US Presidency
2009

We'll do this by creating a new insurance exchange, a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and Government employees get affordable insurance, it's how everyone in this Congress gets affordable insurance, and it's time to give every American the same opportunity that we give ourselves. Now, for those individuals and small businesses who still can't afford the lower priced insurance available in the exchange, we'll provide tax credits, the size of which will be based on your need. And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned. This exchange will take effect in 4 years, which will give us time to do it right.