Health Care: Increasing Access and Improving the Nation's Health
Enacted Most Comprehensive Medicare Reforms in History. In the 1997 Balanced Budget, the Clinton-Gore Administration protected, modernized and extended the life of the Medicare Trust Fund while offering new options for patient choice and preventive care. New preventive benefits passed include coverage of annual mammograms, coverage of screening tests for both colorectal and cervical cancer, and a diabetes self-management benefit. The President proposed a plan to reform and modernize Medicare's benefits, including an optional prescription drug benefit that is affordable and available to all beneficiaries. The President has also proposed a reserve fund to help Medicare beneficiaries with extremely high prescription drug costs. [White House at Work, 8/8/97; National Economic Council/Domestic Policy Committee, 7/2/99]
Extending the Life of the Medicare Trust Fund. When President Clinton and Vice President Gore took office, Medicare was expected to run out of money in 1999. Now, the life of the Trust Fund has been extended until 2023. Medicare is now in the soundest shape it has been since 1975. [HHS Press Release, 3/30/00]
Enacted Single Largest Investment in Health Care for Children since 1965. The five year, $24 billion State Children's Health Insurance Program (SCHIP) will provide health care coverage for up to five million children. Two million children have already been enrolled, and in October 1999 President Clinton announced new outreach initiatives to enroll millions more uninsured, eligible children. Last year, the President launched a nationwide "Insure Kids Now" campaign that will bring together major TV and radio networks, healthcare organizations, religious groups and other community-based organizations to help enroll more children in the Children's Health Insurance Program, with the goal of enrolling 5 million of the estimated 10 million children eligible for health insurance under CHIP within 5 years. This year, the budget includes several of Vice President Gore's proposals to accelerate enrollment of children in CHIP. The President is also proposing a new FamilyCare program, which would give States the option to cover parents in the same plan as their children. [White House Fact Sheet, 1/11/00; White House, 2/23/99]
Passed Meaningful Health Insurance Reform. The President signed into law the Kennedy-Kassebaum Health Insurance Portability and Accountability Act, which helps individuals keep health insurance when they change jobs, guarantees renewability of coverage, and ensures access to health insurance for small businesses. As many as 25 million people will benefit from this law. The bill also eliminated the discriminatory tax treatment the of the approximately 10 million Americans who are self-employed; strengthened efforts to combat health care fraud, waste and abuse by creating a stable source of funding; and provided consumer protections and tax incentives for private long-term care insurance. [FY 2000 Budget, p. 83; Domestic Policy Council]
Enacted Historic Comprehensive FDA Reform that Expedited the Review and Approval of New Drug Products. The President signed into law the 1997 FDA Modernization Act that includes important measures to modernize and streamline the regulation of biological products; increase patient access to experimental drugs and medical devices; and accelerate review of important new medications. This reform builds on the administrative initiatives implemented under the Vice President's reinventing government effort which have led U.S. drug approvals to be as fast or faster than any other industrialized nation. Average drug approval times have dropped since the beginning of the Administration from almost three years to just over one year. [Domestic Policy Council]
Signed Mental Health Parity Provisions into Law. To help eliminate discrimination against individuals with mental illnesses, the President signed into law mental health parity provisions to prohibit health plans from establishing separate lifetime and annual limits for mental health coverage. In 1999, the White House held the landmark, first-ever Conference on Mental Health and released the Surgeon General's first Report on Mental Health. This year, the President's budget includes an investment of $100 million for mental health services, an increase of 16 percent over last year's funding level and a 90 percent increase since 1993. [Presidential Statement, 9/26/96]
Signed Legislation to End Drive-Through Deliveries. President Clinton signed into law common sense legislation that requires health plans to allow new mothers to remain in the hospital for at least 48 hours following most normal deliveries and 96 hours after a Cesarean section. [Presidential Statement, 9/26/96]
Extended Strong, Enforceable Patient Protections for Millions of Americans. Leading by example, the President directed all federal agencies to ensure that their employees and beneficiaries have the benefits and rights guaranteed under the proposed Patients' Bill of Rights. 85 million Americans covered by federal health plans have the security of knowing they will have fair access to health care thanks to the President's work. The President and Vice President have called for passage of the bipartisan Patients Bill of Rights Act, to ensure that all Americans have essential protections, such as guaranteed access to needed health care specialists; access to emergency room services when and where the need arises; continuity of care protections to assure patient care if a patient's health care provider is dropped; access to a timely internal and independent external appeals process with a medical necessity standard; assurance that doctors and patients can openly discuss treatment options; and an enforcement mechanism that ensures recourse for patients who have been harmed as a result of health plan actions. [FY 2000 Budget, p. 85]
