Today, the President announced that he will be issuing an executive order after the passage of the health insurance reform law that will reaffirm its consistency with longstanding restrictions on the use of federal funds for abortion.

While the legislation as written maintains current law, the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation’s restrictions against the public funding of abortions cannot be circumvented.

The President has said from the start that this health insurance reform should not be the forum to upset longstanding precedent.  The health care legislation and this executive order are consistent with this principle.

The President is grateful for the tireless efforts of leaders on both sides of this issue to craft a consensus approach that allows the bill to move forward.

A text of the pending executive order follows:

We are mere feet from the finish line to passing into law historic, fiscally responsible health insurance reform that will give more choice and security to those with health insurance, provide access to coverage to those without, improve the quality of health care for us all, and provide the most deficit reduction of any bill in over a decade.

With momentum building, it’s no surprise that opponents took to the morning talk shows and the Sunday newspaper op-ed pages in an attempt to undermine one of the signature accomplishments of the legislation under consideration today: the fact that it reduces the deficit by more than $100 billion over the first decade, and more than $1 trillion in the decade after that.

Especially at this late hour, it’s important to get the facts right. So let’s consider their main charges one by one.

First, critics charge that the bill uses 10 years of savings to pay for six years of spending. As I have posted before, if this were what we were doing, then health reform would blow a hole in the deficit after the first decade (or the budget window). Yet, as CBO has made clear again and again and in its final score issued last night, the opposite is true with health reform. In fact, the reform would reduce the deficit by a half percentage point of GDP -- or more than $1 trillion -- over the legislation’s second 10 years.

Second, we have heard that the bill is double counting Medicare savings.  To put on the green eyeshade for a moment, let’s be clear: the bill has been scored by using standard budget accounting – the same methods used for years. And again, CBO confirms that health reform will reduce the deficit over 10 years and over 20 years.

Looking at the budget as a whole, this bill will leave us with less debt over time, and that is what matters.

Third, critics contend that there is no way that savings and revenue adjustments put forward will actually happen.  No one has a crystal ball, but we do know how Congress has acted in the past.   When tough decisions were made in the past about our central benefit programs, these changes have tended to stick. As I have noted before, the Center on Budget and Policy Priorities (CBPP) has studied Medicare savings and found that: "Virtually all of the Medicare cuts enacted in 1990 and 1993, which accounted for a significant portion of the savings in those large deficit-reduction packages, were implemented...And most of the savings enacted in 1997 other than the SGR cuts – nearly four-fifths [emphasis theirs] – were implemented as well." 

Fourth, some have charged that there are hidden costs not being counted in the CBO score. One source is authorizations for discretionary spending for items related to health reform. Authorizations are just that; they are not expenditures, and Congress often does not act on them -- or can do so while cutting elsewhere so the overall amount of discretionary spending doesn’t increase.  The other source for these alleged secret costs is the need to fix the Sustainable Growth Rate (SGR) in Medicare, which otherwise would cut physician payments drastically. An SGR fix, however, is not in this bill -- so adding its costs to the legislation posits a piece of legislation that doesn’t exist. Moreover, and more importantly, the need to address the SGR is a longstanding issue that pre-dates health reform and would be an issue even if Congress didn’t undertake health reform.  Both Democratic and Republican Congresses and Administrations have applied temporary fixes in the past.

This brings me to a final point. Perhaps people are appropriately skeptical about some of these budget figures because over the past decade, budget gimmicks and fiscal irresponsibility became the norm. Massive tax cuts (which weren’t paid for) were passed and were presented as temporary to make them seem less expensive – even as supporters fully intended to make them permanent. New health care entitlements were signed into law without any offsets. Budget windows were manipulated to blind people from true costs. It is truly, and sadly, ironic that the central critics of the fiscal underpinnings of today’s health reform legislation are those who supported these policies --and led the way -- as our country spiraled from surplus down into deep budget deficits.

The legislation before the House represents the most important deficit reduction package that would be enacted in over a decade -- and, perhaps more importantly, represents the first serious piece of legislation that would begin the process of addressing our long-term fiscal imbalance by re-orienting the health system toward quality rather than quantity.  We stand by its CBO score. Later tonight, we expect a majority in Congress to stand by it as well – ushering in, among other things, a new era of fiscal responsibility.

Peter Orszag is the Director of the Office of Management and Budget

We are mere feet from the finish line to passing into law historic, fiscally responsible health insurance reform that will give more choice and security to those with health insurance, provide access to coverage to those without, improve the quality of health care for us all, and provide the most deficit reduction of any bill in over a decade.
With momentum building, it’s no surprise that opponents took to the morning talk shows and the Sunday newspaper op-ed pages in an attempt to undermine one of the signature accomplishments of the legislation under consideration today: the fact that it reduces the deficit by more than $100 billion over the first decade, and more than $1 trillion in the decade after that.

