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Obama Health Care Law Upheld

Aired June 28, 2012 - 12:00   ET


WOLF BLITZER, CNN ANCHOR: Only moments ago, you heard Mitt Romney, his Republican presidential challenger, say he lamented the fact that the Supreme Court made this decision based on policy, and he outlined why he would on day one of a Romney administration go ahead and repeal, reverse and repeal the Obama health care law.

Candy Crowley is watching all of this unfold.

You know, Candy, a lot of us thought it would be a 5-4 decision, but we didn't think that it would be John Roberts necessarily would be the decider. We thought Anthony Kennedy would be the decider.

CANDY CROWLEY, CNN CHIEF POLITICAL CORRESPONDENT: We certainly did and that's one of the surprises today. And what's interesting here, Wolf, is that we have a day where at the end of it, legally speaking, not much has changed, but politically an awful lot has. It is going to be interesting, we just heard Mitt Romney. We will soon hear from President Obama. Certainly, he is welcomed to a victory lap here, because the bulk of his health care plan and sometimes derisively referred to, but now they embrace this at the White House, Obamacare.

It was a 5-4 decision. The court upheld the central part of the law that's so-called individual mandate that requires almost every American to have health insurance or pay a penalty. The requirement takes effect in 2014.

Americans have been divided over the health care law and so has the reaction of the court's decision as you might imagine.

I want to bring in our own John King and Jeffrey Toobin.

So, first of all, Jeffrey, the biggest surprise to you in this was the decision or the fact that the chief justice seems pivotal in this case?

JEFFREY TOOBIN, CNN SENIOR LEGAL ANALYST: No, the biggest surprise was the decision. You know, if you looked at Chief Justice Roberts questions in the oral argument, he was less skeptical and than Anthony Kennedy he was. I mean, he had a lot of skepticism, but Kennedy was more skeptical and that's borne out in the decision.

I'd just like to make one point, though, about the oral argument -- someone whose name hasn't been mentioned yet is Donald Verrilli who is the solicitor general. He was given a rough time by the justices. He was given a rougher time by people who watched the argument and especially me, and he won today.

This is a day for Don Verrilli to take an enormous amount of credit and for me to eat a bit of crow, because he won, and everybody should know that argument was a winning argument whatever you thought of it.

CROWLEY: Dually noted, Jeffrey.

John, to you. The politics of this now certainly in the short term seemed to favor the president. We saw Mitt Romney come out and say, hey, just because it's legal does not mean it is the right thing to do. Where does the president take this?

JOHN KING, CNN CHIEF NATIONAL CORRESPONDENT: Well, the president takes this, number one, Candy, it's an achievement, and an accomplishment. If the court wiped this off of the books, what would that big fight have been about? It polarized the country. Some say it cost the Democrats dearly in 2010 elections.

Now, he has a court decision affirming the policy and he can say as he travels the country, I know the economy is tough, but in a time where you're all struggling, I'm trying to help you, and this is one way to help you.

Is that going to answer all the critics? Of course not. Winning elections give you a boost, winning a big court decision will give the president a boost.

You just heard Romney's take, you want a larger and larger government. You want the government reaching further into the decisions of your life. We now have a classic choice laid out for the American people that will make it in 132 days. The president didn't until recently, until the court was right before us, the Democrats and the president don't go out to brag about the health care act. It will be interesting to see if in the president's speeches going forward, if in the advertisement, if in the debates going forward, health care becomes a more positive issue.

In Governor Romney's case, he wants to link it to the broader narrative, bigger government, higher taxes, the government making decisions that individual should make. So, it's a classic contrast here.

We have with us another one of the lawyers from the Obama team that argued these cases in the past.

And, Neil, you talked earlier about the chief justice.


KING: This is the Roberts Court. This is the Roberts Court.

What was he saying today not just about this decision, but about his tenure, he's still a young man?

UNIDENTIFIED MALE: Yes, the chief justice is a young man and he more than any of the justices on the court appreciates -- on the court today, appreciates the institutional role of the Supreme Court in the American democracy. He is a student of history. And I think today's decision was a really resounding reflection of the chief justice's values which are law is not just politics, and the Constitution is not just politics. And we should think about the decisions and partially and dispassionately come to the right decision.

