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[8/13/1993 - 7/23/1996] [Family Planning]
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41052044
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[8/13/1993 - 7/23/1996] [Family Planning]
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Presidential Electronic Mail from the Automated Records Management System (ARMS)
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RECORD TYPE: PRESIDENTIAL (RECONSTRUCTED EMAIL)
CREATOR: Richard B. Bavier
(BAVIER_R) (OMB)
CREATION DATE/TIME:13-AUG-1993 17:23:00.00
SUBJECT: One-pager from framework game
TO: Bonnie L. Deane
(DEANE_B) (OPD)
READ: UNKNOWN
TEXT:
Sorry it took so long. Here's my one page summary.
Since the questions were first asked, back in the 1930s, the public
has consistently told opinion surveys that it wants work-for-
welfare. Long-term public support for spending on programs for low-
income people depends on increasing the legitimacy of that spending
in the mind of the electorate. For this and other reasons, a two-
year transitional program followed by a something-less-than-full-
time work requirement is the one essential piece of welfare reform.
It would be so difficult to implement that all other reform elements
should be designed to support work-for-welfare.
So, in addition to a two-year transitional program (with a mandatory
job search requirement), National Programs over the foundation would
include:
a)
a strong prevention campaign, with family planning at the
core;
b)
more federalization of child support enforcement, along
with changes to improve paternity establishment through
both voluntary acknowledgement programs in maternity
hospitals, and lower federal match of AFDC benefits in
cases where states had not established paternity;
c)
a sub
-minimum wage for AFDC parents who go through the
transitional program and end up in the post-transitional
work-for-welfare program, supplemented with transfers to
the family to make up the difference between the sub-
minimum and minimum wage (the sub-minimum wage would be
appropriate in light of their demonstrated inability to
succeed in the regular labor market, and would be more
likely to interest employers who are unwilling to
participate in job subsidy programs with higher
administrative costs).
Experimental add-ons would include Empowerment Zones, with some
public sector jobs for very hard cases, and an experimental means-
tested child support assurance that would be offered as an
alternative to EITC for AFDC families.
There would be some significant costs associated with the post-
transitional work-for-welfare and the child support federalization.
I would try to design a phase-in plan, dealing first with applicants
and only later (if ever) with recipients that could keep the costs
around where the transition document said they might be.
RECORD TYPE: PRESIDENTIAL (RECONSTRUCTED EMAIL)
CREATOR: Catherine R. Zoi
(ZOI_C) (OPD)
CREATION DATE/TIME:14-APR-1994 10:26:00.00
SUBJECT: press q&a for POTUS
TO: William W. Stelle
(STELLE_W) (OPD)
READ: UNKNOWN
TO: Wesley P. Warren
(WARREN_W) (OPD)
READ: UNKNOWN
TO: Linda K. Breggin
(BREGGIN_L) (OPD)
READ: UNKNOWN
TO: Brian J. Johnson
(JOHNSON_BJ) (OPD)
READ: UNKNOWN
TO: Keith E. Laughlin
(LAUGHLIN_K) (OPD)
READ: UNKNOWN
TO: Daniel P. Blank
(BLANK_D) (OPD)
READ: UNKNOWN
TO: Matthew M. Riordan
(RIORDAN_MM) (OPD)
READ: UNKNOWN
CC: Kathleen A. McGinty
(MCGINTY_K) (OPD)
READ: UNKNOWN
TEXT:
WH communications needs our assistance w/ Q&A. Please submit your
Q&As to me by 3:00 at the latest. Think broadly. Thanks.
ATTACHMENT 1
ATT CREATOR: Richard L. Siewert
(SIEWERT_R)
ATT CREATION DATE/TIME:14-APR-1994 08:56:00.00
ATT BODY PART TYPE: B
ATT SUBJECT: TALKING POINTS
ATT TO: Catherine R. Zoi
(ZOI_C)
READ: UNKNOWN
ATT TEXT:
Cathy
Could you please have someone at OEP write up Q & A for a briefing
book we are putting together for a possible press conference
tomorrow? At a minimum, you might want to include Q & A on
the California desert bill, the US position on family planning in
the UN action plan on population, the status of the Northwest
Forest plan, feedback on the new grazing regs and the outlook for
the water and drinking water bills. Anything else that you think
may come up would be helpful. The Q & A itself should be fairly
short, but feel free to send any back-up materials as well.
Please send it to Mark Gearan's office by about 4:00 p.m. today.
Thanks.
Jake Siewert X62100
The press conference itself is still tentative. I will let you
know if they decide not to go forward.
Also have a suggested response to a possible overarching question
on environmental policy. E.g. "As Earth Day approaches, this
Administration has yet to demonstrate a firm commitment to
protecting the environment. Please defend your record." Or
something to that effect.
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (RECONSTRUCTED EMAIL)
CREATOR: Bruce N. Reed
(REED_B) (OPD)
CREATION DATE/TIME:27-APR-1994 09:28:00.00
SUBJECT: Welfare Reform Decisions
TO: Carol H. Rasco
(RASCO_C) (OPD)
READ: UNKNOWN
CC: Kathryn J. Way
(WAY_K) (OPD)
READ: UNKNOWN
TEXT:
If you talk to the President this a.m. about welfare reform, you
can explain the remaining issues to him much more concisely than
the memo from HHS does. There are two main questions:
1. Family Cap
2. Teen Pregnancy
HHS's argument for leaving out the family cap is that it will
anger the left. This is true, although we have no evidence that
leaving it out will be near enough to get them to like our
package.
