Former President Bill Clinton ignited a mini-firestorm on Monday when he slammed the post-Obamacare U.S. health care system as "the craziest thing in the world."
The comment seemed to be a devastating attack on President Barack Obama's signature domestic achievement, which is strongly supported by his wife, Democratic presidential nominee Hillary Clinton.
After a day of conservatives drawing attention to the lines, Republican presidential nominee Donald Trump tried to feed the furor with a tweet: "Wow, did you just hear Bill Clinton's statement on how bad ObamaCare is. Hillary not happy. As I have been saying, REPEAL AND REPLACE!"
While it was hardly the first time Bill Clinton was careless with his words and caused a headache for his wife, a close reading of the former president's remarks suggests he was not attempting to condemn the entire system, just the ways it has failed certain people.
Bill Clinton said the current system "works fine" for seniors eligible for Medicare, lower-income people eligible for Medicaid (which the ACA expanded to cover those making up to 138 percent of the federal poverty level), and middle-income people eligible for subsidies (covering people from 138 percent to 400 percent of the poverty line).
But those who make "just a little too much" money to qualify for subsidies, he said, are "getting killed" under the new system.
"You've got this crazy system where all of a sudden 25 million more people have health care, and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half," Clinton said at a rally in Flint, Michigan, on behalf of his wife. "It's the craziest thing in the world."
The cost of a health plan sold on the ACA's exchanges is going up by about 25 percent for next year, according to ACASignups.net. While about 9.4 million people get subsidies to help them afford Obamacare plans, Clinton's remarks focused on the millions who don't get government help.
There are at least 8.6 million people buying coverage in the individual market currently without any subsidies, though some may be eligible for help and not know it. The costs they face vary widely by where they live.
In Seattle, Washington, for instance, a 40-year-old would pay $232 a month for the lowest-cost mid-level plan next year, according to the Kaiser Family Foundation. A similar, "silver"-level plan would cost $425 a month in New York City.
But silver plans carry hefty deductibles. Last year, for instance, silver plans had an average deductible of about $3,000, according to the foundation. Still, limits in the Affordable Care Act on out-of-pocket costs have helped reduce spending on average, said Larry Levitt, a senior vice president at Kaiser.
"If anything, the ACA has reduced out-of-pocket costs, rather than increased them,'' he said. "But they're still a challenge for people, particularly those not eligible for cost-sharing subsidies.''
Democrats, including Obama, have acknowledged that the law has problems. Hillary Clinton has proposed policies to help cushion the pain her husband identified. She's called for bigger subsidies under the ACA and tax credits to help individuals with high health-care costs.
"With respect to the Affordable Care Act, I've been saying we've got to fix what's broken and keep what works," Hillary Clinton told reporters Tuesday, hitting Trump's repeal plan as that one that would "all of a sudden go back to the days where insurance companies could deny you coverage because of a preexisting condition."
Bill Clinton tried to clean up his remarks at a rally Tuesday.
"Look, the Affordable Health Care Act did a world of good, and the 50-something efforts to repeal it that the Republicans have staged were a terrible mistake," he said in Athens, Ohio. "We for the first time in our history at least are providing insurance to more than 90 percent of our people."