• Obama has strongly opposed Republican proposals to change Medicare for future beneficiaries (people currently 55 or younger) into a defined-contribution program, in which they would receive a set amount of money each year to buy health coverage, rather than the program's current defined-benefit design.

• In an April 2011 speech, Obama set forth a plan for reducing the deficit and changes to Medicare and Medicaid:

"But let me be absolutely clear: I will preserve these health care programs as a promise we make to each other in this society. I will not allow Medicare to become a voucher program that leaves seniors at the mercy of the insurance industry, with a shrinking benefit to pay for rising costs. I will not tell families with children who have disabilities that they have to fend for themselves. We will reform these programs, but we will not abandon the fundamental commitment this country has kept for generations." – Obama, speech, April 13, 2011

Obama on Health Reform Philosophy:

• The 2010 health law, which is considered to be the Obama administration's signature legislative achievement, has the dual objectives of expanding health coverage and containing costs. Among its key provisions is a requirement that nearly all Americans obtain health coverage, a marked expansion of the Medicaid program (see Medicare and Medicaid sections above for more details), the creation of health insurance exchanges and an array of consumer protections including bans on pre-existing condition exclusions. 

• In 2008, Obama made efforts to overhaul the health system a central theme in his presidential campaign. His reform proposal (PDF) included a requirement that all children have health insurance, and that most large employers either offer employee health benefits or contribute to a new public program. He also advocated expansions for Medicaid and CHIP. He advanced a number of the same types of consumer protections that ultimately were included in the health law. He initially opposed the individual mandate.