Kathi and my argument for making the family cap a state option is
that many Democratic govs really want us to do this for them, they
don't want to have to beg for waivers from Mary Jo who hates the
family cap, and this is certain to be part of what Congress passes
so the President might as well get the credit on a very symbolic
issue. At our last mtg with him 2 weeks ago, he said he thought
we should give states flexibility on this.
There is a compromise position: we could make the family cap an
explicit demonstration in the bill, and say that we were going to
let the 10 states with the best proposals for teen prevention and
family planning test the idea. This would calm the left a little
(not a lot), but allow us to draw a defensible line: we don't
know whether this idea works, but we think it's worth finding out.
Mary Jo doesn't mind this compromise; David hates it.
The related issue is that if you do a state option family cap (or
a demonstration option), how should you spend the approx. $220
million it saves in the first 5 years? One option would be to
spend it on additional working poor child care; the other option
would be to spend it on teen pregnancy prevention.
In any event, we will have to deal with concerns from Galston,
Belle, Edelman, Sperling, and many others that we need to spend
more on teen pregnancy.
Thanks.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Isabel Sawhill ( SAWHILL_1) (OMB)
CREATION DATE/TIME: 3-OCT-1994 11:37:57.70
SUBJECT: A successful program - fyi
TO: Sheryll D. Cashin
(CASHIN_S) ) (OPD)
READ: 3-OCT-1994 11:39:17.51
TEXT:
ATTACHMENT 1
ATT CREATION TIME/DATE: 3-OCT-1994 10:31:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Richard B. Bavier
ATT SUBJECT: Quantum Opportunities Program,
ATT TO: Isabel Sawhill
(SAWHILL_1)
ATT CC: Marti E. Easton
(EASTON_M)
ATT CC: Douglas L. Steiger
(STEIGER_D)
ATT CC: Bernard H. Martin
(MARTIN_B)
ATT CC: William A. Galston
(GALSTON_W)
ATT CC: Paul R. Dimond
(DIMOND_P)
ATT CC: Larry R. Matlack
(MATLACK_L)
ATT CC: FAX (92053598, Howard Rolston) (TLXA1MAIL_\F:92053598\C:Howard Rolstor
TEXT:
Larry shared with me the evaluation summary he mentioned in the
urban youth meeting in your office the other week. The summary
claims that the Quantum Opportunity Program produced statistically
significant impacts on dropping-out, high-school completions,
post-secondary education and training, volunteer activity, and
childbearing!
The treatment targeted children in welfare families who were
entering ninth-grade. A multi-service, year-round, program ran
for four years. Activities included educational services
(tutoring, computer-based instruction, and others), community
service activities, and development activities (described as
"health, alcohol, drug abuse, sex, family planning, arts, career,
and college planning"). Participants received payments and
bonuses for attendance and completion, and staff received
incentive payments as well. I've described the Teen Parent
Demonstration and New Chance as Cadillacs. QOP was a Mercedes.
An experimental evaluation design was followed, with a sample of
welfare children assigned at random to treatment and control, and
program staff told to get the treatment group to volunteer.
The impacts were large. 21 percent lower dropout rates. 14
percent fewer children born.
Unfortunately, the samples were very small - only 25 treatment
eligibles in each site. Moreover, sites varied a lot in their
success at implementing the design, and participation varied a lot
within sites too. I'm trying to get a copy of the full report to
get a clearer picture. All the same, this is the most promising
intervention I've seen.
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Richard B. Bavier (BAVIER_R) (OMB)
CREATION DATE/TIME: 3-OCT-1994 11:22:18.60
SUBJECT: Quantum Opportunities Program
TO: Isabel Sawhill
(SAWHILL_1) (OMB)
READ: 3-OCT-1994 11:38:01.52
CC: Marti E. Easton
(EASTON_M) (OMB)
READ: 3-OCT-1994 11:31:06.21
CC: Douglas L. Steiger
(STEIGER_D) (OMB)
READ: 3-OCT-1994 11:23:56.96
CC: Bernard H. Martin
(MARTIN_B) (OMB)
READ: 3-OCT-1994 11:38:38.51
CC: William A. Galston
(GALSTON_W) (OPD)
READ: 3-OCT-1994 15:23:16.39
CC: Paul R. Dimond
(DIMOND_P) (OPD)
READ: 3-OCT-1994 14:01:46.36
CC: Larry R. Matlack
(MATLACK_L) (OMB)
READ: 3-OCT-1994 11:49:37.24
CC: FAX (92053598, Howard Rolston)
(TLXA1MAIL_\F:92053598\C:Howard RolstonREAD:NOT READ
TEXT:
Larry shared with me the evaluation summary he mentioned in the
urban youth meeting in your office the other week. The summary
claims that the Quantum Opportunity Program produced statistically
significant impacts on dropping-out, high-school completions,
post-secondary education and training, volunteer activity, and
childbearing!
The treatment targeted children in welfare families who were
entering ninth-grade. A multi-service, year-round, program ran
for four years. Activities included educational services
(tutoring, computer-based instruction, and others), community
service activities, and development activities (described as
"health, alcohol, drug abuse, sex, family planning, arts, career,
and college planning"). Participants received payments and
bonuses for attendance and completion, and staff received
incentive payments as well. I've described the Teen Parent
Demonstration and New Chance as Cadillacs. QOP was a Mercedes.
