[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 
    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 
    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