn't happen. so they just keep onrepeating, we're going to repeal it. we're going to repeal it,and we're going to replace it with something better --even though, six and a half years later, they haven't --they still haven't shown us what it is that they woulddo that would be better.
but -- and this is actuallythe main reason i'm here -- just because a lot of therepublican criticism has proven to be false andpolitically motivated doesn't mean that therearen't some legitimate concerns about how thelaw is working now. and the main issue has todo with the folks who still aren't getting enough help. remember, i said 80 percentof people, even before the law passed, alreadyhad health insurance.
and then we expandedmedicaid, and we set up the marketplaces, and another 10percent of people got health insurance. well, but that still leavesthat last 10 percent. and the fact that thatlast 10 percent still has difficulties is somethingthat we've got to do something about. now, part of the reasonfor this is, as i already mentioned to you, not everystate expanded medicaid to
its citizens, which meansthat some of the most vulnerable working familiesthat the law was designed to help still haven'tgotten insurance. as you may have heard,florida is one of those states. if your governor couldput politics aside -- audience: booo -- the president:don't boo -- vote. if your governor would justput politics aside and do what's right, then more than700,000 floridians would
suddenly haveaccess to coverage. and, by the way, that wouldhold down costs for the rest of you, because there wouldbe less uncompensated care in hospitals. and it means that peoplewho did sign up for the marketplace, who oftentimesmay be sicker, qualify for medicaid and so they'renot raising costs in the marketplace. in fact, if the 19 stateswho so far have not expanded
medicaid would just do so,another 4 million people would have coverage rightnow all across the country. so that's step number one. and that's, by the way, justcompletely in the control of these governors. they could be doingit -- right now. they could do it tomorrow. now, the second issue has todo with the marketplaces. although the marketplacesare working well in most of
the states, there are somestates where there's still not enough competitionbetween insurers. so if you only have oneinsurer, they may decide we're going to jack up ratesbecause we can, because nobody else is offeringa better price. in those states where thegovernor or legislature is hostile to the aca, it makesit harder to enroll people because the state is notactively participating in outreach.
and so, as a consequence, inthose states enrollment in the plan -- especiallyenrollment of young people -- has lagged. and what that means isthat the insurance pool is smaller and it gets a higherpercentage of older and sicker people who aresigning up -- because if you're sick or you're old,you're more likely to say, well, i'm going to sign up,no matter what, because i know i'm going to need it;if you're young and healthy
like you guys, you say, eh,i'm fine, life is good -- so you have more older andsicker people signing up, fewer younger and healthierpeople signing up, and that drives rates up, because thepeople who use health care most end up being in theinsurance pool; people who use it least are not. and then, in some cases,insurers just set their prices too low at the outsetbecause they didn't know what the insurance pool wasgoing to look like, and then
they started losing money. and so now they've decidedto significantly increase premiums in some states. now, it's these premiumincreases in some of the states in the marketplacethat sometimes attracts negative headlines. remember, these premiumincreases won't impact most of the people who are buyinginsurance through the marketplace, because evenwhen premiums go up, the tax
credits go up tooffset the increases. so people who qualify fortax credits, they may not even notice their premiumswent up because the tax credit is covered. and keep in mind that thesepremium increases that some of you may have read abouthave no effect at all if you're getting healthinsurance on the job, or through medicaidor medicare. so for the 80 [percent]-pluspeople who already had
health insurance, if yourpremium is going up, it's not because of obamacare. it's because of youremployer or your insurer -- even though sometimes theytry to blame obamacare for why the rates go up. it's not because of anypolicy of the affordable care act that therates are going up. but if you are one of thepeople who doesn't get health care on the job,doesn't qualify for
medicaid, doesn't qualifyfor medicare -- doesn't qualify for a tax creditto help you buy insurance, because maybe you made justa little bit too much money under the law -- thesepremium increases do make insurance less affordable. and in some states, thepremium increases are manageable. some are 2 percent or 8percent, some 20 percent. but we know there are somestates that may see premiums
go up by 50 percent or more. and an extreme example isarizona, where we expect benchmark premiumswill more than double. part of this is becausearizona is one of those states that had really lowaverage premiums -- among the lowest in the country --so now insurance companies basically are trying tocatch up, and they also don't have a lot ofcompetition there. and meanwhile, in stateslike florida, the failure to
expand medicaid contributesto higher marketplace premiums. and then there are someother states that just because of the nature oftheir health care systems, or the fact that they'rerural and people are dispersed, so it's harder toprovide health care, more expensive -- they have atougher time controlling costs generally. again, the tax credits inthe aca will protect most consumers from the brunt ofthese premium increases.
