Press Briefing by Press Secretary Jay Carney
James S. Brady Press Briefing Room
2:00 P.M. EST
MR. CARNEY: Hello, everyone. Welcome to the White House for the first briefing of December, at least from this podium. And I hope everyone here had a terrific Thanksgiving holiday and was able to spend time with friends and family. I have no announcements to make so I'll go straight to your questions.
Q: Thank you. There were some reports over the weekend from administration officials on the status of the healthcare.gov website, basically indicating that the worst of the problems are over but there are still other problems in the system. Is the President comfortable with the level that the website is operating at, at this point?
MR. CARNEY: The President believes that the site has been significantly improved and that the teams in place have worked 24/7 for weeks now to make those improvements, including significant improvements that were made over the weekend. But the work is not done. As we've been saying for some time, there would be continued issues that we needed to address and we'll continue to do that. But with the improvements that were made and discussed by Jeff Zients over the weekend, we believe that this website is and will function effectively for the vast majority of users. And each day, we will continue to take steps to make further improvements so that that experience is enhanced for users every day.
Q: Insurers are saying that there's a problem still on the back end where, for those folks that are actually able to enroll, the information that the insurance companies are getting is garbled, incomplete, in some cases totally unusable. Can the administration assure people who have been able to enroll that they will, in fact, have coverage beginning on January 1st?
MR. CARNEY: Well, I'm glad you asked me that question. There's a couple of things I want to say about that. First of all, we are very mindful of making sure that consumers who want coverage starting in January are able to get it. And CMS is reaching out directly to consumers who have already selected a plan to let them know to be in touch with their plan to pay their first premium to ensure that coverage kicks in and know that plans are working hard to make sure their new customers are covered as well. So this is a joint effort to reach out to those who have enrolled to make sure that every step is being -- that they know they need to take all the necessary steps to ensure that that coverage kicks in.
Furthermore, CMS is having daily conversations with issuers to get feedback from them. We have instituted a number of significant fixes to the so-called 834 forms, which are these -- that's the vehicle by which information is transmitted to the issuers. And we believe that the majority of fixes to 834 forms have been made, including significant ones that were made over the weekend. We expect the info now sent to insurers to be vastly improved. But we're going to continue to work with issuers to make sure that whatever remaining problems exist are addressed and fixed.
Q: So you can assure folks that have signed up or will sign up through December 23rd that they will definitely have coverage beginning on January 1st?
MR. CARNEY: Well, I think what I would say is that CMS is reaching out to those who have enrolled to make sure that they know the steps that they need to take to ensure that coverage kicks in. If a consumer enrolls in a plan by December 23rd and makes their first payment by the date set by their insurer, they are covered beginning January 1st. And if consumers are not sure if they are enrolled, they should call our customer call center or the insurer of their choice so that they can be sure they're covered by January 1st.
So we're making -- this is a high priority, making sure that those who are enrolled are aware of the steps that they need to take, including that they need to pay their premiums on time for coverage. We're working with insurers to make sure that those who are enrolled know this information. And we're reaching out -- or we're telling consumers that if they're not sure that they're enrolled, they should call the call center or their insurer directly.
Q: And if I could just ask quickly about the dispute in the East China Sea. Vice President Biden is in Asia right now visiting Japan and China. Is he carrying any kind of message from the White House in terms of this dispute and what the President would like to see from both sides?
MR. CARNEY: The Vice President is on a long-planned trip to Asia that includes several countries. And while a number of issues will be raised in the discussions he'll, have given the increase in regional tensions, the ADIZ that China announced will be an issue the Vice President will raise. He has an excellent relationship with the leaders of all three countries, and he will underscore how important it is to avoid actions that raise tensions and to prevent miscalculations that could undermine peace, security, and prosperity in the region.
This is an opportunity for Vice President Biden to raise our concerns directly with policymakers in Beijing and to seek clarity regarding the Chinese intentions in making this move at this time. It is also an opportunity to confer with our allies Japan and the Republic of Korea, both of whom are directly affected by China's actions.
Q: Jay, along those lines, North Korea is holding this 85-year-old American, Edward Newman. Has there been any progress toward getting him released? And is this something the Vice President is going to raise on the trip?
MR. CARNEY: We are deeply concerned about the welfare of the U.S. citizens held in custody in the DPRK. Kenneth Bae has been in North Korea custody -- North Korean custody for over a year, and we continue to urge the DPRK authorities to grant him amnesty and immediate release. We also urge the immediate release of Merrill Newman, who was detained more recently. Given Mr. Newman's advanced age and health conditions, we urge the DPRK to release Mr. Newman so he may return home and reunite with his family.
Again, I don't have an itemized list of topics of discussion for the Vice President, but in addition to all the important issues that we discuss with the governments of the countries he's visiting, I'm sure that those that are getting a lot of attention right now will be among those issues discussed.
Q: And then back on health care for a second, the queuing system has been activated.
MR. CARNEY: Yes.
Q: Why was this done? And how much has traffic exceeded capacity on the website?
