Administration of Joseph R. Biden, Jr., 2024

March 26, 2024

The President. Hello, hello, hello, Raleigh! Please, all, have a seat. Thank you.

Thank you, thank you, thank you. Please. Thank you.

Lori, thank you for that introduction and for sharing your story with us. As a daughter, a mom, a granddaughterâgrandmother, I should sayâyou're doing everything you can to care for the family and for yourself while still taking care of others in need. You're incredibleâpretty incredible.

And so is Kamala. She is really incredible.

As Vice President of the United States, as attorney general of California, Kamala always fought for people like Lori who stood for the basic truth that health care is a rightâshould be a right not just a privilege in America.

And I want to especially thank your incredible Governor, Roy Cooperâand by the way, he is an incredible Governorâand First Lady Kristin Cooper for welcoming us today and for their friendship.

You know, when I think of the Coopers, I think of one word, and I mean this sincerelyâ highest compliment I can give anybody who has ever been elected to office. They have enormous integrity. They have enormous integrity.

And because Roy Cooper never gave up, North Carolina finally extendedâexpanded Medicaid coverage, which already is helping 400,000 North Carolinians so farâ400,000. That all by itself is a heck of a legacy.

I also want to thank your attorney general, Josh Stein, who defended ACAâand fought to expand Medicaid as well. He's an outstanding leader.

And, folks, look, speaking of great leaders and legacies, 14 years ago this week, I stood by

âPresident Obama when he signed the Affordable Care Act into lawâObamacare. And as many of you know, I thought it was a big deal.

[*At this point, the President made the sign of the cross.*] [*Laughter*] Thank God my mom wasn't around. [*Laughter*]

Well, look, even asâit's even a bigger deal today. The Affordable Care Act is the most consequential health care since Medicare and Medicaid, and that's a fact.

It was always about millions of Americans lying in bed staring at the ceiling at night wondering, "What will happen if I lose my insurance?"

I'll never forget, my dad came home one day. We lived in a three-bedroom house with four kids and a grandpop living with us. And my bedroom wall backed up to where they were. And I could hear my dad was restless as hell. I couldn't understand why.

And the next morningâI was 14 years oldâI asked my mom, "What's the matter?" She said, "Well, they justâhe just lost his health insurance. The company he worked for no longer is paying for health insurance."

You know, there's a lot of people lying in bed at night, staring at the ceiling, literally wondering: "What will happen if my spouse gets cancer or my child gets seriously ill? Will I have enough insurance? Can we afford the medical bills? Will we have to sell the house? What are we going to have to do?"

Because of all of you in this room and across the country, we changed that and made the Affordable Care Act the law of the land.

But Donald Trump and his MAGA friends are, if nothing thanâbut persistent. They've tried to repeal it 50 times. Not a joke. Fifty times they've tried to repeal it, but we stopped them every time.

And now they just released a budget again. A hundred and twenty or a hundred and sixtyâ I'm not sure how manyâof the House Members put out their budget for next year. They want to get rid of the Affordable Health Care Act again.

But I got news for them. [*Laughter*] We're going to stop them again.

Look, Kamala and I have come back to North Carolina to celebrate the ACA and to remind all of us that we can't take anything for granted.

Just think back before the ACA. A patient with a heart disease, diabetes, or a child with asthma couldn't get coverage. Why? Because the insurance company considered those a preexisting condition that allowed them to deny you coverageââ

Audience member. What about health care in Gaza? Audience member. What about the health care in Gaza? The President. Everybody deserves health care.

Audience member. Hospitals in Gaza are being bombed! [Inaudible]

Audience member. Women are being raped! [Inaudible] [The disruption in the audience continued.]

The President. Be patient with them.

They have a point. We need to get a lot more care into Gaza. [*Applause*]

But, folks, back to the subject at hand. Even pregnancy was considered a preexisting condition. Did you all know that?

Wellâ[*laughter*]âfor all the young people out there, before ACA, you could get kicked off your parents' health care plans before you turned 26, just as you're heading out on your own. A lot has changed.

For so many other people, they couldn't leave a dead-end job or start their own business because they couldn't risk losing the health care they had where they were.

And imagine this: Prior to the ACA, many insurance companies imposed lifetime caps on how much coverage your insurance policy can give youâlifetime caps. That meant a cancer patient could be halfway through chemo when they reached the cap and their insurance cut out.