TOOBIN: Can I ask you a question, Neil, about sort of -- you know, the way that lawyers talk? The politicians and the President Obama said this is not a tax increase. He said it over and over again during this debate. Now, the court upholds it as a tax.

Do you think that contributes to people's cynicism about the law?

UNIDENTIFIED MALE: Well, I don't think so, because the constitutional question is first of all does it function like a tax? What the chief justice said it quacks like a tax, it looks like a tax, it functions like is a tax. It is a tax.

And every American knows that, because if you don't pay the individual mandate, then on the 1040 tax bill, you have to check a box saying so. And so, everyone knows that this functions like a tax.

TOOBIN: So, we just ignore what the politicians say and the lawyers will figure it out.

KING: You can be absolutely certain you won't hear that in anything from the Obama campaign. Go to, you're not going to see the word it is a tax.

But, Candy, you know, as we talk about the politics, just -- well, in the last break, I was reading on the BlackBerry the statement that then-Senator Barack Obama gave on the floor of the United States Capitol, where you are today, and I'm looking at the Capitol building, the Supreme Court behind me, opposing the conformation of John Roberts to the Supreme Court. I would love -- they don't get to talk all that often, but the next time that the president of the United States has a conversation with the chief justice of the United States, boy, would you love to be a fly on the wall.

CROWLEY: You absolutely would. A lot of ironies going on here, because let's remember that when President Obama was candidate Obama, he argued against the individual mandate, and now he argued for it and won and in the Supreme Court. So, we could go round and round and many degrees with of separation from people that did not initially seem to be on the side of the president and vice versa.

So this is an interesting day to be sure, John. Thank you very much.

I want to bring in now Gloria Borger. We have been talking a little bit about this whole idea that Justice Roberts is the one that really seemed to tip the balance here.

GLORIA BORGER, CNN CHIEF POLITICAL ANALYST: Yes, very interesting. This has an awful lot to do with the Justice Roberts that we saw when he was confirmed who talked a lot about stare decis, not upsetting the apple cart, and also about the court's legacy and the way he wants the court to be viewed as a court that is not political, a court of integrity.

You know, in reading through all of this today and you look at the taxing power argument here, this was not the major argument in the case. This was a smaller argument, a subsidiary argument, if you will, that the administration was making. It almost seemed to me that Justice Roberts might have been looking for some way to uphold this law, and in the same way gently admonishing the administration, saying, you know what, call the penalty what it is, and it's a tax.

CROWLEY: Let me bring in someone who will be a familiar face to a lot of us and is to a lot of you out there, Senator Marco Rubio of Florida, often mentioned as perhaps a vice presidential candidate.

He'll be happy to know I'm not going to ask you about that today, Senator. But I want to ask you about your reaction to the Supreme Court. This is essentially a pretty big loss for the Republicans, is it not?

SEN. MARCO RUBIO (R), FLORIDA: Well, I think it's a loss for America.

Let me begin by reminding everybody what the Supreme Court decides is that they decide whether something is a constitutional or not constitutional. They don't decide whether this is a good idea. And it's specific, and when they found that it was constitutional, what they said was that the reason it's constitutional is because it's a tax increase.

Millions off Americans may now have a IRS problem as a result of the ruling.

CROWLEY: So, Senator, how does this play out on the campaign trail, as we all know when Mitt Romney was governor of Massachusetts, he certainly had a similar plan in place, and it takes away some of his ability to argue the individual mandate. But how do you go at this in terms of politically, and in terms of what you say the ultimate goal is which is to turn over this law?

RUBIO: Well, three things. Let me first mention that when Governor Romney was the governor of a state, that's a state policy. If you don't like the policies of the state, you can easily go to another state, and the state, by the way, doesn't have IRS. This has now turned the IRS into an enforcement mechanism for Obamacare.

And, number two, I think this reminds us that this is a broken promise. The president said he would not raise taxes on the middle- class. This is a middle-class tax increase.

And you know why we know it's a middle class tax increase? Not because I'm saying it, because the Supreme Court has said. It's the basis for them upholding it. I think Americans now understand what this law really is all about, and I think now more than ever, you're going to see the opposition to this law increase.

I think it's going to hurt economic growth, which is already doing very poorly. We have new figures today that showed that the economy is not growing. This is not going to help. I think this now becomes a central issue of this campaign again like it was in 2010.