An experimental evaluation design was followed, with a sample of
welfare children assigned at random to treatment and control, and
program staff told to get the treatment group to volunteer.
The impacts were large. 21 percent lower dropout rates. 14
percent fewer children born.
Unfortunately, the samples were very small - only 25 treatment
eligibles in each site. Moreover, sites varied a lot in their
success at implementing the design, and participation varied a lot
within sites too. I'm trying to get a copy of the full report to
get a clearer picture. All the same, this is the most promising
intervention I've seen.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME: 4-OCT-1994 20:20:40.50
SUBJECT: Women
TO: Christine M. Heenan
(HEENAN_C) (OPD)
READ: 5-OCT-1994 09:19:48.39
TEXT:
PRINTER FONT 12_POINT_COURIER
Christine:
-- I would not make welfare a separate heading. I would try to
include it under Children and Families or in the section on
work/jobs/economic development.
-- I don't know what tense you are using. Mine is a little
mixed. See if it works.
HEALTH CARE
?
Women have a harder time getting health coverage than men.
They are more likely to work part-time and in service, sales
and household jobs without health insurance. Of the 16
million women without health insurance as of 1990, half of
them had jobs. And those lucky enough to have insurance at
all pay more; women ages 15 to 44 pay 68 percent more out-
of-pocket for health care than their male counterparts.
President Clinton introduced his Health Security Act to
guarantee affordable, secure health insurance to every
American. The legislation covered a range of benefits that
are essential for women like preventive services
including mammograms and Pap smears, reproductive services,
and prenatal care and invested in a new federal long-term
care program. While the Congress will not pass health
reform legislation this year, we have come further than ever
before in the effort to reform our health care system! We
will continue to fight next year for health security for all
American families.
?
The lifetime risk of developing breast cancer has risen from
1 in 20 women twenty years ago to 1 in every 8 today. It is
estimated that in this decade, 1.5 million new cases of
breast cancer will be diagnosed, and breast cancer will be
responsible for nearly 500,000 deaths.
The Clinton Administration has taken unprecedented action to
combat this deadly disease. Since President Clinton took
office, federal funding for breast cancer research and
prevention has increased substantially -- totaling $650
million in fiscal year 1994 alone. In addition, the
National Action Plan on Breast Cancer provides a blueprint
for a partnership between government and the private sector
to work to prevent, diagnose, treat and ultimately eradicate
breast cancer.
?
AIDS is spreading more rapidly among women than men. From
1989 to 1990 alone, there was a 34 percent increase in the
number of women diagnosed with AIDS. In New York City, AIDS
is the leading cause on death among women age 24 to 44.
The Clinton Administration has created the National Task
Force on AIDS Drug Development that is charged with
expediting the search for new therapies against AIDS and
HIV, increased funding for the Ryan White CARE Act for
outpatient AIDS care, increased the National Institutes of
Health's spending for AIDS research, and increased funding
for the Centers for Disease Control and Prevention. In
total, the President's fiscal year 1995 budget increased
AIDS-related spending by $600 million over the 1994 budget.
TAKING CARE OF OUR CHILDREN AND FAMILIES
?
President Clinton signed the comprehensive Child
Immunization Plan so that every child, regardless of family
income, will be immunized against disease.
?
By the end of 1996, all eligible children between the ages
of one and four will be served by the Women, Infants and
Children Program (WIC). That means that an additional two
million children will have access to the WIC program, a
nutrition program that serves pregnant and post-partum women
and their children.
?
Under the Clinton Administration, American workers are no
longer forced to choose between their job and their family
at times of crisis. The Family and Medical Leave Act allows
workers to take up to 12 weeks of unpaid leave to care for
an infant or a loved one without losing their job.
?
The Administration funded the Family Preservation and
Support Initiative to prevent child abuse and help parents
learn the skills and tools they need to raise their
children.
EDUCATION
?
The President's dramatic increase of Head Start funding will
allow 840,00 children to participate in this preschool
education program next year, up from 621,000 in 1992.
?
The Goals 2000: Educate America Act sets world-class
education standards and gives resources to states and
communities to implement comprehensive education reforms.
?
The Student Loan Reform Act greatly increases access to
higher education 20 million students can take advantage
of low-interest loans and better repayment terms.
?
National Service also helps students further their
education; those who want to contribute to their communities
through public service can receive college tuition
assistance.
?
The School-to-Work Opportunities Act invests in training and
education programs to give students the tools they need to
enter the workforce successfully or continue their
education.
THE RIGHTS OF WOMEN
?
The President continues to protect the right of women to
make their own reproductive choices. He repealed the "Gag
Rule" that restricted abortion counseling at federally
funded family planning clinics; revoked the import ban on
RU-486; reversed the ban on abortion services at military
hospitals; repealed the Mexico City policy that banned
funding to international organizations that promoted
comprehensive family planning; and signed the Freedom of
Access to Clinic Entrances Act to ensure that women and
their doctors can enter clinics without fearing intimidation
and violence.
?