No, I'm serious. I know it sounds hard to believe. Many of you pray to God you haven't had to go through that. But companies would stop covering, andâthat life was put in danger. They just cut off the insurance.

Think about that. At the most vulnerable point in their life, so many Americans heard these words: "Sorry, you're on your own."

Look, for God's sake, this is the United States of America. We're so much better than that.

And that's why the Affordable Care Act is so important and why Kamala and I are making it stronger than ever before.

Folks, through laws I wrote and signedâthe American Rescue Plan, the Inflation Reduction Act, both of which not a single, solitary Republican in the Congress voted forâI enacted tax credits that save an average of $800 per person per year, reducing health care premiums for millions of working families under the Affordable Care Act.

Those tax credits expire next year. I'm calling on Congress to make that $800 expanded affordable health care tax credit permanent. Otherwise, millions of Americans with that coverage could lose their coverage.

Folks, it's because we're making the ACA stronger and more affordableâACA enrollment is breaking records. Today, everyone can get affordable coverage through the ACA. And 80 percentâ80 percentâof the folks on the ACA plan can get a plan for $10 a monthâ$10 a month.

Twenty-one million people covered under ACA, a 75-percent increase just since Kamala and I came to office. And that includes over 1 million folks right here in North Carolina.

And on top of that, more Americans have health care today than any otherâthan under any other President, and it's saving the American taxpayers money. It saves money. They talk about we're spendingâit saves the taxpayers money. It's cheaper to pay for a preventive mammogram than it is to treat a cancer.

And today, 100 million Americans can no longer be denied health insurance because of preexisting conditions, whether you get your insurance through ACA or not. Nearly 25 million low-income adults have gained Medicaid coverage because of ACA, including, as I said, 400,000 right here in North Carolina because of Roy Cooper.

And Kamala and I are making health care more affordable and accessible in other ways as well. Americans pay more for prescription drugs than anywhere else in the world.

I could get you on Air Force One, and you tell me if you have a prescription to fill out here in North Carolina. IâsayâtakeâI could fly you to Toronto, to Berlin, to London, to Rome, and I can get you that same prescription from that same company somewhere between 40 and 60 percent less than you pay for it here.

But through the Inflation Reduction Actâagain, not a single Republican voted for itâwe finally beat Big Pharma. Finally.

For example, instead of seniors with diabetes paying as much as $400 a month for their insulin they so badly need, they now only have to pay $35 a month, period. And by the way, you know how much it costs to make that insulin? Tenât-e-nâdollars. Package it, everything:

$12.50.

Folks, I want to extend those savings to everyone who needs lifesaving insulin, whether you're a senior or notâeveryone. Everyone.

Folksâ[*applause*]âand it saves the American taxpayers money. Guess what that one little act did when we passed it? It saves the American taxpayers $160 billionâ$160 billion. They no longer have to pay $400. They pay $35, among other things.

Folks, forâpeople have talked about giving Medicare the power to negotiate lower prices for prescription drugs the Federal Government pays just like VA pays. I've been fighting for that since Iâand the Congressman and I have been fighting for that since we were almost kids in the Congress. [*Laughter*] Well, guess what? We finally got it done.

Now, that's not just saving seniors money. As I said, it's saving taxpayers, and the Federal deficit is down by $160,000â160 million [billion; White House correction] bucks in the next 10 years. Medicare will no longer have to pay exorbitant, big prices.

Because of the law I signed, Medicare is able to continue to negotiate lower prices for some other of the costliest drugsâfor example, for heart disease, for arthritis. Now it's time to go further and give Medicare the power to negotiate lower prices for even more drugs over the next decade.

This along with other nationsâand other actions we've takenâbut this first time for usâ will not only save lives, it's going to save the taxpayers an additional $200 billion on top of the

160. This saves money. Saves money.

Because the law I signed, starting next year, we've capped total prescription drug costs for seniors on Medicare at $2,000 a year no matter what the total costs are, even for expensive cancer drugs that cost $10-, $12-, $14-, $15,000 a year. It's going to be capped at $2,000 a year and save a hell of a lot more money as well.

And, folks, I want to make sure that's available for everyone. That's my objective in a second term.

And by the way, the pharmaceutical company will still make billions of dollars. They're not going to go broke.

Folks, here's the deal. My predecessor and MAGA Republicans in Congress have a different plan. Let's remember 4 years ago this month we saw how my predecessor didn't care much about science and reason.