MR. CARNEY: Let me say a couple of things. One of the improvements that has been made since October 1st was the improvement to the queuing system. We absolutely anticipated that on this day in particular, because it is the first workday after the deadline we set for ourselves to make sure that the website was functioning effectively for the vast majority of users, we would see a surge in visitors to the website. And I don't have specific numbers for you, but I can tell you that we are seeing that surge, and I believe the -- and I'll leave it to CMS to give more detail. I believe that something on the order of 375,000 visitors had gone to healthcare.gov by noon today -- 375,000, which is obviously a large number.
One of the fixes that has been made was the new queuing system, the improved queuing system, so that when we saw a surge in users, we would have a means by which individuals who are interested in enrolling would get information about when they can return to the site and enroll more effectively and efficiently, and that way make the whole operation more effective and smooth.
Even for those visitors who aren't ready to buy a plan or enroll in a plan, they can avail themselves of a new option that is available now, which is an improved window shopping tool which will allow them, in greater detail, to -- April, I'll get to you. You look very puzzled, as does Anita. But the new window-shopping tool, the upgraded window-shopping tool will allow visitors to get more detail about the options available to them, and they can do that without enrolling and therefore would not have to get in a queue if they are trying to enroll in a surge period like we're seeing today.
Q: So is today sort of a cyber Monday for healthcare.gov? (Laughter.)
MR. CARNEY: Well, what I can tell you is that I certainly will hope to avail myself at some point today of cyber Monday, anyway, to --
Q: When you get home.
MR. CARNEY: -- when I get home, to begin to make some holiday purchases. But look, what we have said all along about the November 30th, December 1st, December 2nd deadline is that this was a marker along the road towards the progress we need to make. That by November 30th, December 1st, we would see the system -- the healthcare.gov website working effectively for the vast majority of users. But the work is not done, and it will continue. And we will continue to make improvements. We continue to have folks working around the clock on the site to make it more and more effective every day.
And what I was trying to say, and Josh and others were trying to say, including the President, in the days and weeks leading up to this deadline is that it wouldn't all happen at once; that those improvements were being made every day. And we saw those improvements affect positively the user experience every day through November.
So I think that we're not done with the work that needs to be done on that website, but we have I think passed an important milestone when it comes to making it work effectively for the vast majority of users.
Q: And on that note, if you go to the website periodically throughout the day today, and you hit the "login" button or if you go to the "apply online" button, it does take you to that screen where you're asked to leave an email and come back later. That seems to be coming up almost every hour that I've checked it all day long.
MR. CARNEY: I'm sure a lot of journalists are checking it today.
Q: But given the volume, it's probably not affecting it that much. But I just want to -- I mean, is that going to be acceptable if that's the norm for a lot of people for an extended period of time?
MR. CARNEY: What I think is important to note is that the queuing system, the more sophisticated, improved queuing system is a feature designed to improve the user experience; that when we talked about concurrent users it was always going to be the case, as we anticipated, that on a day like today we would see a surge beyond even the vastly improved capacity levels that are the result of the changes that have been made and fixes that have been made. And what was important -- and we talked about this before November 30th -- is that we have a queuing system made for a better user experience so that individuals could get in that queue, could be notified when was the best time to return to healthcare.gov and enroll, if they so desired.
As I mentioned earlier, among the other improvements made to the site is an improved and more sophisticated window-shopping tool, which Americans who are only at the stage now of looking at the options available to them can avail themselves of without enrolling and without -- if they're visiting a site during a surge period, without having to get in a queue.
Q: Yesterday -- on a conference call yesterday, Jeffrey Zients seemed to take issue with the management structure and style that had been in place in guiding healthcare.gov to its launch. Was he talking about Secretary Sebelius? Who was he talking about when he seemed to question the way that that process was being managed?
MR. CARNEY: I think what Jeff has been tasked with doing and is working on every day is improving the management of the healthcare.gov operation, and focusing specifically on the teams that are making the fixes necessary to the website. And that work has been ongoing and it has delivered significant improvements.
What I'm sure Jeff was also referring to is something that we've all been quite candid about: The website did not function nearly up to standards that were necessary come October 1st, and it should have. And that's on us. And that's why we've dedicated the resources and brainpower that we have to fixing it, because this is all about the goal we set with the passage of the Affordable Care Act, which is that millions of Americans need to be able to avail themselves of quality, affordable health insurance, for many of them for the first time, or the first time in many, many years.
And we focus on that, and healthcare.gov and the other avenues by which you can enroll are means to that end. But it is absolutely our responsibility to make sure that that website, which is an important part of the process of getting those Americans who want quality, affordable health insurance enrolled works effectively. And Jeff has been an important part of that effort since he came onboard to do this.
Q: Can you clarify the 375,000 really fast? The three -- well, the four of us now are kind of confused. Is it just for today?
MR. CARNEY: Yes, by noon today, 375,000 visitors to the site.
Q: Starting with when?
MR. CARNEY: I believe that is today's figure, not today's and yesterday's. But CMS will be --
Q: Today's figure.