Especially at this late hour, it’s important to get the facts right. So let’s consider their main charges one by one.
First, critics charge that the bill uses 10 years of savings to pay for six years of spending. As I have posted before, if this were what we were doing, then health reform would blow a hole in the deficit after the first decade (or the budget window). Yet, as CBO has made clear again and again and in its final score issued last night, the opposite is true with health reform. In fact, the reform would reduce the deficit by a half percentage point of GDP -- or more than $1 trillion -- over the legislation’s second 10 years.

Second, we have heard that the bill is double counting Medicare savings.  To put on the green eyeshade for a moment, let’s be clear: the bill has been scored by using standard budget accounting – the same methods used for years. And again, CBO confirms that health reform will reduce the deficit over 10 years and over 20 years.

Looking at the budget as a whole, this bill will leave us with less debt over time, and that is what matters.
Third, critics contend that there is no way that savings and revenue adjustments put forward will actually happen.  No one has a crystal ball, but we do know how Congress has acted in the past.   When tough decisions were made in the past about our central benefit programs, these changes have tended to stick. As I have noted before, the Center on Budget and Policy Priorities (CBPP) has studied Medicare savings and found that: "Virtually all of the Medicare cuts enacted in 1990 and 1993, which accounted for a significant portion of the savings in those large deficit-reduction packages, were implemented...And most of the savings enacted in 1997 other than the SGR cuts – nearly four-fifths  [emphasis theirs]  – were implemented as well." 

Fourth, some have charged that there are hidden costs not being counted in the CBO score. One source is authorizations for discretionary spending for items related to health reform. Authorizations are just that; they are not expenditures, and Congress often does not act on them -- or can do so while cutting elsewhere so the overall amount of discretionary spending doesn’t increase.  The other source for these alleged secret costs is the need to fix the Sustainable Growth Rate (SGR) in Medicare, which otherwise would cut physician payments drastically. An SGR fix, however, is not in this bill -- so adding its costs to the legislation posits a piece of legislation that doesn’t exist. Moreover, and more importantly, the need to address the SGR is a longstanding issue that pre-dates health reform and would be an issue even if Congress didn’t undertake health reform.  Both Democratic and Republican Congresses and Administrations have applied temporary fixes in the past.

This brings me to a final point. Perhaps people are appropriately skeptical about some of these budget figures because over the past decade, budget gimmicks and fiscal irresponsibility became the norm. Massive tax cuts (which weren’t paid for) were passed and were presented as temporary to make them seem less expensive – even as supporters fully intended to make them permanent. New health care entitlements were signed into law without any offsets. Budget windows were manipulated to blind people from true costs. It is truly, and sadly, ironic that the central critics of the fiscal underpinnings of today’s health reform legislation are those who supported these policies --and led the way -- as our country spiraled from surplus down into deep budget deficits.

The legislation before the House represents the most important deficit reduction package that would be enacted in over a decade -- and, perhaps more importantly, represents the first serious piece of legislation that would begin the process of addressing our long-term fiscal imbalance by re-orienting the health system toward quality rather than quantity.  We stand by its CBO score. Later tonight, we expect a majority in Congress to stand by it as well – ushering in, among other things, a new era of fiscal responsibility.

[Update from Matt Flavin, who completed deployments to Bosnia, Afghanistan and Iraq and serves as Director of Veterans and Wounded Warrior Policy: As a proud VFW member, I want to underscore that the health reform legislation being voted on today will not adversely impact our nation’s veterans.  In fact, during his time in office, President Obama has provided an historic increase in benefits for our veterans and has upheld every pledge to protect the benefits our veterans have earned in service to our nation.  He will continue to stand firm in his commitment to veterans.

To give our veterans further assurance that this legislation will not affect their health care systems, the Chairmen of five house committees including Veterans’ Affairs Chairman Bob Filner and Armed Services Chairman Ike Skelton, have just issued a joint letter (pdf) reaffirming that the health reform legislation as written would protect those receiving care through all TRICARE and Department of Veterans Affairs programs.  In case any questions remained, yesterday’s unanimous passage of HR 4887 in the U.S. House of Representatives, the TRICARE Affirmation Act, made it crystal clear that our veterans – in particular those who depend on TRICARE - will not be harmed by this bill. The White House supports this legislation as well.]

As Assistant Secretary of the Department of Veterans Affairs, a constant concern for me is having our Veterans dragged into partisan politics. Unfortunately the debate over health reform has seen that happen far too many times, and at the VA we often have to correct misinformation and assure Veterans that the care they rely on will not be taken away from them.

One of the concerns we are hearing the most now is whether health reform will affect the care Veterans receive under the VA system.

Let me be unambiguous: The healthcare that Veterans receive through the VA system, including dependents of certain veterans enrolled in the CHAMPVA program, will be safe and sound under health reform. The Secretary of Veterans Affairs would continue to maintain sole authority over the system and for enhancing the quality and access for all eligible Veterans.

In addition, TRICARE will continue to be available for all eligible servicemen and women, and their families. Those who are covered by TRICARE would meet the shared responsibility requirement for individuals to have insurance, thereby exempting such members of the uniformed services and dependants from being assessed any sort of penalty. The President has made it clear publicly and to me that he is committed to ensuring that America’s servicemen and women have high quality care, and with health reform that commitment remains very much intact.