During the pandemic that went on to claim 1 million American livesâand for every life claimed, it's estimated there's between 8 and 10 people left behindâTrump didn't level with the American people. He told Americans all they had to do was inject bleach in themselves.

Remember that? Not a joke. You'd think I'm making this up if you wereâ"Just take aâor take a real shotâof UV light."

Even before the pandemic, my RepublicanâRepublicans in Congress were hell-bent on getting rid of the ACA, and they came within one vote. But a close friend of mineâwe used to argue like hell, but we spent a lot of time together over the years. But it failed because of my deceased friend John McCain going like this.

[*The President made a thumbs-down gesture*.]

But even during the deadly pandemic, Trump and his MAGA friends in Congress wanted to get rid of the ACA, kick millions of Americans off their health insurance.

It's sick.

Now they want to, quoteâhis wordâ"terminate" the ACA, as my predecessor says. If that ever were to happen, we'd also terminate a lot of lives as well. But we're not going to let that happen, are we?

Audience members. No!

The President. We're not going to let that happen. Here's what it would mean if they get rid of the ACA.

Because of Donald Trump and his MAGA Republicans in Congress, 45 million people nationwide would lose their health insurance, including 1.4 million right here in North Carolina. A hundred million Americans with preexisting conditions, from heart disease to asthma, could

lose their protection as well. And millions of young people, like a 20-year-old kid who just graduated from college could be kicked off his parent's plan because he can't stay on until he's 26 any longer.

Trump and the MAGA Republican officials want to take us back where cancer patients were cut off from insurance halfway through the chemo because they'd reached what they call "their limit" and thatâwhat their willing to payâthe insurance company.

They want to take us back when women could be charged more for health care and preventive services like mammograms and they'd no longer be free.

AndâI'm seriousâthis is whatâif you didn't know any better, you'd think I'm making this stuff up.

But they aren't stopping there. MAGA Republicans in Congress just proposed a plan to get rid of the power of Medicare to negotiate lower prescription drugs, which could drive the cost of insulin back to 400 bucks a month instead of $35 for seniors and so much more. No, I'mâthis is theirâthey plan to slash Medicaid as a result. It could close out a hundred rural hospitalsâ hundreds of rural hospitals.

You know how these rural hospitals make it? They make it because of the health care plans thatâmade available through the ACA. That's how they can afford to stay open. So many across the countryârural plans are closing because they couldn't keep it open. They couldn't afford to stay open.

The Republican plan would deny millions of seniors with diabetes [disabilities; White House correction] access to quality long-term care they get now under Medicaid.

That includes 30 million children who now have access to Medicaidâthey'd be at risk of losing that coverage as well.

Trump also recently said, about Social Security and Medicareâhe said, quoteâI'm quotingâ"There's a lot you can do in terms of cutting. Tremendous amount of things you can do"âif you cut.

Right on cue, the same budget that 180 House Republicans just proposed to gut Medicare and Medicaidâthey'd also raise Social Security retirement age and slash Medicare, giving billions of dollars in tax breaks to the very wealthy instead. They proposed another $2 trillion tax cut. They raised the debtâlarger than anybody did in f4 years, and they're going toâabout to do it again if they win.

I have a better idea. I'll protect Social Security and Medicare.

Instead of giving the very wealthy another $2 billionâ$2 trillion tax cut, I'm going to make sure the wealthy begin to finally pay their fair share of taxes to sustain these programs.

Folks, my predecessor and MAGA officials are going after seniors and people with disabilities and children. As we all know, they're going after women as well.

Trump proudly says, quote, "After 50 years with no one coming close, I was able to kill *Roe*

v. *Wade*." That's his statement. You've seen it on television.

Well, he's talking about how Donald Trump killed *Roe *v. *Wade*. He says it has to be "punishment" for women exercising their reproductive freedom.

Trump and MAGA Republicans are responsible for the chaos that followed, and they're now calling for a national ban on choice for every Stateâin every State, not just what is in law now.

On top of that, just this morning, the Supreme Court heard a case to gut access to a medication that was approved by the FDA 20 years ago to give women a choice.

Folks, if America sends me a Congress that are Democrats, I promise you, Kamala and I will restore *Roe *v. *Wade *as the law of the land again. [*Applause*] We will.

Folks, look, let me close with this. History is made when you decide there's a greater risk in doing nothing rather than doing something when it comes to the health and well-being of the nation.

