[Public Papers of the Presidents of the United States: William J. Clinton (1996, Book II)]
[August 21, 1996]
[Pages 1319-1321]
[From the U.S. Government Publishing Office www.gpo.gov]



[[Page 1319]]


Remarks on Signing the Health Insurance Portability and Accountability 
Act of 1996
August 21, 1996

    Thank you very much. Thank you so much. Thank you very much for that 
wonderful introduction, Merit, and thank you for the courage of your 
example.
    I want to begin by recognizing the Members of Congress who are here 
who worked on this so hard. In addition to Senators Kassebaum and 
Kennedy, we have Senator John Breaux, Senator Bill Cohen, Senator Byron 
Dorgan, Senator Carl Levin, Congressman Mike Bilirakis, Congressman John 
Conyers, Congressman Harris Fawell and Congressman Dennis Hastert, 
Congressman David Hobson, and Congressman Bill Thomas. I thank all of 
them for their work on this.
    I thank Secretary Shalala for her hard work; the SBA Administrator, 
Phil Lader, who is here. I'd also like to recognize a gentleman in the 
audience who did a lot of work with the First Lady on this and who is, 
I'm sure, happy to be here today, our former Surgeon General, Dr. 
Everett Koop. Thank you, sir, for being here. And Dr. Henry Foster, it's 
nice to see you; thank you for being here, sir.
    There are so many others I'd like to thank. I want to thank all the 
consumer groups, the business groups, the labor groups, the grassroots 
people, the people who were personally affected by health care problems 
and problems in our system, who are here. All of you worked so hard to 
make this day a reality. I want to thank all the people who worked on 
the staff at the White House, the people especially who worked with the 
First Lady from 1993 on. All of you should take some great satisfaction 
in seeing this day come to pass, and I want you to know that I will 
never forget the work that all of you have done and the service you have 
rendered to the American people, and we thank you.
    But a lot of people who worked on health reform were just folks, 
people that Hillary met traveling around the country, or people that I 
had the good fortune to run into who told me their stories and who 
helped to work to make this day a reality. People like Dan Lumley, who 
is here with us today, a man we met on our bus tour, from Portland, 
Oregon. And there have been many others who have helped, like Kristin 
Hopper and Tensia Alvarez, who are here with their families today. We 
thank you for coming here with your families.
    And let me again especially thank Merit Kimball and her wonderful 
parents, Jack and Rosemary, who have come here today. They have had the 
courage to tell their story and to fight for their cause and on behalf 
of tens of millions of other Americans. They have given us the hope that 
together we can make things better for more Americans.
    The Health Insurance Portability and Accountability Act shows what 
happens, as Senator Kassebaum said and Senator Kennedy said, when we 
work together, when we cross party lines and put the interests of the 
American people first. This bill is a clear boost to our values as 
Americans. It offers opportunity by allowing people to take their health 
insurance from job to job. It rewards responsibility by helping people 
to work who desperately want to work. It brings us together in a common 
community to do what's right by all of our people, saying that we ought 
to make it possible for more and more people to succeed at work without 
losing the security of knowing that when they need health care it'll be 
there.
    Health care reform is measured by how many lives it improves. With 
this bill we take a long step toward the kind of health care reform our 
Nation needs. It seals the cracks that swallow as many as 25 million 
Americans who can't get insurance or who fear they'll lose it. Now 
they're going to be protected.
    Never has such a measure been more needed for our people. Our new 
economy presents Americans with opportunities like never before to work 
their way into better paying jobs. And yet our health care system has 
worked to paralyze many workers who fear losing their health care 
coverage if they take those better jobs and change their employers. At 
the same time, millions of Americans find themselves labeled as people 
with preexisting conditions, from cancer to AIDS, which disqualifies 
them and their families for coverage, including the husband, the 
pregnant wife who lose their insurance; the young woman who can't change 
jobs because

[[Page 1320]]