MR. CARNEY: Today's figure. So that is just today.
Q: From midnight on to 12 noon?
MR. CARNEY: I think that's correct. So I believe CMS will be briefing and will have more information available, but I was given that before I came out to give you a sense of the volume that we're seeing -- which, again, we anticipated, which is why it was so important to put in place the queuing system, because I know those are just visitors, but there are obviously those who are trying to and want to enroll, and we want to make sure that their experience is vastly improved and that if they are trying to enroll during a surge period, that they are given the information they need to make sure that they're in a queue and can come back to the site at a time when it will be more effective and efficient for them.
Q: Can I just follow up on that? But that's vastly more than they say they can handle in a day, right?
MR. CARNEY: No, the day figure was 800,000 I believe.
MR. CARNEY: Yes.
Q: And so you expect the surge, that's a one-day thing, or you think it will --
MR. CARNEY: I would refer you to CMS for what their expectations are for numbers. We always expected today to be a big day and --
Q: Why the queuing system, if that's far smaller than the 800,000? See what I'm saying?
MR. CARNEY: Again, there are visitors to the site and there are those who are trying to enroll in the site. You can go and visit and shop. You can spend a little time on it, you can spend a long time on it. But if you register and select a plan, thereby enrolling, that activates a different part of the system and that is where you would get in the queue -- not to visit, but to enroll.
Q: So 375,000 in the queue?
MR. CARNEY: No, April. 375,000 visitors to the website.
Q: Jay, first, another numbers question. There have been reports that 100,000, roughly, were able to enroll in the month of November, about four times the month of October. Is that correct?
MR. CARNEY: I don't have specific data. These are the kinds of things that, as we saw in the previous month, that HHS needs to scrub and collect and gather. What I --
Q: Ballpark? Is that roughly four times --
MR. CARNEY: I simply would urge you to wait until we have hard data from HHS and CMS. What I can tell you is that improvements were made to the website throughout the month of November, as we discussed, and I would expect that the numbers who successfully enrolled in November would exceed the numbers who successfully enrolled in October. But I don't have a hard figure for you.
Q: And in terms of the goal that you set for this moment in time, of the website being functional for the vast majority of users, is it mission accomplished?
MR. CARNEY: Well, as I was saying, Jon, we were working very hard to make the necessary fixes to improve the website so that by December 1st it would function effectively for the vast majority of users. The metrics we used to measure that have to do with response time and stability of the site and the error rate, and I know that Jeff and others who do the CMS briefings have gone into those metrics.
And we believe we made the important progress that we set out to make by November 30th, but as we said in November and I've said just now, the work continues to make improvements that still need to be made to the website. And the focus here is not on -- the endgame here isn't the best possible and most effective website that we can build, but a system by which all those millions of Americans who are clearly interested in enrolling and purchasing quality, affordable health insurance are able to do so.
So that's our goal, and that work continues today. We have passed an important milestone in that effort, but the work continues.
Q: Let me just try to crystallize that down, because we tried to pin you down on what "vast majority" means and you guys didn't want to quantify it. Just very clearly, in terms of the goal you set for this moment in time, is it mission accomplished? Have you accomplished that goal?
MR. CARNEY: Using that phrase is not one I would employ. What I would say is what Jeff said, is that we were able to make the necessary improvements to the website so that the vast majority of Americans who use the website have an experience in which the site functions effectively. It does not mean -- as I know I said in November and October -- it does not mean that there will be no problems with the website going forward. That doesn't even occur on the most highly functional private sector websites.
So what it does mean is that we've made significant progress, we've made the improvements to the system that we hoped we could, and that more work continues.
Q: Well, how do you explain that for most of the day so far people that have tried to get on have gotten that message that the website is too crowded?
MR. CARNEY: Well, first of all, I think I noted the number of people who have visited the website just up to noon today. We completely anticipated and I know telegraphed that we would see surges in the number of visitors and the number of people trying to enroll, especially on a day like today. And that is why we built that queuing system, so that we would improve the experience of those users who visited the site over what they experienced back in October when the website was not functioning effectively for the vast majority of users, and those who were trying to get in weren't being queued up through a sophisticated system that allowed them to return to the site at a time when it would function more efficiently for them.
Q: And what do you say to those -- because we've talked to some today that we've been tracking from the start of this -- who still went on yesterday and today, and still are unable to enroll? What do you say to them?
MR. CARNEY: Well, look, I would say that we have seen steady improvement in the site, and that improvement continued over the weekend and today. What is absolutely the case is that we need to continue our work, and that while the vast majority of users are able to access the site and have it function effectively, on a day like today when you have a surge that we're likely seeing, you're going to get this queue message, potentially, if you're trying to enroll, which allows for you to return to the site when it's going to be less crowded. And that's a vast improvement over the experience that people had during surge periods -- or any period, really -- in early October.
Separately, I think it's important to note, because, again -- and this goes back to some of the confusion -- there are visitors to the site and there are those who are trying to enroll potentially, and it's also the issue of how many overall visitors to the site over a certain period of time -- a day or a half a day -- versus the number of visitors at a given moment, which is what generates the queue message.
