    [Public Papers of the Presidents of the United States: William J. Clinton (1998, Book I)]
    [March 17, 1998]
    [Pages 394-396]
    [From the U.S. Government Publishing Office www.gpo.gov]

    [[Page 394]]

    Remarks on Proposed Legislation To Expand Medicare
    March 17, 1998

        Thank you very much. Thank you. Senator Kennedy is even more exuberant than normal today, but you have to
    forgive him and me and Senator Moynihan and isolated others--this is St. Patrick's Day, and
    we're feeling pretty good, the Irish are. [Laughter]
        Thank you, Congressman Stark, for
    your long leadership and your willingness to push this legislation.
    Thank you, Senator Moynihan, for
    making it utterly clear, so that no one can dispute it, that this
    legislation presents no threat to the integrity of the Medicare program
    or the security of the Trust Fund. Thank you, Sherrod Brown, for your initiative and your leadership. As always,
    thank you, Senator Kennedy.
        And I'd like to say a word of thanks to one person who has not
    spoken here today, our Senate Democratic leader, Tom Daschle, who has worked so hard to help one particular group
    of Americans here: Americans who retired early, in part because they
    were promised health care benefits which were then denied to them. This
    will take care of them, and we can keep the promise that others made to
    them. And I think we have to do it. And thank you, Tom Daschle, for
    fighting for them.
        I'd also like to thank Leader Gephardt and Congressman Dingell and
    all the Members of the House caucus who are here; thank you very, very
    much. And I can't help noting that this may be the first public
    appearance in Washington for the newest Member of this caucus,
    Representative Lois Capps from California.
        Let me begin with a point I have made over and over to the American
    people since the State of the Union Address. This is a remarkable time
    for our country. I look out at all these young people who are working
    here, and I think how glad I am they are coming of age at a time when
    America is working, when we are making progress, economically; we're
    making progress on our social problems; we're making progress in our
    quest for peace and security in the world.
        But everybody knows that the world is changing very rapidly. And so
    the question is, what should we be doing in the midst of good times? I
    believe the last thing we should be doing is sitting on our lead, if I
    could use a sports analogy. Good times give us the confidence, the
    resources, and the space not only to dream about the future we want in
    the 21st century but to take action to deal with it. It is wrong to sit
    idly by when we can be taking steps to prepare for that future. That's
    why I don't want us to spend a surplus that is only now beginning to
    materialize until we have saved Social Security for the 21st century.
    That's why I want us to work together to make sure we deal with the
    long-term challenges of Medicare.
        But it's also why I think we should not let a single day go by when
    Americans have problems that we can remedy in ways that will not weaken
    our present success but instead will reinforce it. That's why I hope we
    get a comprehensive bill through to deal with the tobacco problem,
    because there are a thousand kids a day whose lives are at stake. And
    that's why I believe we should be dealing with this issue now.
        President Johnson said, when Medicare was first enacted, that it
    proved the vitality of our democracy can shape the oldest of our values
    to the needs and obligations of changing times. That's what these
    leaders are doing here today.
        You heard Senator Moynihan say most people don't wait till they're
    65 to retire. But the fastest growing group of people are people over
    65. There are huge numbers of people in this age group. There are people
    62 and over who have lost their health insurance, but can't buy into
    Medicare. There are people under 65 who are married to somebody who's 65
    or older who had the health insurance, and that person retired, got into
    Medicare, but the spouse lost the health insurance. There are people who
    are 55 and over who have been downsized, or who actually retired, early
    retirement, because their employer actually promised them they would
    have health insurance, and then the promise was not kept.
        I want to say that this is not an entirely disinterested thing. In
    2001, I will be 55 and unemployed, through no fault of my own.
    [Laughter] And this bill has a lot of appeal to me. [Laughter] I say
    that to make you laugh. I get a lot of letters from people that I've
    known a long time who are my age, who are middle class people, people I
    grew up with, whose spouses