The United States delegation to the International Conference
on Population and Development, led by Vice President Gore,
successfully advocated a global approach to improving the
status of women and stabilizing the world's population. The
conference emphasized the importance not only of increased
access to contraceptives, but also of sustainable economic
development, a reduction in child and maternal mortality,
and the empowerment of women through increased educational
and economic opportunities.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Ingrid M. Schroeder (SCHROEDER_I) (OMB)
CREATION DATE/TIME:14-FEB-1995 19:35:43.64
SUBJECT: More comments
TO: Lin C. Liu
(LIU_L) (OMB)
READ:15-FEB-1995 08:28:45.65
TO: Stephen C. Warnath
(WARNATH_S) (OPD)
READ:14-FEB-1995 19:38:58.97
TEXT:
ATTACHMENT 1
ATT CREATION TIME/DATE:14-FEB-1995 14:48:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Barbara E. Washington
ATT SUBJECT: Comments on LRM 308 - Immigration Amendments
ATT TO: Ingrid M. Schroeder
(SCHROEDER_I)
ATT CC: William G. White
( WHITE_W)
ATT CC: Richard J. Turman
(TURMAN_R)
ATT CC: Mark E. Miller
(MILLER_ME)
ATT CC: Stacy L. Dean
(DEAN_S)
TEXT:
The Health Division has the following comments on the Immigration
Amendments. These comments have not been cleared by Nancy-Ann
Min.
Section 701: Limitations on Eligibility of Certain Aliens for
Public Programs
"Section 250A (a) Ineligibility for Federal and Federally-Assisted
Benefits and Services"
The bill prohibits all aliens (other than qualified aliens) from
receiving any Federal or Federally-assisted benefit or service,
with exceptions. These exceptions include benefits or services
necessary generally to protect the public health of the U.S. as
specified by the Attorney General.
Under the bill, as it is written, the Attorney General, not the
Secretary of HHS, would have the power to designate which programs
in the Public Health Service meet the definition of "necessary to
protect the public health or safety of residents of the U.S."
There is no common or statutory definition of public health or
safety. Therefore, PHS grants for community/migrant health
centers, family planning clinics, sexually transmitted disease or
tuberculosis clinics, HIV prevention centers, and drug abuse
treatment centers may or may not be exempted in whole or in part
as contributing to public health and safety.
HD staff believe that verifying immigration status in these
programs would be administratively burdensome.
HD staff suggest removing the blanket prohibition of benefits for
other than qualified aliens. We suggest instead considering the
approach taken in the Administration's welfare reform bill, which
is to insert the eligibility definition in each affected program's
authorizing legislation (Medicaid, SSI, AFDC). The Attorney
General could be directed to work with each department to
re-evaluate their programs' eligibility requirements with regard
to the new definition of a qualified alien.
We understand that HHS also has concerns about this language. We
believe that their efforts to draft compromise language, that was
submitted to us tonight, merits further consideration.
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Brian J. Johnson (JOHNSON_BJ) (CEQ)
CREATION DATE/TIME:20-MAR-1995 10:06:02.62
SUBJECT: here's chapter 9
TO: Theo Lubke
(LUBKE_T) (OPD)
READ:20-MAR-1995 10:28:44.07
TEXT:
It's all here; no inserts coming later. (except I want to review
the quotes over the next day or two; POTUS has had a couple of
good speeches on envt/reform since I did this -- I imagine that I
can do things like that if I need to as the review is going,
right?).
Also, for some reason, the formatting isn't quite consistent.
Most of the quotes are in boxes, but some are not. I imagine that
you'll have someone go through the whole thing after the review
for things like that.
ATTACHMENT 1
ATT CREATION TIME/DATE:20-MAR-1995 10:02:00.00
ATT BODYPART TYPE:p
ATT CREATOR: Brian J. Johnson
TEXT:
PRINTER FONT 12_POINT_ROMAN
TOP ALL
[DRAFT 3/13/95]
9. ENVIRONMENT AND PUBLIC HEALTH
Introduction
HORIZONTAL_PITCH 9
PRINTER FONT 14_POINT_ROMAN
#8
"Over 25 years ago, I had a professor at Georgetown who
taught me that America was the greatest country in history
because our people believed in and acted on two simple ideas:
first, that the future can be better than the present; and
second, that each of us has a personal, moral responsibility
to make it so."
Candidate Clinton
Announcing his run for the Presidency
October 3, 1991
#9
$8
?
Reinventing Environmental Regulation. On March 16, 1995, the
President announced a comprehensive set of 25 actions to make
environmental protection work better and cost less, including a 25
percent cut in paper work to comply with environmental standards and
a 6 month enforcement grace period for businesses who act in good
faith.
HORIZONTAL_PITCH 11
PRINTER FONT 12_POINT_ROMAN
?
Northwest Forest Plan. Putting Northwest communities back to work
again, while conserving ancient forests for future generations.
?
Common Sense Initiative. Launched an effort to make health
protection cleaner, cheaper and smarter by focusing on results rather
than one-size-fits-all regulations.
?
California Bay-
Delta Water Agreement. Negotiated a consensus plan
that will protect the most valuable economic and environmental
resource of the state of California. The San Francisco Bay and Delta
estuary supplies drinking water to two-thirds of the state's people,
provides irrigation for 45% of America's fruits and vegetables, and
supports 300 aquatic species.
?
Recycling. Signed an executive order to promote recycling, cut solid
waste and create jobs.
?
Community-
Right-
to-
Know. Expanded requirements that companies
disclose information about toxic releases in their area, putting
power back into the hands of the people.
?
Protection for the California Desert. Fought for and then signed the
California Desert Protection Act, the largest single designation of
parks and wilderness areas ever in the lower 48 states.
?
Environmental technology. Supporting initiatives that are creating
jobs for American workers and encouraging innovative new solutions to
tough environmental problems.
?
Fisheries Management. Responded to developing fisheries crises on
both coasts with improved management programs and economic assistance
to families whose livelihoods are threatened by falling fish stocks.