So you're able to window shop using a much more sophisticated tool than you were in the past, and we are confident that the number of people who are successfully navigating the system is improving and has improved significantly.
Q: And just one last question. Your predecessor, Robert Gibbs, as you probably saw, said --
MR. CARNEY: Had a great day on Saturday. (Laughter.)
Q: He says -- well, that's true, he did -- it will be inexplicable if somebody --
Q: He didn't score the touchdown. (Laughter.)
MR. CARNEY: I think it felt like he did. (Laughter.)
Q: But Mr. Gibbs says, "It will be inexplicable if somebody involved in the creation of the website doesn't get fired or a group of people don't get fired." Do you agree with that?
MR. CARNEY: Look, what I would say is that we are focused on -- and I know that Robert said this also in that interview -- that it is important to focus right now on making the necessary fixes to the website so that it functions effectively for the vast majority of users, and that we continue to make those fixes so that improvements continue to be made.
Issues on personnel are not something that we're focused on right now when it comes to making the Affordable Care Act work for the American people. We want to make sure that millions of Americans who so clearly are interested, in significant numbers, in the access provided to them by the Affordable Care Act to quality, affordable health insurance are able to get it. And what we've said in past weeks remains true today. We're focused on -- not on Monday-morning quarterbacking. I think the President noted, we'll go back and look at this period and there's no question that he tops the list among those individuals who are frustrated by the failures that we saw with healthcare.gov and its launch. But right now, he wants his team focused on making improvements for the American people who, again, as today is evidence of, are so clearly interested in this quality, affordable health insurance.
Q: While the President was on the West Coast last week, the White House called in several allies in the enrollment campaign for the health care law, and said, next week, don't pursue a big advertising or enrollment push because we're not quite ready. Doesn't that speak to, though the site is improved, it's still core fragility? That even though people who support the law want to get people enrolled, who are ready to launch a public relations campaign to help you get people enrolled, were instructed by this White House, "Hold off because we're not ready yet"?
MR. CARNEY: Well, I think as the numbers that I cited earlier in this briefing demonstrate, our issue is not with the number of people who have demonstrated their interest in coming to the website and potentially enrolling and getting covered. So we're focused on making sure that that process works for the many, many Americans who are --
Q: These people want to make it work.
MR. CARNEY: Yes, and so do we.
Q: And they have lots of people they want to communicate with --
MR. CARNEY: What I'm saying is that in the first week of December --
Q: -- to say, "Go to the website," and you're still saying -- even with all this happy talk, you're saying, "Don't do it yet because it's not ready yet."
MR. CARNEY: Well, you know what, Major? For the 375,000 people who visited the site by noon today, I think that they didn't need an advertising campaign to visit. We firmly believed and expected that, in this period in particular, we would see many, many Americans looking at their options and enrolling. And so our focus is on not trying to advertise and get more Americans to do that, because we're seeing those Americans show up already with a demonstrated interest. Our focus is on making sure the website works as effectively as possible, and that the other means that they have available to them to enroll are working as effectively as possible in this critical time.
Q: So there's no need for Families USA or labor unions or other groups, Enroll America, to do anything to advocate for people to --
MR. CARNEY: What I'm saying is that -- and this goes to your question -- that on December 2nd and this week, we do not see a need to inform people of the fact that they can go to the website and look at their options and enroll. So we're seeing --
Q: What they need is a functional website.
MR. CARNEY: What's that?
Q: What they need is a functional website that can handle large capacity and help them get enrolled, right?
MR. CARNEY: Again, Major, the website -- and I would point you to the briefings, the many briefings that Jeff Zients and others have given -- as originally designed and as we're targeting for this period, so that it was actually functioning as effectively as it was supposed to function on October 1st, had numbers associated with concurrent users and total visitors in a day that we believe we can achieve. But surge periods were always going to exceed that, which is why it was important to make the improvements to the queuing system that we made.
So in a week like this, when we expect heightened interest, and heightened interest demonstrated by the number of visitors to the website and the number of people trying to enroll, we believe that -- and I think the numbers are bearing us out -- that the focus this week ought to be on making sure that those systems work as effectively as possible.
Q: Let me pick up on that last sentence -- the heightened interest this week. People who are close to the website and also on the projections that you made internally view not this week, not next week, but two weeks from now is a real crucial period of time, because they believe -- and the Massachusetts experience reminds them of this -- that for those who want coverage by January 1st, there's probably going to be an even bigger surge than we saw today or likely to see this week from people probably from December 15th to December 23rd, the final deadline if you want your coverage to be effective on January 1st. So you've got to have this site ready not just for this week but for what's projected even internally here to be even larger numbers of people who are not going to be sort of visiting the site, but needing to get that coverage so they have it on January 1st. Are you confident, is the President confident that the website is going to be ready for that expected and projected surge of people?
MR. CARNEY: We are confident that we've achieved significant improvement in the website and its functionality, as measured by the metrics that we've gone over thus far, and that we will continue to make progress and improvements to the website in the days and weeks ahead.