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    are beginning to have the health problems that go along with just
    working your way through life, people who don't have a great health
    insurance coverage, like I've been privileged to have. And they are
    terrified that they will spend the years between 55 and 65 with maybe
    the most challenging health problems in their entire lives cropping up,
    with no insurance.
        Now, I believe that this is an issue on which Democrats and
    Republicans should be able to unite. We ask the Republicans to come and
    help us on this. Let's don't play election year games on this. We don't
    want to, either. We want to do it in a bipartisan fashion and get it
    behind us. There are hundreds of thousands of people out there in
    America who need this initiative.
        People say, ``Well, why don't you wait until the Medicare Commission
    comes in and issues its report?'' My answer is Senator
    Moynihan's answer: Because we have
    the Congressional Budget Office estimates. They told us that this will
    add nothing to the burden of the Medicare Trust Fund; it will cost less
    than we had originally thought, and we can insure more people.
        But remember the human dimension. Remember Ruth Kain, who spoke when we announced this program in January.
    When her husband turned 65, her employer dropped their insurance
    benefits. He got Medicare; she didn't. But she had a heart condition,
    and they couldn't afford health insurance. So, she didn't get health
    insurance. She went to the hospital one time, and the bill was $13,000.
    Some people have said of our proposal, ``Well, this bill costs a lot of
    money for retired people''--$300 a month or something. One trip to the
    hospital for anything will more than likely be more than twice as much
    in one pop as a whole year's annual premiums--the most minor trip to the
    hospital. The Kains and families like them, the families that
    Congressman Brown mentioned, they ought to have another choice.
        Today I am releasing a report that shows State by State how many
    Americans need these protections--State by State. And we will see, State
    by State, the human lives we're talking about and the number of people
    that will be put at risk if we wait another year to do this.
        Tomorrow the Kaiser Foundation will unveil a study that shows that
    the individual insurance market often denies coverage or charges
    excessive premiums to older, sicker Americans, the very people this
    policy would help to protect. Senator Moynihan said--I want to
    reiterate, because I have heard Senator Kennedy mention the criticisms
    of this program; I want to say this a second time--the Congressional
    Budget Office--not the administration's budget office, the Congressional
    Budget Office--reports this plan will cost individuals even less and
    benefit even more people than we first estimated. It will give somewhere
    between three and four hundred thousand Americans new options for health
    care coverage at a vulnerable time in their lives.
        Let me say one other thing. The bipartisan Kennedy-Kassebaum
    legislation we adopted last year--or in 1996--was also designed to help
    Americans keep their health care when they changed jobs or when someone
    in their family got sick--a bill like this one, designed to give people
    peace of mind. But we now see on news reports today--another good reason
    why it's better for us to do this in this way--because just today we see
    that some insurers are finding ways around that law, giving insurance
    agents incentives to delay or deny coverage to vulnerable Americans.
    These practices have to be stopped. I am directing Secretary
    Shalala and the Department of Health and
    Human Services to conduct a thorough review of the options for
    strengthening the protections of the Kennedy-Kassebaum law.
        And tomorrow the Department will send a notice to every insurer in
    every State in our country affirming what we already know, that impeding
    anyone's access to health care in violation of this law is illegal. It's
    not just wrong; it's illegal. The law is vital to the health and
    stability of America's workers and their families. We intend to enforce
    it vigorously.
        But let me say, you see the problems we have with that kind of
    approach. With this kind of approach, anybody who can afford the premium
    or whose children or relatives will help them to afford this premium
    won't have to worry about whether they have health care coverage. We
    won't have to worry about some regulation or waiting for a report to
    come in to tell us whether this or that or the other person is
    complying. We will know that we're helping hundreds of thousands of
    people who have worked hard all their lives and played by the rules and
    been good citizens to have the decent, secure time in a vulnerable
    period of their lives. We can extend this opportunity in a responsible
    way.

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        Medicare is one of the crowning achievements of this century for the
    American people. With this legislation and with the other challenges
    that we intend to face and overcome, we can make sure, as we become an
    older and older and older country--which is, I always say, a high-class
    problem--that Medicare will be one of the crowning achievements of the
    21st century as well.
        Thank you very much.

    Note: The President spoke at 11:35 a.m. in Room 1100 at the Longworth
    Office Building on Capitol Hill.