her new insurance doesn't cover diabetes; the small-business owner who 
faithfully pays group health insurance premiums for years and then finds 
that his coverage won't be renewed because one of his employees has 
developed a heart condition.
    No more. This bill changes all that. Today we declare a victory for 
millions of Americans and their families. No longer will you live in 
fear of losing your health insurance because of the state of your 
health. No longer need you hesitate about taking a better job because 
you're afraid to lose your coverage. And no longer will small businesses 
be denied access to insurance for their employees. The health insurance 
reform bill I sign today will protect the health care of millions of 
working Americans and give them and their families something that cannot 
be measured, peace of mind.
    The bill also addresses other problems in getting more affordable 
insurance to our workers. It makes it easier and less expensive for the 
self-employed to purchase their insurance. As Senator Kassebaum said, it 
phases in a tax deduction of 80 percent for the self-employed and helps 
to even the playing field with bigger businesses. Second, it prevents 
fraud and abuse. It toughens penalties and helps us to go after bad 
apple health care providers who bilk the system of billions of dollars 
from Medicare, from Medicaid, and from private insurance companies. I 
especially want to thank Secretary Shalala for her work on these fraud 
and abuse provisions. Third, it makes the health care system more 
simple. It will modernize, streamline, and cut the cost of insurance 
paperwork by devising a uniform electronic system for paying health care 
claims. It will provide steps to protect the privacy of people in the 
system as it does so. Fourth, it allows the establishment of a limited 
number of medical savings accounts to allow us to study this approach 
and see how it works, to determine whether this new approach can make a 
positive contribution to health care coverage and to affordability. And 
fifth, it helps with long-term care. It provides consumer protections 
and makes long-term care insurance more affordable. This bill, in short, 
does a very great deal.
    I want to echo what Senator Kennedy said: Senator Kassebaum, we are 
deeply in your debt. We're going to miss you, and you must be very proud 
that here in the last months of your career in the Senate you have done 
such a magnificent thing. We thank you so much, ma'am.
    Senator Kennedy, as I told you before we came out here, when I woke 
up this morning and thought about signing this bill today, I remembered 
a day a very long time ago, almost 18 years ago now, when I moderated a 
panel on health care reform in Memphis, Tennessee, at one of our many 
conventions, in 1978. And you were there, telling the American people in 
1978 that every person in America deserved the health care that your son 
had when he was first taken ill. I'm proud of you for these two decades 
of commitment, sir. Thank you.
    And if you'll forgive me a personal note, I believe, Hillary, that 
this justifies all those days on the road and all those nights you 
stayed up reading the incomprehensibly complex issues of health care. 
[Applause] Thank you.
    I wish this bill had contained the provision to eliminate the 
differential treatment of mental health coverage or at least taken some 
positive steps in that direction. I know this is something that is 
especially important to Tipper Gore, and I know that we all know that 
we're going to have to deal with that.
    And we have to do more, and this is also very important. We must 
find a way to provide coverage for workers and their families who are in 
transition. I have proposed a plan which we put in our balanced budget 
to cover 3 million workers and their families, including 700,000 
children, who today have nowhere to turn for affordable health care 
because the worker is changing jobs. If a person is doing the right 
thing, trying to be responsible, dying to go to work, we should help 
those kind of people to get back on their feet without being thrown flat 
on their back without health insurance.
    Our mission in pursuing health care reform from the start has been 
to provide more fairness and quality for the American people. That's why 
we worked to strengthen the Medicare Trust Fund, although we must do 
more, and our balanced budget plan does that. That's why we've worked to 
preserve and to protect Medicaid, why we focused on the problems of 
health care costs, which, thanks to efforts in the private sector, to 
our own efforts, and to the general direction of our economy with growth 
with low inflation, inflation in health care slowed to 3.9 percent in 
1995, the lowest in 23 years. And for the first half of this year, it is 
down to

[[Page 1321]]

less than 2 percent and may go lower still. We must not let this be a 
temporary development.
    That's also why we've worked to raise childhood immunization rates 
dramatically; to increase investment in biomedical research, including 
funding for breast cancer and AIDS; why we've expedited the FDA review 
process in approval for new drugs, so that people who need a miracle 
might be able to find it; why we fought to protect our children from the 
harmful effects of tobacco advertising aimed at them.
    But now we need to build on what we have achieved. I was encouraged 
to see Senator Kassebaum with her coach's mentality saying that the game 
is not over, and we still have another month this year. And Senator, I'm 
suited up and ready to play. And I appreciate you saying that.
    This is a particularly happy day for me because, like yesterday when 
we signed the minimum wage bill and the bill which gave such strong 
incentives to small businesses to invest in their own businesses and 
made it so much easier for people to adopt children who were willing to 
take on that profoundly important responsibility--these 2 days together, 
and this day especially, helps ordinary Americans to benefit from the 
growth and progress in the American economy. America is on the right 
track, not only when the overall numbers look good but when every 
responsible American family can participate in that.
    It's good that we have 10 million new jobs, record numbers of new 
businesses, that we have the lowest deficit and the highest rates of 
homeownership in 15 years. That's very good. But it's even better when 
every single American who is willing to be responsible for his or her 
family and his or her work can participate in those trends. And with 
portable health care, the minimum wage increase, additional incentives 
for small business growth, more pension security, moving people from 
welfare to work, that will help all Americans to be a part of our 21st 
century America.
    We have more to do in educational opportunity, in helping people 
with their child care and childrearing obligations, in helping people to 
buy their first home, in finishing the job of balancing the budget so 
that we can keep interest rates down and inflation down. But we are 
clearly moving on the right track.
    I look forward to working with Congress when they come back in 
September and to continuing this effort. I want to say again, this bill 
passed almost unanimously. This is a bill that both Senators Kennedy and 
Kassebaum can be proud of because they brought all their colleagues 
along with them. This is a bill that people who have been working in the 
House for years and years and years on health care reform can be proud 
of, and so can everybody else who showed up and voted for it. And 
Congressman Hastert, I want to echo what Senator Kassebaum said, we 
appreciate your work and we know how much you did to get those last few 
difficult issues resolved in a way that we could all live with.
    We can do things when we work together and put the American people 
first. And whenever we work on behalf of our families and our children, 
as we do with the Health Insurance Portability and Accountability Act, 
America always wins.
    So now, in the names of the families and children who will have 
better lives because of it, I am honored to sign this profoundly 
important piece of legislation. And I'd like to ask the Members of 
Congress to come up and join me, along with the families who are here.
    Thank you very much, and God bless you.

Note: The President spoke at 2:50 p.m. on the South Lawn at the White 
House. In his remarks, he referred to Merit Kimball, director of 
communications, Alliance for Health Reform; and Henry W. Foster, Jr., 
Senior Adviser to the President on Teen Pregnancy and Youth Issues. H.R. 
3103, approved August 21, was assigned Public Law No. 104-191.