So you're absolutely right that for those who want coverage on January 1st, they need to have enrolled by December 23rd and obviously to have paid their premium by the deadline set by their insurer. So --
Q: And I'm told this is going to be the biggest spike that this administration will have seen in people coming to the website and seeking coverage -- bigger than they would see now.
MR. CARNEY: That may be the case, but I would refer you to the CMS briefings for what they might have about their expectations. I think it's always been the case, as we've anticipated this even prior to the problems that we had with the website, that you would see relatively small levels of enrollment in the first month -- in our case, it was much smaller even than the levels expected because of the problems with the site -- and that those numbers would increase and that they would increase significantly as we approach certain deadlines. December 23rd is one; March 31st is another.
Q: Would you agree that that period and the usability of the site and the functionality and whether people can get what they need by December 23rd will be the next biggest test of this entire process?
MR. CARNEY: I would certainly agree that that is an important period, that all these days in December are important and every day from now until March 31st is important, to make sure that everybody out there who wants to enroll and then purchase quality, affordable health insurance is able to do so. And it's on us to make sure that they have the means and the tools necessary to do that.
So that's why we're continuing to work; that's why we continue to make improvements and changes that we've made. We believe that the improvements made thus far have been significant, that the website as it functions today is vastly improved over what it was on launch day. But we're going to continue to work every day to make sure that the experiences for users is as good as possible.
Q: On China, real quickly -- what does the administration think is at stake right now? It's been a long time since there's been any kind of even low-level sense of potential military misunderstanding, military confusion, military confrontation with China. What is at stake in this situation right now?
MR. CARNEY: Well, let me say that the United States remains deeply concerned that China announced the establishment of an East China Sea Air Defense Identification Zone -- that's the ADIZ I mentioned earlier. This appears to be a provocative attempt to unilaterally change the status quo in the East China Sea, and thus raises regional tensions and increases the risk of miscalculation, confrontation, and accidents.
We are consulting and coordinating closely with Japan, the Republic of Korea and our friends and allies in the region. China announced the ADIZ without prior consultations even though the newly announced ADIZ overlaps with parts of the longstanding ADIZs of Japan, the Republic of Korea, and Taiwan, and includes territory administered by Japan.
We do not accept the legitimacy of China's requirements for operating in the newly declared ADIZ. And the fact that China's announcement has caused confusion and increased the risk of accidents only further underscores the validity of our concerns and the need for China to rescind the procedures.
As we have repeatedly said and our actions have demonstrated, we believe that these kinds of provocations create risk of miscalculation, and we don't accept the legitimacy of what China announced. So the Vice President is in the region, as you know, holding important meetings, and we're obviously consulting --
Q: Is he carrying that specific message you just read?
MR. CARNEY: Absolutely, yes.
Q: Directly to Chinese leaders?
MR. CARNEY: Yes.
Q: Can you square that with the administration's recommendation that some of the civilian aircraft identify and go through the procedures that China has now requested, even though it does not recognize and considers this ADIZ invalid?
MR. CARNEY: Yes. For safety and security of passengers, U.S. carriers operating internationally operate consistent with notices to airmen issued by foreign countries. However -- and let me be clear -- this in no way indicates U.S. government acceptance of China's requirement in the newly declared ADIZ, and has absolutely no bearing on the firm and consistent U.S. government position that we do not accept the legitimacy of China's requirements. This is about the safety and security of passengers; it is not an indication of any change in our position. We do not accept the legitimacy of China's requirements.
Q: Jay, I just want to go back to health care. It sounds like you didn't meet the deadline, the more I listen to your answers, because Ezekiel Emanuel yesterday said the website is working "reasonably well;" you say it's vastly improved, there's been significant progress, but not necessarily that it's working well and effectively for the vast majority of users, as you acknowledged what Jim and Jon and Major and others have said that people going on, they're still getting the same error messages they got three days ago.
MR. CARNEY: I think you're confusing error messages with the queuing message, which is quite a different thing entirely. The queue message is a specific tool that was upgraded and improved to be more sophisticated so that when there were surges in traffic on the website and when the number of users reached a certain level that people would get those messages that they were placed in a queue, that if they wanted to enroll there was a better time for them to come back.
Q: I understand that, but they're still not enrolling. They're in a different line now, but they're not --
MR. CARNEY: Well, actually, Ed, I contest that and I would ask you to find anywhere where I said that everybody would be able to enroll instantly on this day.
Q: What's the goal then? Just to keep moving them into other lines? I mean, the goal is obviously to enroll more people, right?
MR. CARNEY: Absolutely. And those people who want to enroll --
Q: So if they're still waiting --
MR. CARNEY: Ed, I would point you to the fact that more people are visiting the site and are able to effectively go from beginning to end when it comes to enrolling than was the case in October and in November. Significant improvements have been made, and the vast majority of users we believe are able to use the website and have it function effectively for them.