And just a moment ago, you guys were on the air, Obamacare is not something that this administration brags about. In fact, they wouldn't even call it Obamacare until very recently. There's a reason for that, because the American people don't like it. This now becomes a central issue in this campaign. I don't think that's good for them, but I think it's terrible for America.

CROWLEY: It may be, Senator, but when you really dissect the polls of the 51 percent of Americans or so who don't like the president's health care plan, 13 percent of them don't like it, because they don't think it's liberal enough, which makes the footing of the Republicans a lot less sure, because it means that the actually the number of people who believe it goes too far is well below 50 percent.

Is that something that you really want to campaign on?

RUBIO: Well, let me just I'm more than happy to have that debate. I hope that's what this campaign is about. I hope this is a central issue in this campaign. A, it should be, but secondly, it's going to have a devastating impact on the economy.

Look, they said -- this law is a culmination of a broken series of promises, where they told people: if you like your insurance, you're not going to have to change. We know that that's not true.

They told people this was not a tax increase. The president put off that point, saying this is not a tax increase. And yet his lawyers in front of the Supreme Court said it was, and it is the only reason why this law was found constitutional, is because it is a tax increase. And just wait until Americans start realizing that they are going to have to prove to the IRS that they have health insurance or they're going to be hit with an IRS fine. Just wait until people figure out what that means to their daily lives, you'll see those numbers change really quick.

CROWLEY: Most people have health insurance, but I want to ask you one other quick question about the U.S. Senate. What it may do. We are told that the House, will -- when they come back after the July 4th recess -- vote sort of plank by plank to try to repeal Obamacare.

What's the Senate going the do?

RUBIO: Well, I don't know. Obviously, my party doesn't run the Senate. I can tell you what I hope we will do. What I hope will happen here is that the Republicans and the Democrats will come to the realization that having -- creating an IRS problem for millions of Americans is not what people intended or a majority of people didn't, that we do have a health care problem in America, that it is serious, that it needs to be confronted and solved, but that this is not the right way to do it, that enforcing a mandate through a tax penalty enforced by the IRS is not a good idea for our economy at a time when, by the way, it's not growing very fast.

What I hope some consensus can form around that, that will be able to the repeal the provisions like that, and then really get to work on replacing it as soon as possible, because we desperately do need to confront the health insurance problems in America that we have, but this is the wrong way to do it.

CROWLEY: Senator Marco Rubio, Republican from Florida, thanks for your time.

RUBIO: Thank you.

CROWLEY: And CNN will be right back with this continuing coverage of a huge Supreme Court decision right after this break.


CROWLEY: Welcome back. We are covering today's Supreme Court ruling that essentially said that Obamacare, the president's health care plan is by and large constitutional. They did in fact change one little part of it that had to do with whether the states could be penalized for not expanding their Medicaid programs, but by and large, a huge, huge victory, Wolf Blitzer, for President Obama who is going to do a little bit of a victory lap here in a minute or so.

BLITZER: I'm sure he's not going to be happy that the Supreme Court justices, the majority, said this was a tax increase after he had assured the American people in 2009 this was not a tax increase.

CROWLEY: I'll bit he'll take it.

BLITZER: He'll take it, because the health care reform law -- the Affordable Healthcare Act -- remains the law of the land. It's a huge win for the president. Just imagine, Candy, what would have been the case if it would have been the opposite decision.

Here comes the president. He's walking the microphone in the East Room of the White House.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Good afternoon. Earlier, today, the Supreme Court upheld the constitutionality of the Affordable Care Act.


OBAMA: But today, I'm as confident as ever that when we look back five years from now or 10 years from now, or 20 years from now, we'll be better off because we had the courage to pass this law, and keep moving forward.

Thank you. God bless you. God bless America.

BLITZER: The president of the United States speaking from the East Room. Obviously, very, very pleased that the United States Supreme Court has upheld the Affordable Care Act. His health care reform legislation which is the law of the land and will remain the law of the land --thanks to a 5-4 decision by the United States Supreme Court today, a decision written by the chief justice of the United States John Roberts.

