Charlie Rose Talks to Nancy Pelosi

How do you respond to the strong and growing impression that the Affordable Care Act was not ready for prime time—and not just the website?
Let’s not go too far. What we’re talking about now is the technology, by and large. It was a heavy lift to pass it. Presidents and speakers for over 100 years had tried to pass affordable care for all Americans. It was challenged over and over. The Supreme Court declared it constitutional. In the first year, before full implementation, [we have] kids 18 to 26 on their parents’ plan, little children no longer subjected to a previous condition as an obstacle to getting insurance, lower-cost prescription drugs, and the rest. That went very smoothly. Then we come to the distribution piece, the technology piece. It didn’t work well, not unlike Medicare Part D when it opened up.

What about all those people who are now saying, “But the president promised me I could keep my policy”?
Let’s quantify what that is. Ninety-five percent of the people who have health insurance now can keep their plans. So the 5 percent, most of these people will be able to get a policy that is better for them: no preexisting medical conditions, no lifetime limits on insurance. The issue is, now we go to the distribution. We have to fix the technology.