and with the ability to shoparound on healthcare.gov -- which works really well now-- most people can find plans for prices even lowerthan this year's prices. but there are going to bepeople who are hurt by premium increases or a lackof competition and choice. and i don't want to seeanybody left out without i don't want to see anyfamily having to choose between health insurance nowor saving for retirement, or saving for their kids'college education, or just
paying their own bills. so the question we shouldbe asking is, what do we do about these growing pains inthe affordable care act, and how do we get the last9 percent of americans covered? how do we reachthose last 9 percent? and how do we make sure thatpremiums are more stable going forward, and themarketplace insurance pools are more stablegoing forward? well, i can tell youwhat will not work.
repealing the affordablecare act will not work. that's a bad idea. that will notsolve the problem. because right off the bat,repeal would take away health care from20 million people. we'd go back where 80percent of people had health insurance instead of 90percent -- right off the bat. and all the reforms thateverybody benefits from that i talked about -- like youngamericans being able to stay
on their parents' plans,or the rules that prevent insurance companies fromdiscriminating against people because of apreexisting condition like diabetes or cancer, or therule now that you can't charge somebody more justbecause they're a woman -- all those reforms would goaway for everybody, because that's part of obamacare. all the progress that we'vemade in controlling costs and improving how healthcare is delivered, progress
that's helped hold growth inthe price of health care to the slowest rate in 50 years-- all that goes away. that's what repeal means. it would be badfor everybody. and the majority ofamericans, even if they don't know that they'rebenefitting from obamacare, don't want to see thesebenefits and protections taken away from theirfamilies now that they have them.
i guarantee you there arepeople who right now think they hate obamacare. and if somebody told them,all right, we're repealing it, but now your kid who ison your plan is no longer on your plan, or now you've gota preexisting condition and you can't buy healthinsurance -- they'd be shocked. they'd be --what do you mean? so repeal is not the answer. here is what we can doinstead to actually make the
affordable care act workeven better than it's working right now. and i've alreadymentioned one. florida and every stateshould expand medicaid. cover more people. it's easy to do, and itcould be done right now. you'd cover 4 million moreamericans, help drive down premiums for folks whobuy insurance through and, by the way, because thefederal government pays for
almost all of thisexpansion, you can't use as an excuse that, well, thestate can't afford it -- because the federalgovernment is paying it. states like louisiana thatjust expanded medicaid -- you had a republicangovernor replaced by a democratic governor. he said, i want that money. expanded medicaid, and foundnot only does it insure more people, but it's actuallysaved the state big money
and makes people lessdependent on expensive emergency room care. step number two. since overall health carecosts have turned out to be significantly lower thaneveryone expected since we passed obamacare, sincethat's saved the federal government billions ofdollars, we should use some of that money, some of thosesavings to now provide more tax credits for moremiddle-income families, for
more young adults tohelp them buy insurance. it will make theirpremiums more affordable. and that's not just goodfor them -- it's good for everybody. because when more peopleare in the marketplace, everybody will benefitfrom lower premiums. healthier people, youngerpeople start joining the pool; premiumsgenerally go down. that would be number two.
the third thing we shoulddo is add what's called a public plan fallback -- -- to give folks moreoptions in those places where there are just notenough insurers to compete. and that's especiallyimportant in some rural communities and ruralstates and counties. if you live in l.a. right now, then it's working fine. there are a lot of insurersbecause it's a big market, there are a lotof providers.
but if you're in some remoteareas, or you're near some small towns, it may be thatthe economics of it just don't work unless thegovernment is providing an option to makeit affordable. and, by the way, thisis not complicated. basically, you would justwait and see -- if the private insurers arecompeting for business, then you don't have totrigger a public option. but if no private insurersare providing affordable
insurance in an area, thenthe government would step in with a quality planthat people can afford. and, by the way, thisis not a radical idea. this idea is modeled onsomething that republicans championed under george bushfor the medicare part d drug benefit program. it was fine whenit was their idea. the fact that they're nowopposed to it as some socialist scheme is notbeing consistent, it's
being partisan. and finally, we shouldcontinue to encourage innovation by the states. what the affordable careact says is, here's how we propose you insure yourpopulations, but you, the state, can figure out adifferent way to accomplish the same goal -- providingaffordable, comprehensive coverage for the same numberof residents at the same cost -- then go right ahead.
