Keeping Score: The State of Healthcare in Obamaland

January 13, 2016


One of Washington’s favorite parlor games is to dissect major speeches by the President to see what signals he might be sending to the American people. How long was the speech? What topics got the most attention? The least attention? Did he mention my pet topic?

The annual State of the Union (SOTU) address to a joint session of Congress is the Super Bowl of speeches and lots of people are keeping score. What stood out in President Obama’s 2016 SOTU. For starters, it was shorter than usual, clocking in at just over 58 minutes. And, rather than focusing on the usual laundry lists of things the President wants Congress to do this year, Obama focused more on what he thinks he has accomplished and what lies ahead for the next person to sit in the Oval Office.

So, let’s roll the dice and get this game started. How did healthcare fare? Let’s take a look at the numbers:

  • Total words in the speech: 5,438
  • Topic with the most words: the economy (530 words, 9.7%)
  • Words about healthcare: 252
  • Percentage of speech about healthcare: 4.6%



Some are saying Obama gave healthcare – usually one of his favorite topics – short shrift. Does that signal he no longer sees it as a priority? In this case it’s not how much the President said, it’s how he said it. In a speech that was more thematic than specific, Obama started off by listing what he sees as his five greatest accomplishments: economic recovery, healthcare reform, energy, improving veterans’ care and marriage equality. When you’re number two on the short list that says a lot.

How did 2016 contrast with previous Obama SOTUs? The 252 words dedicated to healthcare in 2016 compare favorably with the 226 (3%) in Obama’s 2015 SOTU. But they are dwarfed by the 545 (10.4%) in 2009, when the President began his push for healthcare reform or the 771 (9.6%) in 2010 as he pleaded with Congress not to walk away from what would become, just two months later, the Affordable Care Act.

But what substance did Obama focus on? First up, not surprisingly, a defense of Obamacare. The ACA is “filling the gaps in employer-based care so that when we lose a job, or go back to school, or start that new business, we’ll still have coverage.” Obama noted that “nearly eighteen million have gained coverage so far. Health care inflation has slowed. And our businesses have created jobs every single month since it became law.”

In one of the most ambitious parts of the speech, Obama said, “Last year, Vice President Biden said that with a new moonshot, America can cure cancer. Last month, he worked with this Congress to give scientists at the National Institutes of Health the strongest resources they’ve had in over a decade. Tonight, I’m announcing a new national effort to get it done. And because he’s gone to the mat for all of us, on so many issues over the past forty years, I’m putting Joe in charge of Mission Control. For the loved ones we’ve all lost, for the family we can still save, let’s make America the country that cures cancer once and for all.” Obama also promised to push for funding to fight malaria and praised the work of “our military, our doctors, and our development workers” to stop the spread of Ebola in West Africa.

The focus now shifts to Iowa, New Hampshire and beyond. Obama’s legacy is central to much of the campaign debate to date but as the two parties sort out who their nominees will be the President will fade a bit into the background and start thinking about a day when his words aren’t counted and scrutinized quite as much.