President Barack Obama used a visit to Maryland on Thursday to push back against congressional Republicans who are working to delay provisions of his health care law set to take effect next week.
The president vowed that his signature domestic initiative is "here to stay," despite an effort unfolding on Capitol Hill to cut funding for it. And he told nearly 2,000 students at Prince George's Community College that signing up for coverage would be as easy as shopping for "a TV on Amazon."
Democrats have been working feverishly to explain the controversial law as health insurance "marketplaces," the centerpiece of the policy, are set to open for business on Tuesday. Much of the effort is focused on getting the young and healthy to sign up for coverage.
"Part of the reason I need your help to make this law work is because there are so many people out there working to make it fail," Obama told the cheering students. "The fact is the Republicans' biggest fear at this point is not that the Affordable Care Act will fail. What they're worried about is it's going to succeed."
Hundreds of thousands of Marylanders are expected to enroll for coverage through the new exchanges.
Republicans ridiculed Obama's address as a sales pitch to unwilling customers. Senate Minority Leader Mitch McConnell cited polls showing skepticism about the law.
"It must be frustrating for him that folks seem to be tuning out all the happy talk," the Kentucky Republican said.
Congress has yet to approve any federal spending for the fiscal year that begins Tuesday. Conservative GOP lawmakers are threatening to vote down any budget bill unless Democrats agree to strip out funding for the health care law.
If the deadlock continues, the government will shut down after Monday.
"The American people don't want the president's health care bill, and they don't want the government to shut down," House Speaker John Boehner said Thursday.
Obama's appearance in Maryland was part of larger effort the administration is planning over the next several days to explain the law. The president appeared with former President Bill Clinton on Tuesday at an event in New York intended to ease fears about the Affordable Care Act's implementation.
But his speech in Maryland was more emphatic and political. He said Republicans who opposed the law are "crazy" and full of "hot air" and called attempts to tie it to must-pass government funding measures irresponsible.
"The closer we get, the more desperate they get," Obama said. "Shutting down the government just because you don't like a law that was passed and found constitutional, and because you don't like the idea of giving people new access to affordable health care — what kind of idea is that?"
He extolled what he said would be the benefits of the law, and made a prediction: "Once it's working really well, I guarantee you they will not call it 'Obamacare.'"
But his argument was undercut somewhat Thursday by the latest in a series of glitches and delays the administration has acknowledged. Officials said small businesses in some states will have to use paper forms to sign up for coverage until November. The delay will not affect Maryland businesses.
Rep. Andy Harris, the state's only Republican congressman, said that "every major promise the president made about Obamacare is turning out to be a lie."
"Another speech won't change the fact that insurance costs are continuing to climb and people across the country are not being able to keep the insurance plans and doctors they like," said the Baltimore County lawmaker, who is also a physician.
Speaking generally, Maryland was friendly territory for Obama's pitch. State officials in Gov. Martin O'Malley's administration have been the most energetic in the nation in setting up the insurance exchanges.
"It's going to be smoother in places like Maryland where governors are working to implement it rather than fight it," Obama said.
The state is home to roughly 750,000 people without insurance; about one-third of those are expected to get coverage through the new exchanges. The U.S. Department of Health and Human Services estimated this week that the lowest-cost plans offered would have an average monthly premium of $197.
Some low- and middle-income families will be eligible for federal subsidies to help offset those costs.
Virtually every American will be required to buy some form of health insurance by Jan. 1. Those who receive coverage from their employers or through an existing government program, such as Medicaid and Medicare, won't use the exchanges.
Winifred Okwuchi, a 19-year-old student at Prince George's Community College, said she found Obama's address "powerful" but also instructive.
She said she is insured under her parents' health plan — the law allows children to stay on their parents' plans until they turn 26 — but she would consider signing up for coverage through the exchange if needed later.
"I feel like it's going to help us in the long run," she said. "It's a starting point for us after we move off our parents'" insurance.
The exchanges are being created by the state, but the policies are sold by private insurers. The exchange will allow consumers to compare private plans in the same way that websites allow travelers to compare airfares before they buy tickets.
Supporters of the law are particularly eager for young, healthy people to sign up for coverage, because their participation is expected to reduce premiums for all participants.
Rep. Donna F. Edwards, a Democrat whose district includes the college where Obama spoke, implored students to sign up. She said she didn't have coverage when she was young, and she almost lost her home when she got sick and had to go to the emergency room.
"You sign up because it's the right thing to do and it's the right thing to do for your families," Edwards said.
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