?
Air Pollution. Implemented an unprecedented measure to reduce by 90
percent the toxic air pollutants emitted from chemical plants by
1997.
?
Restoration of the Everglades. Formed a partnership with the State
of Florida that broke a six
-year legal logjam and allows the country
to get on with the task of restoring the unique Everglades.
?
Wetlands Reform. Reformed the wetlands program to cut red tape,
increase fairness and flexibility for landowners, and protect and
enhance the nation's wetlands.
President Clinton is continuing to fulfill his commitment to the
American people, protecting our families' health and conserving our
country's natural heritage for generations to come. Priorities this year
include:
?
Reinventing Government. Following through on a top-to-bottom reform
of environmental regulation to create a new system based on achieving
environmental results, not just complying with bureaucratic
procedures.
?
Superfund. Building on a historic coalition that included everyone
from the Chemical Manufacturers to the Sierra Club, to work with
Congress again this year to reform Superfund to clean up toxic sites
faster, more fairly and more efficiently.
?
Safe Drinking Water. Reforming the Safe Drinking Water Act to help
local water systems protect their citizens' health and give people
tap water they can trust, while
ensuring that the law that governs our drinking water supply is as
affordable as it is effective for our communities.
?
National Parks. Returning the Park Service to a sound financial
footing and making the parks the best that they can, be without
burdening taxpayers, by reforming concessions practices and revising
fee policies.
9A. PROTECTING PUBLIC HEALTH
HORIZONTAL_PITCH 7
PRINTER FONT 18_POINT_ROMAN
#8
"Preserving the environment is at the core of everything we
have to do in our own country. Building businesses, creating
jobs, fighting crime and drugs and violence, raising our
children to know the difference between right and wrong, and
restoring the fabric of our society."
President Clinton
#9
$8
HORIZONTAL_PITCH 9
PRINTER FONT 14_POINT_ROMAN
#8
Actions to Date
In his first two years in office, President Clinton
took the following actions:
?
Reinventing Environmental Regulation. On March
16, 1995, the President announced 25 actions to
make environmental protection work better and cost
less, including a 25 percent cut in paperwork to
comply with environmental standards and a 6 month
enforcement grace period for businesses who act in good faith.
?
Expanded Community-
Right-
to-
Know reporting to
require companies to tell people about toxic
releases in their area. People will have
information about nearly twice as many chemicals
as before.
?
Common Sense Initiative. Launched an effort to
make health protection cleaner, cheaper and
smarter by focusing on results rather than one-
size-fits-all regulations.
?
Promoted recycling, with actions such as an
executive order directing the Federal government -
- the largest purchaser in the world -- to buy
recycled.
?
Cut toxic air pollution. The Clinton
Administration took an unprecedented action to
reduce by 90 percent the toxic air pollutants
#9
$8
HORIZONTAL_PITCH11
PRINTER FONT 12_POINT_ROMAN
Background
PRINTER FONT_12_POINT_ROMAN_ITALIC
"I want to see a different approach. I want a government that
is limited but effective, that is lean but not mean, that does
what it should do better and simply stops doing things that it
shouldn't be doing in the first place, that protects consumers
and workers, the environment, without burdening business,
choking innovation or wasting the money of the American
taxpayers."
PRINTER FONT 12_POINT_ROMAN
President Clinton
Announcing "Reinventing Environmental
Regulation"
March 16, 1995
Twenty-five years ago our nation created from scratch the most
advanced system of environmental protection in the world. The result is a
system that is envied and copied around the globe. Where 25 years ago the
roads were littered with boxes and beer cans, today we find 5,000 community
recycling programs. Lead levels in our children's blood are down 70
percent. And the bald eagle soars again.
But much remains to be done, and while the current system of
environmental protection has accomplished a great deal, it is reaching its
limits. Over the years, environmental programs evolved into a complex and
court-driven system of prescriptive regulation that often leaves little
room for common sense. Increasingly, we pay too much for too little
protection.
The answer is not to roll back health and environmental standards and
return to the smoke and smog of yesteryear. The answer is not to add
another layer of complex and inflexible requirements on top of the existing
system or to create even more opportunity for lawsuits. People don't
want a government that spends more of their money in order to get less
done. People want a government that works better and costs less.
It is time to draw upon the lessons we have learned over the last 25
years and reinvent environmental protection. We have learned that the
American people are deeply committed to a clean and healthy environment for
their children and communities. We have learned that pollution is often a
sign of economic inefficiency and business can make money by preventing it.
We have learned that better decisions result from a collaborative process
with people working together, than from an adversarial process that pits
them against each other. And we have learned that standards that provide
flexibility but demand accountability -- can provide greater protection
at a lower cost.
To meet the challenges of the next 25 years, President Clinton is
making common sense reforms to environmental programs to make them work
better and cost less. He is working hard to protect our families' health
and to provide lasting economic opportunities for generations to come. He
is cutting through the bureaucracy to focus on results -- and allowing
flexibility along the way. He is moving toward a system based on
performance standards, flexibility and accountability. He is encouraging
innovation and common sense.
The Initiatives
HORIZONTAL_PITCH 9
PRINTER FONT 14_POINT_ROMAN_ITALIC
"Just as we yearn to come together as a people, we yearn to move
beyond the false choices that the last few years have imposed upon
us. For too long we have been told that we have to choose between
the economy and the environment; between our jobs; between our
obligations to our own people and our responsibilities to the future
and to the rest of the world; between public action and private
economy."
