RENEE MONTAGNE, HOST:
And a big focus back home for President Obama this week is health care. The deadline to sign up for health coverage for 2015 under the Affordable Care Act is this coming Sunday. 9.9 million Americans have signed up for private insurance on federal and state exchanges. And the White House is making a big push to alert people without insurance about the deadline.
DAVID GREENE, HOST:
There are still big challenges from Republicans now fully in charge of Congress and from a case before the Supreme Court that challenges the government subsidies that make Obamacare more affordable. Some supporters of Obamacare say it would be disastrous if the High Court decides against subsidies.
MONTAGNE: We reached senior presidential adviser Valerie Jarrett at her office in the White House. Considered President Obama's closest adviser, she's optimistic about this year's sign-up.
VALERIE JARRETT: We have navigators all across the country. We are working with mayors and governors and local elected officials. We're encouraging people to have conversations within their family, encouraging everybody to talk about the benefits. In fact, just last week, the president invited into the Roosevelt Room here at the White House a group of people who had written him letters.
I remember one young woman said that her mother had nagged her and nagged her and nagged her about getting health insurance, and so she signed up last year. And just a few weeks after receiving coverage, she went to the doctor for what she thought was a bad root canal problem, and it turned out to be a brain tumor. And as a result of the Affordable Care Act, she was able to get the treatment she needed. And so those are the kinds of stories that we're really lifting up so that people who currently haven't signed up understand how it could improve their lives.
MONTAGNE: Well, of course, we all know that Republicans are still strongly believing that the Affordable Care Act should be just plain repealed. But given a Republican-controlled Congress, is it time for the president to compromise on some of the elements that are not core parts of the law, that Republicans have railed against for years? And I'm thinking here on the tax on medical devices, also the designation of the 30-hour workweek as a full workweek for purposes of mandated coverage, are there areas that, you know, the president has held firm on so far, but we could imagine these elements changing?
JARRETT: Well, let's take a step back and remember what the president's trying to accomplish here. He was trying to make sure that every American had the opportunity to purchase affordable health care. These are huge numbers of people who are benefiting from the Affordable Care Act. And so the Republicans in Congress have repeatedly have tried to repeal the entire act. They have not been interested in putting forth a proposal that actually achieves what the president was trying to achieve. And so we're always willing to work with them and figure out how we can provide basic health care to the American people.
MONTAGNE: OK. But still, is there anything that you can name that the president is willing to reach out, compromise, please, if it comes to that, critics of this health care?
JARRETT: That's kind of a theoretical question. When you say compromise, no, we're not willing to compromise on providing access to affordable health care for all Americans. That's the underpinning of this. And the only way that you can, for example, cover pre-existing conditions is to ensure that everybody has the obligation to sign up.
I mean, this is structured in a way you can't cherry pick. You can't just say, yes, I want everybody covered if they have a pre-existing condition. But, no, I'm not going to require everybody to have coverage. The numbers don't work that way. And I think what's really telling here is a reason why the Republicans have not come forward with their own plan is that they can't come up with one that works. They can't make the numbers work.
MONTAGNE: Let me ask you about a challenge coming from a different quarter here. The federal government subsidizes the premiums of a lot of people enrolled in Obamacare insurance plans. The Supreme Court is considering a challenge to the legality of those particular subsidies. In most states, if those subsidies are judged not legal, millions of Americans could suddenly find their insurance unaffordable. The White House has been criticized for not having a backup plan should the Supreme Court rule against the subsidies.
JARRETT: Well, I'd say, first of all, we're confident that the Supreme Court is going to rule in our favor. Second of all, the very same people who are being critical of the administration for not having a backup plan are the people who are challenging the plan in the first place. And so all of our energy is going into marketing the Affordable Care Act, describing the benefits, knowing that we have a high degree of confidence in the Supreme Court coming out in favor of the constitutionality of the Affordable Care Act.
MONTAGNE: Well, one key way of getting more people insured is expanding Medicaid, and quite a few states with Republican governors have refused to expand. But there are indications that some states are on the fence. What is the president doing about that?
JARRETT: Yeah. That's a really good question. So so far, 28 states and the District of Columbia have expanded Medicaid. And we have been working both sides of the aisle with governors and state legislators, encouraging them to do so, Indiana being the most recent state that decided to do so. And just recently, the Executive Committee of the Governor's Association came in and met with the president, and he encouraged them all to work very closely with his secretary of Health and Human Services who is, you know, taking a personal interest in working with each and every state to see whether there are opportunities to tailor the expansion to meet their needs. And so we are working aggressively to see what we can do with the remaining states to encourage them to expand.
MONTAGNE: I'm curious. What is changing their minds?
JARRETT: I think pressure from their constituents who are saying, wait a minute. Right next door, I would be eligible for affordable care and here I can't. Well, why not? And they're also facing the cost of having to make sure that the residents of their community have access to health care. So the governors who have come around are listening to the residents of their state and meeting that demand.
MONTAGNE: Speaking to us from the White House, Valerie Jarrett, senior adviser to President Obama. Thank you very much.
JARRETT: You are welcome. It's a pleasure. Transcript provided by NPR, Copyright NPR.