    [Public Papers of the Presidents of the United States: William J. Clinton (1993, Book I)]
    [February 1, 1993]
    [Pages 25-27]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks Following a Meeting With the Nation's Governors
    February 1, 1993

        The President. Well, I want to say good morning to the members of
    the press who are here from Washington and many of you from around the
    Nation.
        I'd like to read a statement and then call on the Governors, Romer
    and Campbell, to make a statement about the meeting we had here today
    and the actions which I will take today as a result of this meeting and
    the work that I have been doing over the last couple

    [[Page 26]]

    of months.
        The day before my Inauguration, on one of the last days people
    called me Governor, I had lunch with many of the Governors here and many
    others with whom I have served over the past 14 years. I pledged to them
    a partnership between the country's Governors and this administration,
    rooted in our common experience on the front lines of people's lives.
        I've told my friends, my colleagues, that the one thing I hoped that
    I could actually demand from them was a commitment to keep me rooted in
    that common experience and the real problems of real people. The White
    House, after all, only works when it is the people's house.
        Today we have continued our partnership in earnest. We agreed to
    challenge together the one obstacle that could keep us from success in
    virtually every arena of national endeavor: the twin monsters of
    spiraling health care costs and the agony of having no access to health
    care, no health care coverage, or living in fear of losing it.
        Left unaddressed, the health care crisis has had devastating impacts
    on families, businesses, the fiscal conditions of State and local
    government, and the economic performance of the United States. For 12
    years our national Government has ignored the problem, partisan gridlock
    has prevented action, and Americans are paying the price. The amount we
    spend on health care has more than tripled. Now we spend far more than
    any other nation on Earth, about 30 percent more of our income, and we
    get less for it.
        We send American companies out into the world with this 30 percent
    handicap simply because of high health care costs. The average American
    car alone includes over $1,000 in health care costs, twice as much as
    its Japanese competitor. You know as well as I do that the real people
    of this country are paying the price: working families who live in fear
    of losing their insurance; small businesses who have to choose between
    dropping coverage or going broke; State and local governments who have
    to balance their books every year and are now choosing between cutting
    education, raising taxes, or cutting other needed investments just to
    pay more for the same health care bills.
        If every person striving to overcome this challenge will bring to
    that work the same depth of drive and determination that our Nation's
    Governors have brought here to the White House today with their policy
    position, the American people will have the commitment it takes to solve
    this problem.
        This meeting was a model of everything I want my relationship with
    our Governors to be. It wasn't scripted or staged. It was simply an
    honest discussion where real work was done, real opinions were argued
    and a room filled with women and men who left their partisan banners
    outside the door. And in that spirit and what I hope is the first of a
    series of announcements we will make together, I want to announce that I
    am taking the following steps to help them meet the health care needs of
    their people in their States.
        For years the Nation's Governors have been arguing that the process
    through which waivers from the Medicaid mandates imposed on them by the
    Federal Government is Byzantine and counterproductive. They are right. I
    have today directed the Department of Health and Human Services and its
    Health Care Financing Agency to take immediately a series of actions
    designed to streamline the Medicaid waiver process to enable the States
    of our country to serve more people at lower costs. These include a
    requirement that from now on the Health Care Financing Agency and its
    regional centers will have only one opportunity to ask for additional
    information and clarifications on States' waiver requests. I also want
    the Health Care Financing Agency to examine the development of a list of
    standard initiatives for automatic approval for State action.
        In consultation with the National Governors' Association, I want a
    rapid review of the entire waiver request process that produces a list
    of additional streamlining recommendations within 60 days. And I am
    directing the Health Care Financing Agency to reopen negotiations with
    the National Governors' Association to issue new regulations related to
    how they can use provider taxes and disproportionate share reimbursement
    to meet the needs of the people in their State.
        Finally, I am directing the Department of Health and Human Services
    to conduct a similar review of the non-Medicaid waiver submissions not
    addressed in the matters I have just discussed.
        I'm also happy to announce that Hillary and the leadership of the
    National Governors' Association have agreed on a formal process for the
    Governors to have input into the Health Care Task Force. Their input,
    their advice, their per-

    [[Page 27]]

    spective is essential to our success. When all this is said and done,
    the health care problems of this country can only be met if we have a
    good partnership.
        And for those of you in the press and the general public who may not
    understand all the language that I have used about Medicaid and waivers,
    if I could put it in simple terms, it amounts to this: The Federal
    Government requires the States to provide a certain number of health
    services in a certain way to people who are poor enough to qualify for
    Medicaid. The States very often believe that they can provide more
    services at lower cost if we don't impose our rules and regulations on
    them.
        For years and years and years, Governors have been screaming for
    relief from the cumbersome process by which the Federal Government has
    micromanaged the health care system affecting poor Americans. We are
    going to try to give them that relief so that for lower costs we can do
    more good for more people. This will be one big step on a long road to
    giving this country the kind of health care system it needs.
        Governor Romer.

    [At this point, Gov. Roy Romer and Gov. Carroll Campbell made statements
    on cooperation with the administration on health care reform.]

        The President. That's our statement. I know a lot of you here want
    to take pictures of your Governors, so have at it.
        Governor King, of all of the people of America, they know you from
    behind as well as from the front, but turn around. I think you ought to
    turn around. How about giving them a profile, at least, that sort of
    tough western profile? [Laughter]
        Thank you all very much.

    Note: The President spoke at 11:23 a.m. in the East Room at the White
    House.