Candy, as we watched the president, our very robust defense of the health care law, we haven't seen a lot of that over the past several months during this campaign and the president, himself, acknowledged that it may not be popular politically, but it is the right thing, he says, for the American people.

CROWLEY: And he may feel a little wind at his back. I think there's nothing like a Supreme Court decision that says, of course, it's constitutional, after two years of this, that gives him a boost up.

I think -- I want to bring in our Jessica Yellin here to kind of join us in this conversation, Jessica. And the first thing he said, I know we all look at this through the prism of politics, but I don't -- this is about people. And then he went on the say, well, while I'm here, let me explain all of the things that are in it, that are very popular provisions that people like.

The setting is the East Room, which I also found interesting, a very presidential sort of place. So, apparently to take the politics out of it while putting the politics in it?

JESSICA YELLIN, CNN CHIEF WHITE HOUSE CORRESPONDENT: That's true, Candy. And that argument, though, cuts both ways because this administration has been brutally criticized for failing to effectively sell the health care bill after it was passed.

And so, now, the president is trying -- it would seem -- to emphasize that the elements of this legislation that are popular and I think that we will see a lot more of that in fact on the campaign trail when the president does go out and hit the trail.

You know, while polling shows that the bill, itself, is not as popular, the individual components do rate well, the children under 26 getting health insurance. You heard him hit some of the key groups that he is trying to woo in this election -- women, selling this idea of the consumer protections in here, and of course, that there is this element of fairness which is a key part -- of fairness for the middle- class -- which is a key part of the campaign.

One thing that I can add for you is a little bit of color from Chicago headquarters. I'm told that they, too, were bracing and uncertain about what would happen just as they were at the White House when this came down, feeling there of both relief and celebration. And now, they are planning their next moves as well.

And no doubt, a response to Mitt Romney who we have seen already, Candy, releases from the Democrats, saying, look -- this is not from the campaign but other Democrats have said -- look, if Republicans are going to call this now a new tax, then Mitt Romney also raised taxes when he was governor of Massachusetts because he imposed a mandate, too. So, look for that battle to start brewing on the campaign trail or between the two sides in the coming days.

CROWLEY: Yes. This has been a very mixed blessing for Mitt Romney all of the way down the road ever since signing that bill in Massachusetts.

Jessica Yellin at the White House, thank you, stick with us today.

We're going to take a quick break. But when we come back, some of you have been talking to our Dr. Sanjay Gupta, and he has some answers for your questions.


CROWLEY: Welcome back to CNN's rolling coverage of the Supreme Court decision this morning that allowed President Obama's health care law to stay pretty much intact.

I want to bring in our Dr. Sanjay Gupta in New York.

Sanjay, so many people looking at this going, so what happens now?

And I think probably the best advice is, whatever you had this morning, you still have.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes. I think, you know, most people certainly have health care insurance. But this is the people who do not have health care insurance or had some sort of chronic illness that have made it difficult for them to obtain health care insurance are probably the people that are paying the most attention to this.

But, you know, Candy, there are 450 provisions in this. I'm probably one of the few people who have actually read this bill twice as part of our reporting. So, there's lots of different people affected by this. And I think the nuances as we go forward are going to be very important.

CROWLEY: And when you look at what the next big thing is that will come in -- we heard the president sort of tick off those things, Sanjay, that people like, no lifetime caps, and you can't be denied health insurance because you have a pre-existing condition, et cetera, et cetera. What is the next big thing that comes online?

GUPTA: Well, I think in 2014 is sort of going to be some of the biggest things. A couple of them you mentioned, but this whole idea that insurance companies will not be able to deny coverage is one of the big things. We have a couple of questions that might sort of speak to this point. I believe that Thomas, one of the viewers has a specific question related to some of the provisions. Thomas, go ahead.

THOMAS, STUDENT: Yes. I am a 23-year-old student who is currently under his parent's insurance plan and how does today's decision on the health care law affect my qualification for coverage in the next few years?

GUPTA: Well, thank you, Thomas, for asking that. This is a very important point. You know, as I've been reporting on this, this issue comes up one of the most frequent issues that comes up. Thomas, you will be able to stay on your parents' plan now until age 26. You fall into a population of people who have been very tricky to cover. You are no longer getting coverage through your parents' plan or no longer in school previously, but now up until the age of 26, that does a couple of things. Besides providing him health care coverage, and Thomas for you, businesses out there that may be more likely to hire you, because you are already covered. So that is one of the big, big provisions. I think we have another question from Heather as well. Heather?

