Meaning: The quote you've provided is from former President Barack Obama and it addresses the potential increase in costs resulting from providing health care to an additional 30 million people. This statement was made in the context of the Affordable Care Act (ACA), often referred to as "Obamacare," which aimed to expand health care coverage and make it more affordable for millions of Americans. The quote reflects the acknowledgment that expanding health care access would come with associated costs, and it highlights the awareness of this consequence during the implementation of the ACA.

President Obama's statement underscores the recognition that providing health care to more individuals will inevitably have financial implications. The phrase "as a consequence of us getting 30 million additional people health care" indicates the direct correlation between expanding coverage and the resulting increase in costs. It conveys an understanding of the cause-and-effect relationship between the policy decision to extend health care benefits and the anticipated financial impact.

Moreover, the mention of "at the margins" suggests an acknowledgment of the incremental nature of these cost increases. This phrase indicates that the impact on costs may not be uniform across all aspects of health care but rather might manifest at the edges or peripheries of the system. It reflects an awareness of the nuanced and complex financial implications associated with expanding health care access on such a significant scale.

The phrase "we knew that" further emphasizes the proactive understanding of the cost implications. It portrays a sense of foresight and planning, suggesting that the potential increase in costs was not an unforeseen consequence but rather a known aspect that was factored into the decision-making process. This acknowledgment of prior awareness conveys a sense of responsibility and transparency regarding the financial considerations associated with the policy initiative.

President Obama's statement also alludes to the broader societal benefits of expanding health care access. The reference to "us getting 30 million additional people health care" reflects a commitment to improving the health and well-being of a substantial portion of the population. It underscores the underlying motivation behind the policy decision, highlighting the goal of extending vital health care services to a significant number of individuals who were previously uninsured or underinsured.

In the larger context of health care policy and public administration, this quote encapsulates the multifaceted nature of decision-making. It illustrates the intersection of social welfare objectives with fiscal realities, emphasizing the need to balance the noble aim of expanding access to health care with the practical considerations of budgetary constraints and financial sustainability.

Overall, President Obama's statement encapsulates a recognition of the financial implications of expanding health care access, while also underscoring the commitment to broadening coverage and improving the well-being of millions of Americans. It reflects a nuanced understanding of the complexities involved in enacting policies that seek to address societal needs while being mindful of the associated costs and financial implications.