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Remarks on the Health Insurance Initiative and an Exchange With Reporters

January 19, 2000

The President. Good morning, everyone. I'm glad to be joined today by Secretary Shalala, Secretary Herman, Deputy Secretary Eizenstat, and OPM Director Janice Lachance. We want to talk to you about the health care of America's families, one of the biggest challenges we face still in this new century.

Today I want to talk about two major proposals that are in my budget for 2001, which will help Americans to shoulder the cost of health care by extending coverage to millions of people who do not now have it and by helping Americans of all ages meet the demands of long-term care. These proposals are a significant investment in the health of Americans, another step toward giving every American access to quality health care.

As our Nation ages and we live longer lives, we face the need to provide long-term care to larger and larger numbers of Americans. Yesterday we put forward proposals to help Americans to face these new challenges, first by providing a $3,000 tax credit for the cost of long-term care—that is 3 times the one I proposed in last year's State of the Union; second, by expanding access to home-based care through Medicaid; and third, by establishing new support networks for caregivers. We shouldn't let another year go by without helping those who are doing so much to help others. And I will say again, we should also, this year, pass the Patients' Bill of Rights.

We must also keep fighting to extend affordable health care to Americans who lack it. This is a continuing problem in our Nation, as all of you know. Still there are too many children who lose their hearing because an ear infection goes untreated or wind up in the emergency room because they couldn't see a doctor in a more regular way. Too many parents skimp on their own health to provide coverage for their children. Too many missed chances to prevent illness and prepare young people to lead healthy lives—all these the products of the fact that tens of millions of Americans still don't have affordable health care.

So today I'm announcing that my budget will set aside more than $110 billion over 10 years to expand health care coverage. If enacted, this would be the largest investment in health coverage since the establishment of Medicare in 1965, one of the most significant steps we could take to help working families.

This proposal has four components. First, it's hard to have healthy children without healthy parents. We know parents who have access to health care themselves are more likely to get care for their children. And children who see their parents getting regular medical care learn good habits that last a lifetime. Yet, most of the parents of the children covered in our Children's Health Insurance Program, the CHIP program, are themselves uninsured. That's why, as the Vice President has urged, I propose to allow parents to enroll in the same health insurance program that now covers their children. I thank the Vice President for this proposal. I believe it can make a difference to millions of families. You all remember that we set up the CHIP program in the 1997 Balanced Budget Act.

Second, we will work with States to reach every child now eligible for CHIP or for Medicaid. We've doubled the enrollment in the CHIP program in just the last year, as the States have really gotten up and going and taken the right initiatives on this. We now have something over 2 million children in the program. But still, many children are missing out. To find them, we have to take information and enrollment to where they and their parents are: in school lunch programs, in day care facilities, in centers for the homeless. Our budget will fund efforts to do just that, because there is no reason for any child in America to grow up without basic health care.

Third, we are reaching out to Americans who have few or no options for affordable insurance. The numbers of people without insurance are growing fastest among those nearing retirement, an age when many people are already on fixed income or have limited health insurance choices. I met a woman who lost her home trying to pay medical bills on a retirement income while she was waiting to become eligible for Medicare. This shouldn't happen to anyone. I've already proposed that this group of Americans be allowed to buy into Medicare coverage, that is, those between the ages of 55 and 65. And now, this new budget will provide for them a 25percent tax credit to help them do it.

It's also hard to keep insurance for those who change jobs or are laid off, something that happens more and more in our fast-moving economy. That's why we have the COBRA benefits, allowing workers to pay to stay enrolled in health insurance when they're laid off. But too many workers cannot pay the full costs themselves. That's why we're also proposing tax credits that will make COBRA insurance affordable to more people and help workers take advantage of job flexibility without worrying every single day that they may lose their health insurance coverage if they do so.

We will also build on public and private sector insurance programs to help cover 19- and 20-year-olds aging out of insurance, people moving from welfare to work, employees of small businesses, and legal immigrants.

Finally, we must strengthen the network of clinics, hospitals, and dedicated professionals who serve the uninsured. They care for families in need and help to provide the referrals that get children and parents into insurance programs. And their resources are stretched very thin. So I will ask Congress to make a significant investment in these public health facilities next year.

Investing in health care coverage is a smart choice for America. We're meeting our responsibilities to all our American citizens, supporting seniors, helping make our children more ready for the future. I look forward to working with Congress to seize these opportunities this year.

Again, let me say what I have said so many times: In my lifetime we have never had this much economic prosperity and social progress with the absence of paralyzing internal crisis or external threat. We have an opportunity now to really make a dent in this problem of health insurance coverage, in the problem of long-term care, and we ought to do it. I hope we will.

2000 Presidential Campaign

Q. Mr. President, are you happy that health care is an issue on the campaign trail? And what do you think of Bill Bradley's plan? You seem to be endorsing Gore here.

The President. His plan is more extensive than mine, too, the Vice President's is. But they're in a different position.

Number one—let me answer your first question—I am elated that health care is an issue in the campaign. It is a good thing. It's an issue in people's lives. You can see that every time we debate a health care issue. You can see that support we got for the Children's Health Insurance Program in '97. You can see it in the enormous grassroots support for the Patients' Bill of Rights.

And just as Hillary and I predicted in 1994, when the health care proposal was defeated, we said there would be an increase in the number of uninsured people because the cost of insurance would go up and it would be harder for employers, particularly smaller business employers, to continue to cover their employees. So I think that what's going on in the campaign is a great thing for America.

Both the candidates have proposed—made proposals even more sweeping than the one I make today—even though if this were adopted, as I said, it would be the biggest expansion in health coverage since Medicare. But the reason—they should be doing that because they're looking at what they can do over 4 years, what they can do over 8 years. This is a proposal for this year's budget, and it is a very ambitious one-year proposal that will add millions of people to the ranks of those with insurance.