PRINTER FONT 14_POINT_ROMAN
President Clinton
Earth Day 1993
The Clinton Administration is making environmental programs work
better and holding the line against those who would eliminate them.
President Clinton is expanding the Community-Right-to-Know program to put
power back into the hands of the people, promoting recycling, cutting air
pollution and increasing job-creating investments in "green" technologies.
He is moving away from the prescriptive regulations of yesterday to the
results-oriented programs of tomorrow.
Reinventing Environmental Regulation. On March 16, President Clinton
announced a sweeping set of 25 reforms to make environmental protection
work better and cost less. With this package, the President will expand
the use of market-based emissions trading programs, make a 25 percent cut
in the paperwork associated with meeting environmental standards -- a move
that will save businesses and communities 20 million hours of work, cut the
reporting system down to one step, create centers to help small businesses
comply with environmental programs and give them a 6 month enforcement
grace period when they act in good faith, give more responsibility to
states, tribes and local governments, and save taxpayers billions of
dollars by refocussing priorities for safe drinking water and hazardous
waste. In addition to improving the current system, the President proposed
fundamental reforms -- environmental protection for the 21st century.
These reforms include Project XL -- for eXcellence and Leadership -- a
pilot project where EPA will allow 50 companies or communities to replace
current regulatory requirements with an alternative system of the company's
design if the company can do it cleaner, cheaper. In other words, if
you've got a better way to do it, you can throw out the EPA rulebook.
Common Sense Initiative. The Environmental Protection Agency's Common
Sense Initiative is both the name of a major program and a reflection of
President Clinton's environmental philosophy. It is a reform to move from
one-size-fits-all regulations to a system based on real results, the first
program in the next generation of environmental protection. The approach
will achieve results that are cleaner, cheaper and smarter --cleaner for
the environment, cheaper for business and taxpayers, and smarter for our
children's future.
Community Right-
To-
Know. President Clinton expanded Community Right-to-
Know laws to protect public health by requiring companies to disclose
information about toxic chemical releases to the public. EPA added 286
harmful chemicals -- nearly doubling the current amount -- to the Toxic
Release Inventory (TRI). The TRI program lists chemical releases and makes
the data available to the public through outlets such as public libraries.
At the same time, EPA made it easier for small businesses to provide
information by creating a shorter, less time-consuming reporting form. The
Community Right-to-Know program puts power back into the hands of the
people.
Environmental Technology. The President's environmental technology
initiatives are helping American business compete more effectively in the
fast-growing global markets for "green" technologies, creating jobs for
American workers, and encouraging innovative new solutions to tough
environmental problems. Vice President Al Gore recently unveiled a new
Rapid Commercialization Initiative to test and verify the performance of
innovative technologies and get them to the market faster.
Air Pollution. The 100 million Americans who live in areas with polluted
air will be able to breathe more easily. The President is working with
States to develop common sense solutions to our nation's air quality
problems and to implement strong new rules under the Clean Air Act, such as
an unprecedented action to cut toxic air pollution from chemical plants 90
percent by 1997.
Leadership on Risk Analysis. The Clinton Administration is committed to
basing its regulatory decisions on sound scientific evidence and ensuring
that the benefits of its actions justify the costs. The President's
executive order on Regulatory Planning and Review is the cornerstone of
these efforts. The President recognizes that there is an important role
for regulation in protecting public health, safety, and the environment for
the American people; at the same time, he insists that government has a
basic responsibility to govern wisely and carefully, regulating only when
necessary and only in the most cost-effective manner.
Enforcement. President Clinton reversed previous Administrations' attempts
to weaken EPA's enforcement capabilities. EPA reformed its environmental
enforcement program to get tough with polluters who threaten public health,
but work with those who act in good
faith. The reforms include small business assistance centers and a 6 month
enforcement grace period for small businesses whomove quickly to correct
violations.
Recycling. To boost recycling, promote environmental technologies, save
taxpayers money and reduce the burden on landfills, President Clinton
signed an executive order directing Federal agencies to purchase recycled
and environmentally preferable products. The Federal government is the
largest purchaser of goods and services in the world, and the Clinton
Administration is putting that enormous purchasing power to work for
recycling.
Leading by Example -
Toxics Reduction. President Clinton signed an
executive order directing Federal agencies to cut their use of toxic
substances 50% by 1999 and report those remaining emissions under Community
Right-to-Know laws -- a move to open government that previous
Administrations refused to make.
Leading by Example -
Energy and Water Efficiency. President Clinton
signed an executive order directing Federal agencies to improve energy and
water efficiency wherever it is cost-effective a move that will cut the
government's taxpayer-funded utility bills $1 billion a year.
Clean Cars. The Partnership for a New Generation of Vehicles is a historic
new partnership between government and industry. This strategy will
strengthen U.S. competitiveness by developing technologies for a new
generation of vehicles up to three times more fuel efficient than today's -
- a technological challenge comparable to the Apollo project. This
initiative will create jobs, spur economic growth and help Detroit continue
to lead the world in auto technology.
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Case Study: Reinventing Environmental Protection
The Clinton Administration has launched an ambitious
new pilot program that is revolutionizing the way we
approach environmental protection. The current system of
environmental regulation has accomplished a great deal, but
it is reaching its limits. EPA is initiating a pilot
program to develop a common sense system for the next
generation of environmental protection.
Through EPA's Common Sense Initiative, we are bringing
business, community groups, state and local representatives
and local environmental leaders together to find common
sense, consensus strategies for addressing environmental
problems.