HEATHER, STUDENT: Hi. I have a question, I'm a graduate student and a single mom, and how does this affect me now? And what will happen in 2014?

GUPTA: There's a couple of important points, you are a graduate student and I don't know how old you are. Are you over the age of 26?

HEATHER: I'm 39.

GUPTA: Okay. You look terrific, and the health care so far is serving you well. But I will say that --

HEATHER: Thank you.

GUPTA: -- with regard to your child, and this has already happened as part of the implementation, your child were to get sick or is sick, also cannot be denied health care coverage because of that illness. Again, a significant problem. I see this as a doctor that kids at a time when they need health coverage the most can't get coverage or the premiums are prohibitively high. That is something that you don't have to worry about now for your child. For you, yourself, depending upon what you do next, if you take a job and get employer-based coverage after school, then you can get your health insurance through your employer. If you decide to start a small business, and you are now a business owner who has to provide coverage to your employees, there will be tax benefits for you, but also I think the most important thing for you, Heather, is that if you were to become ill, and again, you cannot be denied coverage because of your gender or some pre-existing illness or something else. So you will pay the same health premium as someone your age who lives in your community. That is sort of a simplistic definition of a community rating, Heather. So that is a little bit how it lays out over the next couple of years. Again, some of that has taken place in 2014. Heather, thanks for that. Thomas as well. Candy, we get lots of questions like that, I hope that gives people a little bit of an overview of how this is going to roll out.

CROWLEY: And whatever is going to roll out before this, and actually I going to ask you a question, but Nancy Pelosi who really helped engineer health care through Capitol Hill now talking, and we want to go to her, Sanjay. Thanks.


NANCY PELOSI, D-CALIFORNIA, HOUSE MINORITY LEADER: It was a victory for American families when we passed the Affordable Health Care Act and the president signed it in law. Since then, tens of millions of people in our country are already benefiting from the legislation. As you know, and as the president said so eloquently, children can no longer be denied coverage due to pre-existing condition, and young people and children and students and young people can stay on their parents' policy until they are 26 years old, and seniors are paying less for prescription drug and have access to free wellness and preventive visits. When the bill comes into effect, being a woman, it will no longer be a pre-existing medical condition. Great victory for women. It is about wellness, it's about prevention, it's about the health of America, and not just the health care. It's pretty exciting. Earlier this morning I met with our caucus after the decision was announced, and it was as you know, no surprise to us. We knew that it would -- we thought we were on solid grounds in terms of interstate commerce, solid grounds in terms of the constitution. It was just a question of what the vote would be. With that confidence, we happily embraced the decision that came down. Now we can move forward to the full implementation of the law, and when that happens for the American people, the best is yet to come. I want to say a word about Senator Kennedy. I spoke to Vicki Kennedy this morning and to Patrick Kennedy before coming here, and thanking them for the important role that he played. A lifetime of commitment to making health care a right not a privilege in our country. He called it the great unfinished business of our country, of our society. I knew that when he left us he would go to heaven and help pass the bill and now I know he was busily at work until this decision came down inspiring in one way or another, and now he can rest in peace. His dream for American families has become a reality. I will be pleased to take any of your questions.

REPORTER: Madam Leader, the president has said, himself, on numerous occasions that the individual mandate is not a tax. Do you feel that the individual mandate in the health care law is a tax?

PELOSI: The court has upheld the legislation. I think, and I have to see the specific language that they identified with how he wrote the bill in the house as part of the decision, the documentation for the decision. Call it what you will. It is a step forward for America's families, and you know what, take yes for an answer. This is a very good thing for the American people. What you are talking about --


CROWLEY: That of course is Minority Leader Nancy Pelosi. She doesn't care what you call it as long as it is constitutional and she is very happy with the supreme court decision today and rightly so. She is minority leader now and she was speaker of the house, and if anything, she was called the backbone of the White House, and the backbone of the house when everyone began to get cold feet after they were hearing so many complaints about the mandate and other parts of the health insurance law. It was Nancy Pelosi who stood up and said, we can do this and kept pushing and pushing, so a victory for her today and she is taking it.