Fighting Medicare Fraud and Waste. Since 1993, the Clinton-Gore Administration has assigned more federal prosecutors and FBI agents to fight health care fraud than ever before. As a result, convictions have gone up a full 410 percent, saving more than $50 billion in health care claims. The Balanced Budget Act gave an array of new weapons in our fight to keep scam artists and fly-by-night health care out of Medicare and Medicaid. [Domestic Policy Council, Health Care Achievements]
Increasing the Participation of Seniors in Clinical Trials. President Clinton signed an executive memorandum directing Medicare to begin covering all the routine medical costs of participation in a clinical trial, removing a major barrier to seniors' participation in these trials. These actions, strongly advocated by the Vice President and initiated through his leadership, follow a recent Institute of Medicine report recommending policy changes to encourage greater use of clinical trials by older Americans and the completion of a review of Administration policy. With the fast pace of medical advancement and continuing efforts to make evidence based medical decisions, clinical trials serve as the first step towards providing new clinical innovations to the forefront of medical practice. [White House, Executive Memorandum, 6/7/00]
Released Strong New Protections for the Privacy of Electronic Medical Records. The Clinton-Gore Administration released a new regulation to protect the privacy of electronic medical records held by health plans, health care clearinghouses, and health care providers. This rule would limit the use and release of private health information without consent; restrict the disclosure of protected health information to the minimum amount of information necessary; establish new requirements for disclosure of information to researchers and others seeking access to health records; and establish new administrative and criminal sanctions for the improper use or disclosure of private information. [Domestic Policy Council]
Implementing Comprehensive Nursing Home Quality Initiative. The Clinton-Gore Administration has issued the toughest nursing home regulations in the history of the Medicare and Medicaid programs, including increased monitoring of nursing homes to ensure that they are in compliance; requiring states to crack down on nursing homes that repeatedly violate health and safety requirements; and changing the inspection process to increase the focus on preventing bedsores, malnutrition and resident abuse. Won $43.5 million increase in FY 2000 to fund more rigorous inspections of nursing facilities and improved federal oversight and enforcement of nursing home quality. [HHS Fact Sheet, 12/14/99; National Economic Council, 11/18/99]
Ensuring Safe Food for America's Families. President Clinton created the President's Council on Food Safety to develop a comprehensive food safety strategic plan for federal agencies. The Clinton-Gore Administration has implemented a new science-based inspection system -- Hazard Analysis and Critical Control Points -- and reduced the prevalence of salmonella in raw meat and poultry by as much as 50 percent. The Administration formed national computer network of public health laboratories, called PulseNet, to help rapidly identify and stop outbreaks of foodborne illness by performing DNA "fingerprinting" on foodborne pathogens. The President signed the Food Quality Protection Act, which included special safeguards for kids and strengthened laws governing pesticides and food safety. The Administration also issued new rules to prevent foodborne illness caused by pathogens such as E. coli. [Executive Order 13100, 8/25/98; USDA Press Release, 10/7/99; Presidential Statement, 8/3/96; USDA Press Release, 10/7/99]
Raised Child Immunization Rates to All Time High. Childhood immunization coverage rates in 1998 were the highest ever recorded. 90 percent of toddlers in 1996, 1997 and 1998 received the most critical doses of each of the routinely recommended vaccines, surpassing the President's 1993 goal. Because childhood vaccination levels in the United States are at an all-time high, disease and death from diphtheria, pertussis, tetanus, measles, mumps, rubella and Hib are at or near record lows. There was only one reported case of diphtheria, 100 reported cases of measles, and no reported cases of wild poliovirus for 1998. [HHS Fact Sheet, 9/23/99; HHS Fact Sheet, 12/31/99]
Issued Regulation that Drug Companies Provide Adequate Testing for Children. President Clinton directed an important Food and Drug Administration regulation requiring manufacturers to do studies on pediatric populations for new prescription drugs -- and those currently on the market -- to ensure that prescription drugs have been adequately tested for the unique needs of children. [Domestic Policy Council]
New Efforts to Help Consumers Understand Important Information on Over the Counter Drug Labels. The President unveiled a historic new FDA regulation that, for the first time, requires over-the-counter drug products to use a new product label with larger print and clearer language, making it easier for consumers to understand product warnings and comply with dosage guidance. The new regulation provides Americans with essential information about their medications in a user friendly way and takes a critical first step towards preventing the tens of thousands of unnecessary hospitalizations caused by misuse of over-the-counter medications each year. [Domestic Policy Council]
Promoting Reproductive Health. The Clinton-Gore Administration has taken strong steps to protect a woman's right to choose and to promote safe reproductive health services for women. The President has provided contraceptive coverage to more than a million women covered by federal health plans; provided family planning services to low income women through the Medicaid program; stood up against attempts to prohibit the FDA from approving RU-486; and continues to fight restrictions on international family planning. [Domestic Policy Council, Health Care Achievements]
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