TIME's Exclusive Interview with President Obama

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Brooks Kraft / Corbis for TIME

President Barack Obama

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Can I just ask, every time you say, "If you like what you have, you can keep it," I wonder what about if you don't like what you have? What if you think your employer's plan is too expensive or you don't like the doctors that are on the list? The House and the Senate have two different approaches on this.
Here's what we're trying to balance. On the one hand we want to make sure that employers don't dump their coverage and try to just put the burden onto the government. That's been one of the concerns that I had originally during the debates with John McCain about completely eliminating the exclusion. The majority of people still get health insurance from their employers. For them to suddenly just lose that and get some sort of tax credit and have to go out on the open market would be a radical change that I think would increase people's vulnerability as opposed to increasing their security.

At the same time, as you said, there are people whose premiums are going up or out-of-pocket costs are going up or so constrained that they might be able to access a better deal through the health insurance exchange that we've set up. I think right now what we're thinking is that certainly the uninsured can access the exchange. Small businesses who want to provide coverage can access the exchange. The self-employed can access the exchange.

If you are getting health insurance through your employer there are going to be some criteria that would allow you to switch off. If the deductibles are so high or the premiums are so high or the levels of insurance are so poor that you are effectively underinsured, then we want you to be able to access other options through the exchange. If on the other hand your employer's health insurance is good then you're still going to benefit from the insurance regulatory rules on preexisting conditions, but you probably don't need the mechanism of the exchange and the subsidies in order to stay healthy.

All right.

Well, again, thank you very much.
Thank you so much.

I just so appreciate you doing this.
Well, I appreciate you. You've been doing a good job on the reporting on this.

Thank you so much.
It's hard stuff and you've been very serious about it, so we appreciate it.

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