That does not mean and we never said it would mean that there would be no problems moving forward, that there would never be an error message or a delayed response for a page to load. That's certainly not the case with even the most high-functioning commercial websites of complexity and size. But what our goal is, is to make sure that we continue to improve the overall experience, because the purpose here is to make sure that Americans have access to quality and affordable health insurance. And the healthcare.gov site is an important part of that; it's not the only part. But we're continuing to work every day to make the improvements that are necessary.
Q: Quick question. You compare it to the private sector. The progress report put out by the administration over the weekend said, "The team is operating with private sector velocity and effectiveness now." Can you reasonably expect that it's working to that effectiveness, according to the administration, with, by your own estimation, 24/7, bringing in outside consultants? Is it reasonable to expect that you can keep that same level of private sector velocity and effectiveness, as you call it, over the next months, years, as it's really the government doing it, not the private sector? This is a government operation and it was not obviously working before. You now say it's working with private sector velocity. Can you reasonably keep up that pace in the days ahead?
MR. CARNEY: Well, I'd say a couple of things about that. The answer is, yes, we can, in the days ahead, continue to work around the clock, as we have in recent days and weeks, to make the necessary improvements. Two, what is absolutely the case is that the private sector does some things very well and better than the government can, and running effective websites may be one of them, is one of them. What the Affordable Care Act demonstrates is that it is important for government to take action in order to, for example, do something the private sector has failed to do, which is reduce the inflation rate in health care costs.
What we saw prior to the passage of the Affordable Care Act was enormous increases annually in the amount of money that this country spends on health care. And what we have seen since the passage of the Affordable Care Act, contradicting every prediction made by Republicans who opposed to it, is that the costs of health care and the growth in those costs have been declining. And that is a significant goal set by the Affordable Care Act and a significant achievement over these three years. These three years have seen the lowest growth in health care costs of any time in the past half-century.
So we're going to keep -- I mean, it goes to the -- I think the heart of the matter is, was the launch of the website unsuccessful? The answer is yes. Was it absolutely our responsibility to take every measure necessary to make the fixes we could make so that that website functioned more effectively for the Americans who want -- they don't want an effective website; they want health insurance. They want affordable, quality coverage. And that's what we're working to achieve.
Q: On that point, long term, not the short-term squabbles now with Republicans -- David Plouffe on Sunday was talking about the subject of Medicaid expansion, and he said -- again, he was talking about Medicaid, not necessarily the -- "It may take until 2017, when this President leaves office. You're going to see almost every state running their own exchanges, expanding Medicaid, and I think it will work really well then." Is that sort of the long-term goal here, that it's going to take years? This is not months in terms of not just Medicaid --
MR. CARNEY: Well, when it comes to Medicaid expansion, I think that David made an important point, which is based on the decision allowed by the Supreme Court ruling of a number of Republican governors to cut their constituents out of the possibility of getting covered through Medicaid. And what we have seen is a number of Republican governors make the decision against the ideological advice of their counterparts to expand Medicaid coverage for their constituents in Ohio, in Florida and Arizona and elsewhere.
And what I think David Plouffe was saying is that because of the wisdom of that choice for those constituents, that eventually -- and I don't think 2017 is that far in the distance when we're talking about the number of states that still need to make the decision to expand -- that eventually that decision will be made even by Republican governors, because there are millions of Americans who are being left out of the possibility of getting covered by Medicaid because of that very political ideological decision some Republican governors made. And we're continuing to work with states to urge them to provide that benefit to their constituents.
Q: But there are, as you know, other Democrats saying they'd like to see improvement by 2014. They've got a big election coming up.
MR. CARNEY: Well, again, you noted in your question that we're talking about Medicaid and expansion --
Q: But Medicaid is critical to turn the corner on this whole thing.
MR. CARNEY: Well, I don't think that's what David was saying. We were going to see -- we have seen improvements. And I think that if you talk to Democrats who are as frustrated as we are with the way the launch of the website began, they would also say that there have been significant improvements in the functionality of the website and that we passed an important milestone on November 30th.
But that work continues, and we're going to see those improvements continue over the course of December and into next year, because as I think someone noted earlier -- Major -- about the deadlines that we're looking at, we're looking at making sure that those Americans who want insurance through the exchanges have it if they want it by January 1st, and also that everybody who wants to enroll during the six-month enrollment period is able to do so by March 31st.
And I promise that beginning tomorrow I'll do the back again. I'm sorry, for those in the back. Yes.
Q: Knowing that we've discussed these last -- you can be succinct in some of your answers to these, but just to make clear that I understand some things -- the 375,000 number that you brought to us today, do you have any sense of what number of those people actually were able to get through the site as far as they wanted versus had to queue? Because many of the people in this row, I guess, as they discussed, who have tried, were among those who had to queue. So 375,000 got to do whatever they wanted, or just checked out the site?
MR. CARNEY: I would refer you to CMS. That is an overall visitors to the website figure, which I think simply demonstrates the level of interest today, which we anticipated.