This program will help us move beyond confrontation to
consensus in solving this nation's environmental problems.
Instead of a focus on specific problems caused on specific
problems cause by individual pollutants, we are
comprehensively looking at the overall environmental
impacts of entire industries.
The six industries participating in the first phase of
the Initiative -- automotive, computers and electronics,
iron and steel, metal finishing, petroleum refining and
printing -- form a sizable piece of the American economy.
Comprising over 11% of the U.S. Gross Domestic Product and
employing nearly 4 million people these industries also
account for 12.4% of the toxic releases reported by all
American industries in 1992. The six industries share a
key attribute: each is committed to working with the EPA
and with national and grassroots environmental groups to
find cleaner, cheaper, smarter ways to protect public
health and our environment.
The Common Sense Initiative reflects the Clinton
Administration's commitment to setting strong environmental
standards while encouraging common sense, innovation and
flexibility in how those standards are met.
This new approach to environmental protection is
designed to achieve results that are cleaner, cheaper and
smarter. Cleaner for the environment, cheaper for business
and taxpayers and smarter for America's future.
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HORIZONTAL_PITCH_10
PRINTER FONT 12_POINT_ROMAN_ITALIC
"We seek to set our course by the star of age-old values, not
short-term expediencies; to waste less in the present and provide
more for the future; to leave a legacy that keeps faith with those
who left the Earth to us. That is the American spirit."
PRINTER FONT 12_POINT_ROMAN
President Clinton
Earth Day 1994
Incineration. The Clinton Administration announced a tough new
incineration policy that makes safety the number one priority,
encourages industry to reduce waste, strengthens oversight of
existing combustion facilities and tightens requirements for
permitting new ones. New standards for municipal incinerators
will result in a 95 percent reduction in emissions of dangerous
pollutants.
Pesticides and Food Safety. The President is taking aggressive
action to protect children and reduce the use of pesticides on
food. At the same time, his Administration is working to move
safer substitutes onto the market more quickly.
Greening of the White House. The President's initiative is making
the White House a model for all Americans to follow
demonstrating practical steps people can take to protect the
environment, improve the comfort of their surroundings and save
money. Specific actions include energy-efficient lighting,
appliances, heating and cooling, as well as recycling and water
conservation -- each of which improve the local environment and
save taxpayers money.
Superfund. President Clinton proposed a major reform of
Superfund, the bill that cleans up toxic dumps. One in four
Americans still lives near a toxic dump site 14 years after Love
Canal. Contaminated, neglected land costs communities jobs,
development and their tax base. In the past, too much money that
should have gone to clean up toxic dumps was spent on lawyers
instead. Last year, President Clinton brought together in support
of his Superfund reform an unprecedented array of interested
parties, from environmental groups, insurers, businesses and
communities. The Administration will work with Congress again
this year to strengthen the Superfund law based on the following
principles: cleanups must be faster, fairer and more efficient;
we must promote economic redevelopment in our communities; less
money should go to lawyers and more money should go to cleanups;
and the polluter should pay.
HORIZONTAL_PITCH 9
PRINTER FONT 14_POINT_ROMAN
#8
Case Study:
EPA's Brownfields Program -
-
Bill Robinson
"Poor neighborhoods in our cities suffer most from
toxic pollution. Cleaning up toxic waste will create
new jobs in these neighborhoods for those people and
make them safer places to live, to work, and to do
business."
President Clinton
Earth Day, 1993
In his first Earth Day message, President Clinton
committed to revitalize urban communities by cleaning up
abandoned pieces of contaminated land that are a blight to
our communities, a threat to our health, and a terrible
obstacle to economic growth.
The EPA Brownfields program is an innovative
Administration initiative that awards grants to cities to
redevelop contaminated land -- creating jobs and returning
the land to productive community use. With the money
provided by the grants, cities can promote economic
development the way the local community believes it will
work best. The program brings together people who live
near contaminated land, businesses that want to get land
cleaned up, community leaders, investors, lenders and
developers.
Like many hard working Americans, Bill Robinson had
a difficult time when his company relocated and he was
unemployed for eight months. A forty year old man with
three children depending on him, Mr. Robinson felt
discouraged and had few prospects in Cleveland's depressed
economy.
As part of a Brownfields grant to the City of
Cleveland, Mr. Robinson now works as a Warehouseman Order
Selector at Dedicated Transport, Inc. He is filling one of
one hundred new trucking and warehouse jobs created by the
redevelopment of contaminated, abandoned property in
Cleveland. Dedicated and its sister company hope to employ
another 100 people within the next year.
This initiative captures the best of what we can do
together to revitalize the cities of this country. It is a
common sense, cost-effective way to redevelop contaminated
land and return it to productive community use, create jobs
and preserve the green area outside our cities.
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HORIZONTAL_PITCH 10
PRINTER FONT_12_POINT_ROMAN
Safe Drinking Water. Safe drinking water is easily the biggest
environmental concern of America's working families. Across the
country, people are worried that they can no longer take the
safety of their drinking water for granted. A year ago, millions
of residents of
major U.S. cities -- such as Milwaukee, New York and Washington,
DC -- were ordered to boil their water. One year after thousands
of people got sick and 100 died after drinking contaminated tap
water in Milwaukee, President Clinton proposed to reform the Safe
Drinking Water bill to help local water systems protect their
customers' health and give people tap water they can trust. The
Administration will work to ensure that the law that/governs our
drinking water supply is as affordable as it is effective for our
communities. The President will work with Congress again this
year to improve the Safe Drinking Water Act and provide resources
to communities so that they can do the job of keeping their
citizens safe.