Through the leadership of President Obama, we made history with the Affordable Care Act. And while there are those who want to take us back in time, all of us together are determined to move us forward. And here's the future I see.

I see a future where we defend democracy, not diminish democracy. I see a future where health care is a right and we restore the freedom to choose and protect the freedoms, not toâand not take it away. I see a future where the middle class finally has a fair shot and the wealthy begin to pay their fair share.

Folks, you notice the leading economists aren't making much fun of Bidenomics anymore.

They're thinking maybe it works to build from the middle out and the bottom up. The wealthy can still be very wealthy.

You know how many billionaires there are in America? There's now a thousand billionaires. You know what their average tax they payâFederal tax? Eight-point-two percent. Anybody want to trade with a billionaireâtheir tax rate? [*Laughter*]

Well, guess what? If they just paid 25 percentâit's not the highest bracket by a longshotâ 25 percentâdo you know what that would do? That would raise $40â$400 billion over the next 10 years.

Imagine what we could do with that. We could fundamentally slash the Federal deficit. We could make sure there's home care. We could do so many thingsâconsequentialâincluding finally making sure that we take care of Ukraine from that butcher Putin.

Look, I see a future where we save the planet from the climate crisis and our country from gun violence. Above all, a future for all Americans, for a country of all Americans, and I'll always be President for all Americans.

I've never been more optimistic about our future. And I know I'm only 40 years oldâ [*laughter*]âtimes 2, plus 1. [*Laughter*]

Look, we just have to remember who in God's name we are. And I mean this sincerely, and I'll end with this. We're the United States of America.

No, I'm serious. We're the United States of America. We're the only country in the world that's come out of every crisis stronger than we went inâthe only country in the world. There is nothing beyond our capacity when we act togetherânot a single thing.

This is the United States of America. Let's get together and get it done. God bless you all, and may God protect our troops.

Thank you, thank you, thank you.

[*As the President was joined on stage by Vice President Kamala D. Harris and Gov. Roy A. Cooper III of North Carolina, he turned to shake Gov. Cooper's hand*.]

The President. This is the guy, right here, one of the best Governors in America. All right. [Inaudible]

Vice President Harris. ââJoe, all right.

[*The President turned to greet Vice President Harris*.]

The President. Oh, there you are. I was wondering when you were going to come out. [Laughter]

Vice President Harris. I'm right here.

The President. Thanks, everybody.

Every time I'd walk out of my grandfather's house up in Scranton, he'd yell, "Joey, keep the faith." And my grandmother would yell, "No, Joey, spread it." Let's go spread the faith, guys.

Thank you.

NOTE: The President spoke at approximately 3:45 p.m. at the John Chavis Memorial Park Community Center. In his remarks, he referred to Harrisburg, NC, resident Lori Kelley, a beneficiary of North Carolina's expansion of Medicaid coverage under the Patient Protection and Affordable Care Act; Vice President Kamala D. Harris; former Presidents Barack Obama and Donald J. Trump; and President Vladimir Vladimirovich Putin of Russia. He also referred to his sister Valerie Biden Owens and brothers Francis W. and James B. Biden. The transcript released by the Office of the Press Secretary also included the remarks of Vice President Harris and Ms. Kelley.

Categories: Addresses and Remarks : Health care cost reduction efforts in Raleigh, NC. Locations: Raleigh, NC.

Names: Biden, Francis W.; Biden, James B.; Cooper, Kristin; Cooper, Roy A., III; Harris, Kamala D.; Kelley, Lori; Obama, Barack; Owens, Valerie Biden; Putin, Vladimir Vladimirovich; Stein, Joshua H.; Trump, Donald J.

Subjects: Abortion; Cancer research, prevention, and treatment; Climate change; COVIDâ19 pandemic; Economic improvement; Federal deficit and debt; Gaza, humanitarian situation; Gun violence, prevention efforts; Health care costs and affordability; Health insurance exchanges; Health insurance, access and availability; Insulin cost controls; Medicare and Medicaid programs; North Carolina, Governor; North Carolina, President's visit; Patient Protection and Affordable Care Act; Prescription drug costs, reduction efforts; Preventive health care, improvement efforts; Russia, President; Social Security program; Tax Code reform; U.S. Supreme Court opinion overturning 1973 decision in Roe v. Wade; Ukraine, U.S. assistance; Vice President.

DCPD Number: DCPD202400229.