Q: Understood. We'll ask CMS. In the document, as Ed just referred to, it says that the tech team is able to work with private sector velocity and effectiveness. Isn't that in the very language that they used a concession or an indictment of the way government works, that we're now -- only now able to achieve something similar to what the private sector does?
MR. CARNEY: I think it's an assessment of how the website worked on October 1st and that what Jeff Zients and those he's working with set out to achieve by November 30th was --
Q: But he said the tech team is working at that level. He didn't say the website is working at private sector velocity.
MR. CARNEY: Well, the tech team is working on the website. And I think as somebody with a huge amount of experience in the private sector, Jeff is able to make the assessment that he did -- that we have a team that he's managing, or helping manage, that is working at peak effectiveness, if you will. And because of that, they've been able to make some of the improvements that we wanted to make and will continue to work to make sure that this experience for those millions of Americans who want quality, affordable health insurance continues to improve.
Q: The CBO set a number by March 31st -- 7 million uninsured Americans would be able to sign up. That was their projection. It wasn't your projection; it was their projection, but still ultimately from this administration. Do you believe that that number right now is still attainable?
MR. CARNEY: Well, again, that was CBO's projection, not ours. I'm not aware that we put a numerical projection on what we hope to see by March 31st. I think that --
Q: Is your number still attainable?
MR. CARNEY: Our goal is to make sure that everybody who wants to enroll through the exchanges is able to do so during the open enrollment period, and that we believe those numbers will be sufficient and that the pool of people who enroll will be of the necessary diversity to make sure that the ACA works as envisioned -- and that the exchanges, rather, work as envisioned.
So I would -- for some of these numerical questions, the CMS briefing might be a better place to go. But we believe that as we continue to see improvements and we continue to see Americans successfully register and enroll, that we will begin to make the progress necessary towards the kind of population of people who are going to avail themselves of insurance on the exchanges that we hoped.
Q: Finally, I want to get your thoughts. Senator Dianne Feinstein said when asked, "Are we safer now than we were a year ago, or even two years ago," she said, "I don't think so. I think terror is up worldwide. The statistics indicate that. The fatalities are way up." She went on and on. I just want to get a sense from you right now if you disagree with that statement.
MR. CARNEY: Well, I didn't see that statement, but I can tell you that we share with Senator Feinstein and every other lawmaker who focuses on these issues the belief that we need to be intensely vigilant as a nation in making sure that we're doing everything we can to protect ourselves against those who would do us harm.
Q: So to be clear, are we safer? In your perspective --
MR. CARNEY: Again, I don't think that that work is ever done, Peter, and that every day that we succeed in thwarting potential attacks against American interests, Americans, our allies is important, but that that work never ends and we are ever vigilant as we combat the many threats that this country faces.
Q: The White House has indicated that when Jeff Zients moves to his NEC post that someone would succeed him in the role of heading up healthcare.gov. Could you tell us what the White House is looking for in Zients's successor and whether that person would report directly to the President?
MR. CARNEY: The role, as I understand it, that Jeff has played and continues to play will be filled when he leaves and, as you noted, will take over as Director of the NEC -- because the President believes and Secretary Sebelius believes that that is an important role, and that we have seen in the way that Jeff has worked in that role that that kind of management position needs to be filled even after he comes over to the White House.
I don't have -- I believe that Jeff works for CMS in his current arrangement, so I don't have any information on what the structure of that will look like for that position moving forward. I don't know that it will look any different than it does today. But it is correct that it is the Secretary's intention and the President's intention that that role continue to be filled after Jeff leaves.
Q: Jay, has a decision been made to delay Jeff Zients's movement from the website special assignment to the White House, to the NEC?
MR. CARNEY: I'm not sure that there was a specific end date on that. I know that Jeff will come to the White House early next year, and that when he does, that position that he's filling now will be filled by a successor.
Q: I noticed that last week, President Obama and you today, and even Josh, were avoiding using the word "Obamacare." Is that now -- you're avoiding that reference?
MR. CARNEY: No, I think, in fact, after the initial stories about that, I came out and talked about Obamacare several times. So --
Q: I know you did. But --
MR. CARNEY: No, I --
Q: But nobody is using the word anymore.
MR. CARNEY: Look, I think what --
Q: Which word was it, Mark?
Q: Obamacare. (Laughter.) I was helping a colleague.
MR. CARNEY: I think we're going to see this somewhere. (Laughter.)
I think that -- I know I'm fine with calling it Obamacare, the President is fine with it. We're focused on making sure that the "care" part is delivered to the Americans who want it. And whether it's the Affordable Care Act or Obamacare or anything else, what matters to the President is that the benefits available to every American who gets covered, either through the exchanges or has coverage already, are delivered.
Now, let's not forget that already millions of millions of Americans, every one of us who has insurance coverage, already has benefits from the Affordable Care Act -- from Obamacare. That if you have a child between 18 and 26, that child is now able to stay on your insurance coverage, whereas before he or she was not. There are benefits when it comes to the inability now of insurers, because of the Affordable Care Act, to throw you off a plan or deny you coverage if you have a preexisting condition.