there may be more thanone way to skin a cat. maybe you've got an ideawe haven't thought of. just show us, don'ttalk about it. show us what theplan looks like. republicans who claim tocare about your health insurance choices and yourpremiums, but then offer nothing and blockcommon-sense solutions like the ones that i propose toimprove them -- that's not right.
and my message to them hasbeen and will continue to be: work with us. make the system better. help the people you serve. we're open to good ideas,but they've got to be real ideas -- not just slogans,not just votes to repeal. and they've got topass basic muster. you can't say, well, if wejust do -- if we just plant some magic beans --
-- then everybody will have health insurance. no, we've got to have healthcare economists and experts look at it and see if thething would actually work. so that's where we are. number one, obamacare ishelping millions of people right now. the uninsured ratehas never been lower. it's helping everybodywho already has health insurance, because it makestheir policies better.
number two, there are stilltoo many hardworking people who are not beingreached by the law. number three, if we tweakthe program to reach those people who are not currentlybenefitting from the law, it will be good for them andit will be good for the country. number four, if we repealthis law wholesale that will hurt the people who don'thave coverage right now. it will hurt the 20 millionwho are already getting help
through the law. and it will hurt thecountry as a whole. so this should bean easy choice. all it does -- all itrequires is putting aside ideology, and in good faithtrying to implement the law of the land. and what we've learned,by the way, is that when governors and statelegislators expand medicaid for their citizens and theyhold insurance companies
accountable, and they'rehonest with uninsured people about their options, andthey're working with us on outreach, then themarketplace works the way it's supposed to. and when they don't, themarketplaces tend to have more problems. and that shouldn'tbe surprising. if state leaders purposelytry to make something not work, then it's not going torun as smoothly as if they
were trying to make it work. common sense. you don't even have to go tomiami dade to figure that out. the point is, now is not thetime to move backwards on health care reform. now is the timeto move forward. the problems that may havearisen from the affordable care act is not becausegovernment is too involved in the process.
the problem is, is that wehave not reached everybody and pulled them in. and think about it. when one of these companiescomes out with a new smartphone and it had afew bugs, what do they do? they fix it. they upgrade -- unless itcatches fire, and they just -- -- then they pullit off the market. but you don't go back tousing a rotary phone.
you don't say, well, we'rerepealing smartphones -- we're just going todo the dial-up thing. that's not what you do. well, the same basicprinciple applies here. we're not going to go backto discriminating against americans withpreexisting conditions. we're not going to go backto a time when people's coverage was droppedwhen they got sick. we're not going to go backto a situation where we're
reinstating lifetime limitsin the fine print so that you think you haveinsurance, and then you get really sick or you kid getsreally sick, and you hit the limit that the insurancecompany set, and next thing you know they're notcovering you anymore, and you got to figure out howyou come up with another $100,000 or $200,000 to makesure that your child lives. we're not going togo back to that. i hear republicans incongress object, and they'll
say, no, no, no, no,we'll keep those parts of obamacare that are popular;we'll just repeal everything else. well, it turns out that thesum of those parts that are popular in obamacareis obamacare. it's just peopledon't always know it. and repealing it would makethe majority of americans worse off when itcomes to health care. and as i said, part of thisis just -- you know, health
care is complicated. think about this speech --it's been pretty long, and you're just -- you'rethinking, wow, i just want to take a picture with thepresident or something. so it's hard to get peoplefocused on the facts. and even reporters who havecovered this stuff -- and they do a good job; they'retrying to follow all the debate. but a lot of times they justreport, "premium increases." and everybody thinks, wow,my insurance rates are going
up, it must be obama's fault-- even though you don't get health insurance throughobamacare, you get it through your job, and eventhough your increases have gone up a lot slower. or suddenly you're payinga bigger copay, and, ah, thanks obama. well, no, i had nothingto do with that. so part of it is this iscomplicated, the way it gets reported.