We will take a quick break here, but when we come back, I want to talk to a young man who has played a cameo, but very important and emotional part of this whole health care law debate. We will be right back.


CROWLEY: When President Obama signed his health care overhaul into law two years ago, 11 year old Marcellus Owens was his by side. Owen's mother had died without health insurance. She has fought an incurable heart disease that took away her ability to walk, cause her to lose her job, and with her job went her insurance. Marcellus dedicated himself to health care advocacy in her honor. I am happy to say that Marcellus you join us now. Have you carefully followed this whole supreme court issue as the health care law went up through the courts?

MARCELLUS OWENS, HEALTH CARE PROPONENT: Well, I have been watching most of it and paying mostly the attention to the decisions that they have been making.

CROWLEY: I imagine that today is a pretty happy day for you if you have been spending these years dedicating yourself to this fight for your mom. A pretty happy day?


CROWLEY: Tell me what sorts of things - I know you must remember your mom everyday in your own personal way, but what sorts of things have you been doing in her honor?

OWENS: Well, mainly, I have been trying to just help with keeping the obama care alive and helping to make sure that it stays and gets upheld.

CROWLEY: Not many 13 year-olds, I think you are now Marcellus, not many of you would be out there with this kind of passion for the kind of legalities and all sorts of things that are going on with this, and I have to imagine that you are a President Obama supporter coming up in this next election, correct?

OWENS: Yes, if I could vote, I would definitely put my vote on him.

CROWLEY: A little while before you can do that. And so, when you do remember your mom, does it help to know that the sort of thing that she went through and you watched her go through, won't happen to anyone when this law takes full effect, because you won't be able to lose your health insurance just because you get sick.

OWENS: Yes, I'm kind of happy that happens, because I don't want anyone else to feel the same and see the things that I saw happen. Nothing that happened to my mom with losing her health care happens to anyone else. CROWLEY: Well, Marcellus Owens you have an important voice in the debate, and it was fun seeing you two years ago in the White House, and it was a big time for you, I know and thank you for joing us today on another important day on the battle for health care.

OWENS: Thank you for having me here. It is fun. And it helps.

CROWLEY: Good. I'm glad. I'm glad to hear that. You take care.

Dr. Jorge rodriguez is a board certified internist who joins me from Los Angeles. Dr. Rodriguez, I know you have been a supporter of this law. Can you tell me looking forward to things that are coming in, and coming online how this is going to impact you and how you think it will impact the patients?

DR. JORGE RODRIGUEZ, BOARD CERTIFIED INTERNIST: Well thanks for having me on, Candy, first of all. I was a supporter of the law in general and in time, it seems to have changed and diluted and listening to this all day today shows me what a political ball actually this has been. It actually makes me very ambivalent, because the problem is that I think that both parties have actually put the cart in front of the horse. They have provided people access to a health care system that I think that is broken. So there was a doctor from Grady who spoke earlier and I think the problem is this, I'm an internist. I'm Marcus Welby. I'm not a surgeon and my patients come to me everyday and I battle the insurance companies and I see the frustrations. They complain about not having access to their doctors, not spending enough time with their doctors, being seen by physician substitutes, so what I am afraid is going to happen is that we are now bringing 30 million more people into a broken system, overall, a lot of people are going to be getting care they did not get. That is wonderful, and I think that everyone deserves health care, but I would have preferred if both parties stepped back and actually said, how are we going to provide good care for Americans? How are we going to provide preventive care? Doctors are retiring and quitting at the highest rate ever. Less people are going into the med. school, we actually need to provide better care, more physicians for the people who are coming into health care access. That is what concerns me.

CROWLEY: Well, as I understand things coming down the pike, it certainly will begin to reward doctors for wellness - for their patients who remain well. The goal will be less about procedures and payment less about that than about the success rate of a doctor. Will that not help?

RODRIGUEZ: That would help actually and that will help. But you know who needs to be incentivized is that the patient needs to be incentivized. I would be very much in favor --

CROWLEY: In what way?