And the list of existing benefits and benefits that will kick in once the exchanges kicks in is long. And that's what we're focused on. We're focused on the care, and we're focused on making sure that the Americans -- the millions of Americans who clearly want affordable, quality health insurance are able to get access to it and purchase it.
Q: Thanks, Jay. Can you give us an updated estimate on how much it has cost thus far to build and to fix healthcare.gov?
MR. CARNEY: You would have to ask CMS. I know that the -- as we've talked about in the past, that the tech surge, the individuals who came in, came in under existing contracts with contractors. But I don't have a figure on it.
Q: We actually have checked with CMS and they've referred us to budgeted figures, so I'm just wondering, if they were listening, is it okay for them to give us the updated actual figures?
MR. CARNEY: I'll have to refer you to CMS, and I'll talk to CMS. I just don't have that information, Margaret.
Q: Whether it's through the White House or CMS, if we could get up-to-date estimates, that would be great.
MR. CARNEY: Got it.
Q: Awesome, thanks.
MR. CARNEY: April, then Jon.
Q: Jay, on another subject. Could you talk to us about what the President is doing in efforts to try to stave off another government shutdown? Because we understand there are possibilities of some -- maybe a couple days after January 15th, that there could be a situation like there was a couple of weeks ago.
MR. CARNEY: Well, I'd say a couple of things. One, it is hard to imagine that Republicans would want to go down that road again, and I think a number of leading Republicans have assured the American people that they would not shut the government down again over an ideological pursuit. So we are working with the relevant members of Congress and committees and leaders to try to find an agreement on the budget that ensures that we make the investments necessary to help our economy grow, that we make the right choices when it comes to how we fund the variety of things the government does. But I don't have a progress report on that except that we would certainly agree with those Republican leaders who have said since the debacle that they imposed on the American economy and the American middle class ended, that they won't do that again.
Q: The President was asked by Brianna Keilar the night that he came out saying the shutdown was over -- he was asked, should we expect this to happen again? Walking out of that door, he said no. What is this White House doing to prevent that from happening?
MR. CARNEY: Well, again, if I would refer you back to that experience, that we ask for nothing in return for keeping the government open. And we have from the beginning of the year made clear that we are willing, when it comes to budget deals, to make reasonable compromise to ensure that the economy grows faster, creates more jobs, that the middle class is more secure, and that we make the kind of investments that help our economy grow, not just now but in the future. And the only side in this ideological debate, or in this debate that had put forward a comprehensive plan that included both -- all the elements that we've talked about over the last several years was the President's.
So we continue to negotiate in good faith, and we hope and believe that the Republicans who said that they would not shut the government down again meant it when they said it.
Q: And Democrats are saying that $90 billion is just too much. What would the White House say was a good number that they could work with that is acceptable to deal with when it comes to budget cuts?
MR. CARNEY: Ninety -- I'm not sure specifically what --
Q: According to those who are wrangling this out on the Hill, Republicans want to cut $90 billion, and they're saying that's just too much money to cut.
MR. CARNEY: I don't have specific information for you about negotiations, and if I did, I wouldn't negotiate from here. But --
Q: I'm not asking you to negotiate. I'm just asking for information.
MR. CARNEY: Well, I think the President has been very clear about his priorities. I just don't have any more for you on that.
Q: Thanks, Jay. Has the President signed up for Obamacare, or the Affordable Care Act?
MR. CARNEY: I don't have an update for you on that. I know that he will, and has said that he will -- or the White House has said that he will, but I don't have an update.
Q: Do you know what he's waiting for? And when he does do that, will you make it open press? (Laughter.)
MR. CARNEY: I'll get back to you.
Q: Thank you, Jay. Yes. On Ukraine, the Prime Minister of their country has called in some ambassadors and said that the way they look at the recent events -- the events have all the hallmarks of a coup attempt, a potential coup attempt. Basically, my question to you: Is the White House interested in any more color revolutions in any --
MR. CARNEY: Well, we certainly don't consider peaceful demonstrations coup attempts. The violence by government authorities against peaceful demonstrators in Kiev on Saturday morning was unacceptable. While we note that the police have generally exercised restraint since then, there have been a number of disturbing reports of journalists and members of the media being targeted and assaulted by security forces. We urge Ukraine's leaders to respect their people's right to freedom of expression and assembly. These are fundamental to a healthy democracy and the respect for universal values on which the United States' partnership with Ukraine depends.
Consistent with the principles embodied by the OSCE, we call on the government of Ukraine to foster a positive environment for civil society and to protect the rights of all Ukrainians to express their views on their country's future in a constructive and peaceful manner in Kiev and in other parts of the country. Violence and intimidation should have no place in today's Ukraine.
We continue to support the aspirations of the Ukrainian people to achieve a prosperous European democracy. European integration is the surest course to economic growth and to strengthening Ukraine's democracy.
Q: What tools do you expect to use to promote that message?
MR. CARNEY: I just used one of them right now. (Laughter.) Thanks very much.
END 2:55 P.M. EST
Jay Carney, Press Briefing by Press Secretary Jay Carney Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/304559