there's a lot of hysteriaaround anything that happens. and what we need to do isjust focus on this very specific problem -- howdo we make sure that more people are getting coverage,and folks right now who are not getting tax credits,aren't getting medicaid, how do we help them, howdo we reach them. and we can do it. instead of repealing thelaw, i believe the next president and the nextcongress should take what
we've learned over the pastsix years and in a serious way analyze it, figure outwhat it is that needs to get done, and make theaffordable care act better and cover even more people. but understand, nopresident can do it alone. we will need republicansin congress and in state governments to actresponsibly and put politics aside. because i want to remindyou, a lot of the affordable
care act is built onrepublican ideas. in fact, bernie sanders isstill mad at me because we didn't getsingle-payer passed. now, we couldn't getsingle-payer passed, and i wanted to make sure that wehelped as many people as possible, given thepolitical constraints. and so we adopted a systemthat republicans should like; it's based on acompetitive, market-based system in which people haveto a responsibility for
themselves by buy insurance. and maybe now that i'mleaving office, maybe republicans can stop withthe 60-something repeal votes they've taken, andstop pretending that they have a serious alternative,and stop pretending that all the terrible things theysaid would happen have actually happened, when theyhave not, and just work with the next president tosmooth out the kinks. because it turns out, nomajor social innovation in
america has ever workedperfectly at the start. social security didn't. its benefits werestingy at first. it left out a wholelot of americans. the same was truefor medicare. the same was truefor medicaid. the same was true for theprescription drug law. but what happened was, everyyear, people of goodwill from both parties triedto make it better.
and that's what weneed to do right now. and i promise, ifrepublicans have good ideas to provide more coverage forfolks like amanda, i will be all for it. i don't care whose idea itis, i just want it to work. they can even changethe name of the law to reagancare. or they can callit paul ryan care. i don't care --
-- about credit, i just wantit to work because i care about the american peopleand making sure they've got but that brings me to myfinal point, and that is change does not typicallycome from the top down, it always comes fromthe bottom up. the affordable care act waspassed because the american people mobilized, not justto get me elected, but to keep the pressure on me toactually do something about health care and to putpressure on members of
congress to dosomething about it. and that's how changehappens in america. it doesn't happenon its own. it doesn't happenfrom on high. it happens fromthe bottom up. and breaking gridlock willcome only when the american people demand it. so that's why i'm here. only you can break thisstalemate, but educating the
public on the benefits ofthe affordable care act, and then pressing your electedofficials to do the right this and supporting electedofficials who are doing the right things. and this is one of thereasons why i'm so proud of what miami-dade college isdoing, because it's making sure that students andfaculty, and people throughout this communityknow about the law, know about how to sign up forhealth care, and then
actually helpspeople sign up. and i'm incredibly proud ofthe leadership joe peã±a and the entire team inencouraging people to sign up. thanks to them, miami-dadehas been hosting enrollment office hours and workshops,even on nights and weekends. right here on the wolfsoncampus, and on all the miami-dade campuses, you cango for a free one-on-one session where a trainedexpert can walk you through the process and answer anyquestions you have -- and
then help you sign up forhealth care right there and then. joe says he doesn't have aconversation without making sure people knowhow to get covered. the more young and healthypeople like you who do the smart thing and sign up,then the better it's going to work for everybody. and the good news is, in afew days, you can do just that because openenrollment, the time when
you can start signing up,begins on november 1. and you just need to go tohealthcare.gov, which works really well now. and campuses will becompeting to come up with the most creative ways toreach people and get them signed up -- and i'm prettysure that miami-dade can set the standard for therest of the country. 'cause that's how you do. that's how you do.
so much has changed sincei campaigned here in miami eight octobers ago. but one thing has not: thisis more than just about health care. it's about the characterof our country. it's about whether welook out for one another. it's about whether thewealthiest nation on earth is going to make surethat nobody suffers. nobody loses everything theyhave saved, everything they
have worked forbecause they're sick. you stood up for the ideathat no american should have to go without thehealth care they need. and it's still true today. and we've proven togetherthat people who love this country can change it -- 20million people out there will testify. i get letters every day,just saying thank you because it's made adifference in their lives.
and what truethen is true now. we still need you. our work to expandopportunity to all and make our union more perfect isnever finished -- but the more we work, and organize,and advocate, and fight, the closer we get. so i hope you are goingto be busy this november signing folks up. but more importantly, ihope, for all the young
people here, you neverstop working for a better america. and even though i won't bepresident, i'll keep working right alongside you. thank you, everybody. god bless you. god bless america. thank you.
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