RODRIGUEZ: Well, for example, if you have health insurance and some employers are doing this and you receive a rebate from your premium if you have a yearly physical, if your weight is controlled, if your cholesterol is controlled, if your blood pressure is controlled, then the patient is incentivized to actually stay healthy. There are a lot of things that can be done. Again, what we are doing now? We're providing people with insurance for when they get sick. So, listen, this may be a great start and in the future we can modify this, but I just wish now looking in retrospect that a little bit more thought had be given to this. And plus, Candy, I don't think America has actually answered the main question which would have alleviated a lot of problems and that is whether health care is a right or a privilege? Once we answer that I think we can decide whether we should have one pair system nationalized health care. But, you know what? It's a beginning. Hopefully we'll be able to tack through the years and improve it.

CROWLEY: So if I understand you correctly, your fear is now we're putting 30 million or so uninsured people into the system but the system itself, you think, can't handle that or isn't handling what they already have. Whichever way you want to put it.

RODRIGUEZ: The system right now can't handle that. The system - it's going to shift people, for example, perhaps, from emergency rooms into primary care physicians offices. We don't have more primary care physicians, and the president spoke about perhaps some how incentivizing to have more nurse practioners and if you have more people accessing health care, you need more people to be able to be able to assist them. Granted, right now people are going to emergency rooms who don't have insurance, and that is going to be shifted over. So you may have the same number of clinics that are now going to be more overcrowded with people. Is that better than no care? It remains to be seen. I don't know.

CROWLEY: And are you saying that we need when you are talking about doctors retiring, I know there is a lot of frustration and particularly among the doctors in the 40s and the 50s and around in there that are looking elsewhere now, what would help doctors, what would make this better for doctors and bring more folks into the profession, into the health care profession and not just doctors but the age you are talking about?

RODRIGUEZ: Well, which is my age, and it is unsavory for physicians to talk about reimbursement, because we are supposed to be above that, but the truth is we have families and we have mortgages and debt ourselves and that's just a fact. Medicare reimbursement for physicians has decreased 30 percent to 40 percent over the past few years and will continue to decrease. As Medicare goes, so goes other insurance companies. I don't think that any physician is asking anything other than good reimbursement, so what happens? We have to see more patients in order to cover our costs, and then the patient becomes dissatisfied. So I think that the reimbursement for physicians and for teachers has to be looked at. It has to be commensurate with the responsibility. You know, that comes along with the profession. And another thank is very frustrating is that we really don't have any resource. You may think that the American Medical Association represents us. It doesn't. There is nobody really fighting for, you know, physicians' rights. So I am putting it out there, and you can see that by actually of the quality of students that are applying to medical school. The grade point average of the applicants has continued to drop yearf a year. And if you ask most physicians would they recommend that a young person go into medicine over 50 percent of them nowadays would say no. So this is not the only problem, but it is certainly a large problem.

CROWLEY: One of the problems.

RODRIGUEZ: That needs to be looked at.

CROWLEY: I think that you heard the president today say that there were certainly going to be things that he is looking for improvements all of the time. And as you say, maybe a start, but certainly not the finish. Thank you so much for your time today dr. Jorge rodriguez. We appreciate it.

RODRIGUEZ: Pleasure.

CROWLEY: Thank you.

President Obama did score a major victory on health care today, and the battle for reform is 100 years old, and a fascinating look back at the history of the health care fight.


CROWLEY: Welcome back to our continuing coverage of the health care ruling today from the Supreme Court, which basically held that President Obama's health care law is constitutional, certainly in the main.

I want to bring in Senator Patrick Leahy. He is chairman of the Judiciary Committee, as well as someone who fought pretty hard for this health care law.

Senator Leahy, let me ask you first, do you consider this health care law to be the beginning or the middle or the end of fixing what ails America's health care system?

SEN. PATRICK LEAHY (D) CHAIRMAN, JUDICIARY COMMITTEE: Well, I think it's a beginning. But I think that it's a good beginning because we have the Supreme Court saying it is constitutional. A very conservative Supreme Court saying it is constitutional. I agree with their decision.

You know, you go back in the history books and you watch what happened after we had passed Social Security. That had to be fought all the way to the Supreme Court to see if it was constitutional. You got a lot of people saying, well, you've got to get rid of Social Security. Once it was declared constitutional, they did what they should do now. They said, OK, we have Social Security, not let's see how we make it better. And over the years we have.