It also is very important because of the $3,000 long-term care tax credit. That's something that I've been involved with, well, for more than 20 years now, something that I feel I know something about and I care a great deal about, and I believe there will be a lot of bipartisan support for that.

Go ahead, Mark [Mark Knoller, CBS Radio].

Health Insurance Initiative

Q. What makes you think that you can get a more expansive health care program through Congress this year than you were able to get through last year?

The President. Well, for one thing, the budget picture is clearer. At least so far, the Republican leadership in the Congress has not put on the table a tax program which would make it impossible to pay the debt off and make it impossible to meet our fundamental obligations.

And I believe if you just look at what's going on in the election season this year, the public cares a lot about health care, and they're talking a lot about it. And all these people, without regard to their party, who come here in the Congress, they've been home talking to the people they represent. They've been listening to this. They know what their folks are up against. They know what kind of problems people face with long-term care. And I think they also, those with a lot of experience, understand how very complex this is and how difficult it is to add to the ranks of the insured in a cost-effective way. And this is clearly, based on our experience, the most cost-effective way to add people to the ranks of the insured.

Let the parents of kids in the CHIP program buy into CHIP or cover them with our funds. And let the people between the ages of 55 and 65 buy into Medicare, and give them a tax credit to do so. Republicans, you know, naturally are inclined to have tax solutions to social problems, and in the case of long-term care, that is exactly the right thing to do. The tax credit is exactly the right way to go there, because there are so many different kinds of long-term care options out there that are appropriate for different families given different circumstances. So I'm actually quite hopeful that we can work together and get something done on this.

Q. Do you think Harry and Louise will support you this time?

The President. Well, I hope so. They've been acting like they want to support me. And I'd like to get together with Harry and Louise; I thought they were pretty effective last time, and we ought to be on the same side. So I'm hoping old Harry and Louise—I wish they would come into the Oval Office here, and we could have a little press conference, a Harry and Louise press conference, endorsing this expansion of health coverage.

Q. After what they did to you?

Q. Can we cover it? [Laughter]

The President. You bet. I want you all to be here. It will be a crowded room if they come, but I'd love it if Harry and Louise would just sidle right on in here and say that they think this is the greatest idea since sliced bread, and we could go forward together. And it would be great.

Israel-Syria Peace Talks

Q. Mr. President, you've spoken to President Asad. Do you have any reason to believe that the peace talks will restart soon?

The President. Well, first of all, I think it's very important that you—I think this has been well and accurately reported, as nearly as I can tell. But I want to reiterate, neither side has decided to back away from the peace talks, call an end to them, call a freeze to them. That's not what's going on. They are having a genuine dispute about sequencing now that I'm trying to work through for both of them.

But the good news about this is that both these leaders, I think, want a peace that meets each other's needs. That is, they're both quite mindful of the fact that there won't be a peace agreement unless the legitimate concerns of both sides are met.

And I would not say the gaps in the positions are 90 percent; I'd say they're much closer to 10 percent than 90 percent. But keep in mind, these folks had not dealt with each other in a very long time. And that week they spent together at Shepherdstown was really the first time they had had these kind of direct contacts, get a feel for where they were. They wanted to go home and reassess their positions. And so we need to do some trust-building. We've got some work to do, but I'm actually quite hopeful.

And I see that both sides have continued to evidence a fairly high level of confidence that they can succeed, and that's good news. So we're in a little patch here where I've just got a little extra work to do, and I'm working at it. And hopefully, we can do it.

Q. [Inaudible]—Asad today or yesterday?

The President. Yes, I talked to President Asad, I think yesterday, wasn't it?

Q. But since then——

The President. No, not since yesterday morning. But I'll be in regular contact with him continuously. So we're working this very, very hard. And of course, we're also working on the Palestinian track, and tomorrow Chairman Arafat will be here, and I expect to have a good meeting with him. You know, if this were easy, it would have been done a long time ago. But we're working at it, and I'm pretty hopeful.

President's Last Year in Office

Q. Are you mournful that tomorrow is the last—the start of your last year in office, sir?

The President. Yes, tomorrow is the day, isn't it?

Q. Yes.

The President. Well, I will certainly mark the day.

Q. In what way?

The President. I mean, I'll just be conscious of it, in all kinds of little ways. When I go in a room in the White House now, I look around more carefully to make sure there's something—that I've actually noticed something that I may not have seen. You'd be amazed, when you're living a busy life and you're working really hard—I bet it happens to you, too— how many times you walk in and out of a room, and you'll see something in a room that you've been in the room for 5 years and you never noticed before. So I'm sensitive to all that.

But I'm actually very—I'm so grateful that the country is in the shape that it's in. And I'm so grateful that I've had the chance to serve. And I'm so energized about the State of the Union and, in many ways, in the sweep and depth of the proposals that I will make to the Congress and the country in the State of the Union are arguably the most far-reaching since the very first one I made. So I'm feeling good and grateful, and I just want to milk every last moment of every day.

The only thing, I wish I didn't have to sleep at all for a year. [Laughter] I wish that God would give the capacity to function for a year without sleep. That would make me very happy. [Laughter] But I think it highly unlikely. Therefore, I will keep trying to get some.

Thank you.

NOTE: The President spoke at 11:50 a.m. in the Oval Office at the White House. In his remarks, he referred to Harry and Louise, characters in Health Insurance Association of America-sponsored television advertisements in opposition to health care reform legislation proposed in 1993; President Hafiz al-Asad of Syria; and Chairman Yasser Arafat of the Palestinian Authority.

William J. Clinton, Remarks on the Health Insurance Initiative and an Exchange With Reporters Online by Gerhard Peters and John T. Woolley, The American Presidency Project

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