I have personally seen what a devastating medical condition can cost. Had I been injured on the freeway and not in combat, it is likely that I would be bankrupt even though I had medical insurance through my civilian employer. I personally receive my world class healthcare from the VA and as a dependent on my husband's Tricare eligibility. This bill is good for our nation and our Veterans and Service Members and their families can be reassured that their benefits are safe. 

Tammy Duckworth is the Assistant Secretary of Public and Intergovernmental Affairs for the Department of Veterans Affairs

Increasingly desperate opponents of health reform continue their effort to shift the debate from the popular aspects of reform, such as more consumer protections for people, competitive marketplaces that offer small businesses health insurance at reasonable rates, and the reduction of overall health care costs over time.  Instead, opponents of reform often choose to invent wild claims without any regard for evidence or accuracy.

Take, for example, recent outlandish and false allegations in the news that the White House has sent unsolicited emails to drum up support for reform.  Let's be clear -- and done -- with this incorrect claim: the White House only sends mass messages to email addresses submitted through email signup forms on WhiteHouse.gov.  And every message we send has a clear unsubscribe link at the footer to stop receiving messages at any time.

While some people unsubscribe from the White House’s email program, many more have signed up. Since inauguration, the number of people who have opted-in for email updates has steadily grown, making this an increasingly popular way for anyone to stay current and informed about what's happening with President Obama and the White House.  Anyone can sign up for them here.

Just today a fierce critic of health reform, Karl Rove, went a step further on ABC's "This Week" by making the absurd and unfounded claim that the White House “sent out unsolicited e-mails to federal employees asking them to contact their legislators about this bill.”  This is simply not true and unless Mr. Rove can point to a White House email making this request of anyone, federal employee or otherwise, he should correct this dangerous and inaccurate assertion.

 In his remarks to the House Democratic Caucus yesterday, President Obama put the upcoming health insurance reform effort into a larger context with some powerful thoughts about how he got invovled in politics and what moments like now mean for the country.

Click here to see the video.

Here are some particularly poignant thoughts from the end:

Sometimes I think about how I got involved in politics.  I didn’t think of myself as a potential politician when I get out of college.  I went to work in neighborhoods, working with Catholic churches in poor neighborhoods in Chicago, trying to figure out how people could get a little bit of help.  And I was skeptical about politics and politicians, just like a lot of Americans are skeptical about politics and politicians are right now.  Because my working assumption was when push comes to shove, all too often folks in elected office, they’re looking for themselves and not looking out for the folks who put them there; that there are too many compromises; that the special interests have too much power; they just got too much clout; there’s too much big money washing around.

And I decided finally to get involved because I realized if I wasn’t willing to step up and be true to the things I believe in, then the system wouldn’t change.  Every single one of you had that same kind of moment at the beginning of your careers.  Maybe it was just listening to stories in your neighborhood about what was happening to people who’d been laid off of work.  Maybe it was your own family experience, somebody got sick and didn’t have health care and you said something should change.

Something inspired you to get involved, and something inspired you to be a Democrat instead of running as a Republican.  Because somewhere deep in your heart you said to yourself, I believe in an America in which we don’t just look out for ourselves, that we don’t just tell people you’re on your own, that we are proud of our individualism, we are proud of our liberty, but we also have a sense of neighborliness and a sense of community and we are willing to look out for one another and help people who are vulnerable and help people who are down on their luck and give them a pathway to success and give them a ladder into the middle class.  That’s why you decided to run.

And now a lot of us have been here a while and everybody here has taken their lumps and their bruises.  And it turns out people have had to make compromises, and you’ve been away from families for a long time and you’ve missed special events for your kids sometimes.  And maybe there have been times where you asked yourself, why did I ever get involved in politics in the first place?  And maybe things can’t change after all.  And when you do something courageous, it turns out sometimes you may be attacked.  And sometimes the very people you thought you were trying to help may be angry at you and shout at you.  And you say to yourself, maybe that thing that I started with has been lost.

But you know what?  Every once in a while, every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises that you made in all those town meetings and all those constituency breakfasts and all that traveling through the district, all those people who you looked in the eye and you said, you know what, you’re right, the system is not working for you and I’m going to make it a little bit better.

And this is one of those moments.  This is one of those times where you can honestly say to yourself, doggone it, this is exactly why I came here.  This is why I got into politics.  This is why I got into public service.  This is why I’ve made those sacrifices.  Because I believe so deeply in this country and I believe so deeply in this democracy and I’m willing to stand up even when it’s hard, even when it’s tough.

Every single one of you have made that promise not just to your constituents but to yourself.  And this is the time to make true on that promise.  We are not bound to win, but we are bound to be true.  We are not bound to succeed, but we are bound to let whatever light we have shine.  We have been debating health care for decades.  It has now been debated for a year.  It is in your hands.  It is time to pass health care reform for America, and I am confident that you are going to do it tomorrow.