LITTLE ROCK, Ark. -- Former President Bill Clinton, once dubbed America's "secretary of explaining stuff" by President Obama, laid out a rigorous defense of the Affordable Care Act on Wednesday, urging supporters and detractors of the health care reform law to work together on its implementation instead of refighting the "same old battles."
"The benefits of reform can't be fully realized and the problem certainly can't be solved unless both the supporters and the opponents of the original legislation work together to implement it and address the issues that arise whenever you change a system that's this complex," he said during a speech at the Clinton Presidential Center in Little Rock, Ark. "We all get paid to show up for work, and we need all hands on deck here. The health of our people, the security and stability of our families and the strength of our economy are all riding on getting health care reform right and doing it well. That means we have to do it together."
Clinton urged Obamacare's supporters to recognize the need to adapt and change as implementation reveals problems with the law - "And there are some," he said.
At the same time, however, he challenged opponents of the law to recognize that the "direst predictions" about the law's adverse consequences "have not materialized," and that the law has "already done a lot of good."
Clinton's bottom line: "Do the best you can to implement this law. Be up front and open about the problems that develop, and deal with them."
The former president said he was "amazed at how much misunderstanding there is" about America's current health care system, which he called "unaffordable and downright unhealthy," and how Obamacare would change it.
He rebutted fears that Obamacare would increase the growth rate of health care spending, noting that health care inflation in the last few years has been at a record low. Some of that slower inflation he attributed to the "hangover" from the 2008 economic crisis, but part of it is due to Obamacare, he said.
He criticized those state governments that have declined to accept federal money to expand the Medicaid program, saying their lack of cooperation means their taxpayers will pay for services that will end up going somewhere else. He compared the move to a state declining to accept federal highway money while its citizens continue to pay the gas tax that funds that element of the transportation budget.
He also disputed the fear that Obamacare would force employers to shift employees from full time to part time to avoid having to pay for their health care coverage, noting that since 2010 - the year the law was passed - 90 percent of the new jobs created in America have been full-time.
Still, Clinton conceded, there are problems that inevitably arise with a reform program this comprehensive. As one example, he cited the tax credits provided to small-businesses to subsidize the cost of providing insurance to employees. Businesses are only provided tax credits for 25 employees currently - an inadequate system that "needs to be improved," he said.
He also said the Supreme Court's decision to allow states to opt out of the Medicaid expansion has created problems by preserving coverage gaps in states that refuse to participate. That particular problem, Clinton said, can only be addressed by the states themselves.
Clinton hailed those states - particularly those run by Republican governors and legislatures - that have worked to implement the law despite the partisan furor, saying Congress would do well to heed their example of cooperation.
The Republican-controlled House of Representatives, Clinton noted, has held "40 votes to repeal this law" but presented "no real alternatives" to fix the current system.
Despite Clinton's message of reconciliation, detractors of Obamacare continue to raise objections to the law, most recently condemning a proposed public relations campaign urging citizens to enroll in the law's insurance exchanges.
Sen. Marco Rubio, R-Fla., in a letter to Health and Human Services Secretary Kathleen Sebelius on Tuesday, noted that the Obama administration proposes to spend $8.7 million dollars on the campaign to publicize the insurance exchanges and blasted the proposed expenditure as a "blatant misuse of federal dollars."
"Until critical questions can be answered regarding the availability and type of health insurance to be provided by Obamacare, it is unconscionable to spend taxpayer dollars to promote and advertise ObamaCare plans that have yet to be finalized," he said.
Administration officials have noted that past health care reform efforts, including President Bush's 2005 expansion of the Medicare prescription drug program, have been aided by a publicity campaign, according to the Hill.
Republicans and Democrats are currently locked in an epic struggle over funding for Obamacare. Democrats are near-unanimous in their drive to implement the law as planned, but Republicans who want to de-fund the law are divided over how best to accomplish their shared goal.
Some, like Rubio as well as Sens. Ted Cruz, R-Texas, and Rand Paul, R-Ky., have urged Republicans to use an upcoming budget fight to insist on the law's undoing even if it results in a government shutdown, while other Republicans have warned that a shutdown would do nothing to stop the law's implementation and could well damage Republicans politically.