President Clinton Announces New Initiatives To Protect Medicare Beneficiaries

Office of the Press Secretary

For Immediate Release October 8, 1998


The Roosevelt Room

11:49 A.M. EDT

THE PRESIDENT: I would like to begin by thankingSenator Rockefeller and Congressman Dingell for their steadfastsupport of Medicare and their participation in our MedicareCommission. Let me say just in advance, I would think that the veryissue we discuss today offers further evidence that it is time totake a look at the challenges and the responsibilities of theMedicare program, long-term, and I'm glad we have Jay Rockefeller andJohn Dingell on that commission.

I'd like to thank Senator Kennedy and Senator Liebermanand Congressman Stark and Congressman Cardin also for being heretoday. I'd like to thank Secretary Shalala for her marvelousservice, and Nancy Ann Min DeParle who is here with her. I'd like tothank all the members of the seniors groups who are representingtheir constituents -- standing to my right here -- I thank them forjoining us today.

Since this is the only time I'll have to talk to thepress for the next several hours, I hope you will indulge me for amoment while I make a few comments about the present situation inKosovo.

As a result of the unconscionable actions of PresidentMilosevic, we face the danger of violence spreading to neighboringcountries, threatening a wider war in Europe. We face a humanitariancrisis that could be a catastrophe in the making, as tens ofthousands of homeless refugees risk freezing or starving to death aswinter comes on.

Our goal is simple: It is full compliance with UnitedNations Security Council resolutions by President Milosevic. MySpecial Envoy, Richard Holbrooke, has just completed three days oftalks with Mr. Milosevic, making absolutely clear that he must meetthe demands of this Security Council resolution -- end the violence,withdraw his forces, let the refugees return to their homes, give thehumanitarian relief workers full and free access to the people whoneed them, and begin negotiations with the Kosovar Albanians onautonomy for their region, which is provided for under the law oftheir nation.

Yesterday I decided that the United States would vote togive NATO the authority to carry out military strikes against Serbiaif President Milosevic continues to defy the international community.In the days ahead, my counterparts in Europe will be making similardecisions. We would prefer -- we would far prefer -- to securePresident Milosevic's compliance with the will of the internationalcommunity in a peaceful manner. But NATO must be prepared to actmilitarily to protect our interests, to prevent another humanitariancatastrophe in the Balkans.

Now, let me echo, first of all, the sentiments whichhave already been expressed here. Since John Dingell was in thechair when Medicare was passed, it has been more than a program; ithas been a symbol of our intergenerational unity as a country,fulfilling our responsibilities to our grandparents and parents,protecting our families.

Strengthening Medicare has been one of thisadministration's top priorities. Last year we took historicbipartisan action to improve benefits and extend the life of thetrust fund for a decade. We expanded the number and types of healthplans available to Medicare beneficiaries so that older Americans,like other Americans, would have more choices in their Medicare.

I think it ought to be said in defense of this decisionand the enrollment of many seniors in managed care plans, that one ofthe principal reasons that so many seniors wanted it is that therewere managed care plans who thought for the reimbursement thenavailable they could provide not only the required services underMedicare, but also a prescription drug benefit -- something thatthese members and I tried to get done for all the seniors of thecountry at an earlier point in time.

Well, today there are 6.5 million Medicare beneficiariesin HMOs. As we all know, in recent weeks the HMO industry announcedthat unless all Medicare HMOs could raise premiums and reducebenefits -- all -- some health plans would drop their Medicarepatients by the end of the year.

We told them, no deal. That's what we should have done.We were not going to allow Medicare to be held hostage tounreasonable demands. So several HMOs decided to drop theirpatients. These decisions have brought uncertainty, fear, anddisruption into the lives of tens of thousands of older Americansacross the country. While the overwhelming majority of seniorsaffected will be able to join another HMO covering Medicare in theirarea, 50,000 of them will left without a single managed carealternative.

Now, these HMOs say they are looking after the bottomline. All of you who understand the Medicare program know that thereimbursement rates are different across regions and in differentareas. We have tried very hard to alleviate that -- the problemswith that system. And we recognize that there were problems; we haveworked to alleviate them. But that wasn't what we were asked todo. We were asked just to give all HMOs permission to raise rateswhether they needed to or not, without regard to how much money theywere making or not. And I think that was wrong.

We have to do everything we can to protect Americans whohave been dropped by their HMOs and to protect the health careoptions of all seniors in the future. So today we're taking threesteps. First, we'll do everything we can to encourage HMOs to enterthe markets abandoned by managed care. Beginning immediately, theHealth Care Financing Administration will give first priority in itsreview and approval process -- first priority -- to all new HMOsapplying to serve seniors in deserted areas.

Second, I am asking Secretary Shalala to work withCongress, aging advocates, and health plans to develop new strategiesto prevent another disruption in coverage like the one we are seeingnow. I'm asking the Secretary to consider all possible legislativeoptions that can be included in the next budget I send to Congress.

Finally, I am launching a comprehensive, publicinformation campaign to make sure all affected seniors understand thehealth coverage plans that are already available to them. We'llbring together a broad public and private coalition from the AARP tothe Older Women's League to the Social Security Administration tolocal offices on aging, to educate seniors about all their rights andoptions. We must say to them, losing HMO coverage does not meanlosing Medicare coverage. You are still protected by Medicare. Youare still eligible for the traditional fee-for-service program andfor Medigap policies.

Let me just say one other thing. In the last few daysbefore it adjourns, let me ask Congress again to put asidepartisanship and embrace our common responsibilities by reauthorizingthe Older Americans Act. For years, this law has improved the livesof millions of our senior citizens, providing everything from Mealson Wheels, to counseling, to legal services. Every day that goes bywithout passing the bipartisan legislation to reauthorize the actsends a troubling message to seniors that their needs are not apriority.

More than 30 years ago, Congress was able to putprogress before partisanship when it created Medicare in the firstplace. As a result, millions of older Americans have been able tolive healthier, happier, more stable lives. It is one of the signalachievements of this century.

So let me say again, we have to do that again -- to workto strengthen Medicare, to reauthorize the Older Americans Act, totreat each other in the work of America as we want people out inAmerica to treat each other and to work. The members who are herehave certainly done that, and for that I am grateful.

Secretary Shalala and I hope very much that these stepswe are taking today and the work we will do with these senioradvocates will provide some peace of mind, some support, and somehelp to the seniors who have been so shaken by the events of the lastfew days here.

Thank you very much. (Applause.) Thank you.

I want to say one other thing. Senator Dodd came inlate, but has actually offered legislation in this area, so I want togive him credit for that. Connecticut is the only state here with100 percent representation. (Laughter.) Thank you very much.(Applause.)

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