Bill Clinton's Obamacare remarks put Hillary on the hot seat

Former President Bill Clinton put his wife in a tough political spot by re-injecting Obamacare into a policy-free presidential race — with just 35 days until Election Day and the media intensely focused on Donald Trump’s tax returns.

Clinton’s comments about “this crazy system,” as he referred to Obamacare Monday night, threaten to shift the campaign’s focus to the Affordable Care Act and its mounting problems, among them, soaring health insurance premiums, fleeing health plans and young people reluctant to sign up for coverage.


Even more importantly, Bill Clinton’s frank take on Obamacare’s shortfalls tees up more policy questions for Hillary Clinton, the candidate -- so much so that Clinton herself felt the need to address them only hours later. "I’ve been saying we’ve got to fix what’s broken and keep what works," she said, "and that’s what exactly we’re going to do."

She contrasted her commitment to tackle premium and drug costs with Trump's proposal to scrap the Affordable Care Act altogether, which she said would turn the health system "back over to the insurance companies."

All the while, Trump and other Republicans gleefully exploited the ex-president’s health care tirade as evidence the health care law is not working -- and that Clinton herself is part of that legacy of Democratic dysfunction.

"Did you hear yesterday?” Trump asked supporters at a rally Tuesday in Prescott Valley, Arizona. “...President Bill Clinton came out and told the truth about Obamacare. “... He’s absolutely trashed President Obama’s signature legislation."

“At least he’s honest,” Trump said, while noting that Hillary Clinton “wants to double down on Obamacare.”

At a campaign event for his wife in Flint, Mich., Bill Clinton had praised the law for insuring millions of Americans, but noted that many middle-class Americans were still unable to afford coverage and talked up his wife's plan to allow those close to retirement age to buy into Medicare.

“The people who are getting killed on this deal are small business people and individuals who make just a little too much to get any of these subsidies because they’re not organized," he said. "They don’t have any bargaining power with insurance companies so they’re getting whacked.

“So you've got this crazy system where all of a sudden 25 million more people have health care and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It's the craziest thing in the world."

Republicans see Bill Clinton’s comments as validation of what they’ve been saying all along about Obamacare’s woes. “It is unusual when a high-profile Democrat states the obvious about the law—with premiums rising rapidly and coverage getting worse,” says Michael Cannon, health policy director for the libertarian Cato Institute. “Clinton was flirting with the reality on Obamacare, you could say.”

Hillary Clinton has long acknowledged affordability problems with the Affordable Care Act, promising to build on and tweak the law instead of scrapping it as Trump has promised. She just didn’t say it as bluntly as her husband.

But the former president's comments about the plight of those unable to afford coverage dredged up Democrats’ worries about electoral backlash against Obamacare, just as sign-ups for the next year are set to begin Nov. 1, and as the Obama administration tries to woo enrollees, particularly the young and healthy.

So far, the Clinton campaign is not completely distancing itself from Bill Clinton’s comments, nor are those close to the couple.

“I think what he was saying was maybe less than precise language, but he was saying what all Democrats say, which is that the Affordable Care Act is a historic achievement that’s made a difference in the lives of millions of people,” says Chris Jennings, a former top health care official in the Clinton White House. “He was saying, just as Hillary Clinton has said, that it needs to be improved.”

A spokesman for Bill Clinton said accused media outlets of taking his description of the law's shortfalls "out of context."

“President Clinton spoke about the importance of the Affordable Care Act and the good it has done to expand coverage for millions of Americans. And while he was slightly short-handed, it's clear to everyone, including President Obama, that improvements are needed,” says Angel Urena. "That’s why Secretary Clinton has proposed measures including tax relief to cover excessive out-of-pocket costs, a public option and Medicare buy-in for those over 55. She'll build on the progress we've made by increasing competition, choice, affordability and the number of Americans with insurance."

Hillary Clinton outlined a number of ideas to try to make health care more affordable in a recent article in the New England Journal of Medicine. She would let Americans older than 55 buy into Medicare; offer a refundable tax credit of $5,000 per family for excessive out-of-pocket health costs; and limit out-of-pocket prescription drugs costs to $250 a month on covered medications, among other proposals.

“The question will be: Do those proposals go far enough and where the money would come to pay for them?” says Larry Levitt, a senior vice president at the nonpartisan Kaiser Family Foundation.

Levitt added: “If you listen to the totality of what Bill Clinton said, it was about affordability challenges that people are still having and some ways of addressing them, and that is a central issue with the ACA right now. If you look at Hillary Clinton’s proposals, she has a number of ways of addressing the problems people still have with health insurance.”