The same with this. We know now it's constitutional. We now know that a lot of Americans are going to be covered who wouldn't have been covered. We know a lot of Americans with health problems will not be dropped from their health insurance. But let's work together to make it even better. Set aside the partisan posturing, and let's just work together as Americans for Americans.

CROWLEY: Are you certain that this battle is over? And I don't mean just politically. And I think we can both agree that it isn't over politically. But one of the things that I thought was interesting in this ruling was the Medicaid provision, where it said that -- and one of the parts of this bill is, expand Medicaid. That will bring some people into the system. So different sorts of requirements for Medicaid so that more people are brought into it. That, of course, is administered by the states. So it's saying to the states, use these rules and broaden your Medicaid coverage.

And what the Supreme Court said was, as I read it, and you're the lawyer here, so tell me this, is that the federal government cannot punish states who choose not to do that. What does that mean? Does that mean that we next move to the states for this battle?

LEAHY: Well, I think there will be, to the states (INAUDIBLE). Vermont has always been a leader in providing health care. One of the reasons we're the healthiest state or one of the two healthiest states in the country is we've made sure, for example, that all our children are covered until the age of 18. We do a lot of preventive health care, and so our costs are lower and our people are healthier. I think that argument could be made in each state.

But, remember, the basic thrust of the law has been upheld. And that's why I say set aside the posturing, set aside the political stuff -- oh, we're going to repeal this on day one, that kind of stuff. That's not going to happen. Let's not waste any energy on that. Let's have Republicans and Democrats come together and make -- if their products can be any better, make them better. Forget the sloganeering and the posturing. Let's do what's right for Americans.

CROWLEY: OK, Senator Leahy, I don't think either you or I want to take odds on that happening in an election year, but we certainly hear your message. Thanks so much.

LEAHY: No, no, I don't. But eventually it will happen, just as it did in Social Security.

CROWLEY: Thank you so much for your time today, sir. I appreciate it.

LEAHY: Thank you.

CROWLEY: We're going to take a quick break. We'll be right back.


CROWLEY: With today's historic Supreme Court vote upholding Obamacare, the president has managed to do what many other presidents have tried to do but failed, significantly reform the nation's health care system. Presidential historian Doris Kearns Goodwin joins me now by phone.

Doris, we thought two years was a long time in the making, but this fight for health care and improvement in health care has been a long time coming.

DORIS KEARNS GOODWIN, HISTORIAN (via telephone): No question. I mean this president has finally accomplished something that no president was able to accomplish, as you say, for a century. I mean think about it. It began with Theodore Roosevelt, who put a plank into his Bull Moose campaign in 1912. FDR tried to get health insurance into the Social Security bill and he failed. Harry Truman supported national health insurance. But it was branded as socialistic at the height of the Cold War and he lost out. JFK called it the most important measure he had advocated. And then, of course, Clinton, was defeated by the process (ph) and the Harry and Louise ad. So the fact that this has finally gotten through the Supreme Court is a very historic accomplishment that all presidents wish when they first come into office.

CROWLEY: So basically what Doris Kearns Goodwin is telling us, not just a moment for the Obama administration but a moment in history when you look back over all the presidents who have fought to do something. Thank you so much, Doris Kearns Goodwin. We do appreciate it.

GOODWIN: You know, I think the important thing to think about even so I mean when you look back at Ronald Reagan's fight with Lyndon Johnson over medicare. The words that he used were it would compel all Americans to spend their sunset years telling children and children's children what it was like in America when men were free. I mean that's how deep that battle was in that period of time. Yet Medicare has been sustained and is now approved. But I still think the battle for public sentiment lay ahead. You know, one of the things that we still haven't got is what I think the president tried to start doing today, as you've been saying, is to make a clear understanding of what this bill is about. Because Lincoln once said, with public sentiment nothing can fail, without it nothing can succeed. So, consequently, he who molds public opinion go deeper than he who enacts the statues or pronounces the decisions. That's the battle that Clinton lost with the Thelma and Louise ads, that's the battle that the Republicans have gained over these last couple of years with the Death Panels and the idea that government is going to get in between you and your doctor. That's the battle that still has to be won. So the Supreme Court decision has come down on the side of the administration.

CROWLEY: Doris Kearns Goodwin, historian, thank you so much for your perspective on this.