"We can have common sense and still provide for safe drinking
water. We can have fairness and still clean up toxic dumps,
and we ought to do it."
President Clinton
State of the Union
January 1995
9B. TAKING RESPONSIBILITY
FOR OUR LAND AND WATER
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"All across this country, there is a deep understanding
rooted in our religious heritage and renewed in the
spirit of this time that the bounty of nature is not
ours to waste. It is a gift from God that we hold in
trust for future generations. Preserving our heritage,
enhancing it, and passing it along is a great purpose
worthy of a great people."
President Clinton
Earth Day 1993
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HORIZONTAL_PITCH 9
PRINTER FONT_14_POINT_ROMAN
#8
Actions to Date
During his first two years in office, President
Bill Clinton:
?
Developed a Northwest Forest Plan to put
communities back to work again and conserve
ancient forests for future generations.
?
Developed reforms to exempt small landowners from
wetlands and endangered species laws.
?
Reached an agreement with the state and water
users over California Bay-
Delta Water, the most
valuable environmental and economic resource in
the State of California.
?
Reached an agreement with the State of Florida to
restore the Everglades, home to more than 50
threatened or unique species, including the
Florida Panther.
?
Signed the California Desert Protection Act, the
largest single designation of parks and wilderness
areas ever for the lower 48 states.
?
Reformed the Wetlands Program to cut red tape,
increase fairness and flexibility for landowners,
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HORIZONTAL_PITCH11
PRINTER FONT 12_POINT_ROMAN
Background
HORIZONTAL_PITCH 9
PRINTER FONT 14_POINT_ROMAN_ITALIC
"If there is one commitment that defines our people, it is our
devotion to the rich and expansive land we have inherited. From the
first Americans to the present day, our people have lived in awe of
the power, the majesty, and the beauty of the forest, the rivers, and
the streams of America."
PRINTER FONT 14_POINT_ROMAN
President Clinton
Earth Day
April 21, 1993
The American conservation ethic dates back to the very first days of
our country's history and to the farmers, hunters and fishermen who made
our country great. Americans have always understood that if they want their
children to continue farming or fishing at a living wage, they must look
after the land and the water. And we have always felt a deep, moral duty
to be responsible caretakers of the Earth for those who come after us.
A century ago, Congress created the world's very first national park
at Yellowstone. As American as baseball and jazz music, national parks are
an idea that virtually every nation has since copied. The national parks
are one of America's greatest treasures; their beauty is unsurpassed.
A century later, resource management of our land and water requires a
new approach beyond simply setting it aside. We can use our resources both
for economic development today and to fulfill our responsibilities to the
future, but only with careful planning and commitment. Where economic
needs and environmental imperatives come into conflict, it is usually the
result of poor management or a failure to make tough decisions until a
situation gets so bad it can no longer be ignored.
When Bill Clinton came into office, he inherited a number of these
poorly managed situations -- looming crises brought on by the Federal
government's refusal to assume its share of the responsibility for looking
after our nation's land and water. In the Pacific Northwest, the Federal
government failed to set up a responsible old-growth forest management
plan, and a judge blocked all timber cutting on those lands -- a drastic
blow to timber-dependent families. In New England and the Northwest,
fisheries collapsed following years of pollution, overfishing and changes
in climate patterns a drastic blow to the men and women who were
dependent on the industry.
President Bill Clinton is standing up for those families. Rather
than ignoring these crises, President Clinton went to work and addressed
them directly. Issue after issue from California water use to the
Florida Everglades -- he is finding solutions where others had seen only
problems.
The Initiatives
PRINTER FONT_14_POINT_ROMAN_ITALIC
"If we have the vision, the will and the heart to make the changes we
must, we can still enter the 21st century with possibilities our
parents could not even have imagined and enter it having secured the
American Dream for ourselves and for future generations."
PRINTER FONT 14_POINT_ROMAN
President Clinton
February 17, 1993
President Clinton promised that he would take responsibility for our
places of natural beauty and ecological significance; that he would look
out for our national parks, wilderness areas, old growth forests and
wetlands; that he would support programs that put people to work today and
contribute to a better world tomorrow. During his first two years in
office the President developed a forest plan for the Northwest, helped
fishermen get back on their feet again, reached a historic agreement to
manage California water and signed the California Desert Protection Act.
Northwest Forest Plan. For years, mismanagement and conflict over timber
cutting in public forests threatened the livelihood of people in the
Pacific Northwest. To put an end to the gridlock and put people back to
work, President Clinton convened the Forest Conference in Portland, Oregon,
shortly after taking office. For the first time, he called
environmentalists, timber companies and citizens as well as states, tribes
and local governments came together around one table to hammer out a
solution. The President's Northwest Forest Plan is forcing government
agencies to work together to restore the economic health of the region's
communities and the vitality of the region's ancient forests. The
Administration is awarding more than $1.2 billion in grants and loans over
five years to more than 100 communities throughout the region to help
people through their period of transition, and putting people to work with
more than 600 watershed restoration projects to protect the environment for
years to come. The President's Forest Plan was recently upheld by the
judge who earlier blocked all cutting. That means that for the first time
since 1991, forest management is out of the courtroom and back in the
communities where it belongs.
California Bay-
Delta Water Agreement. In a triumph of common sense over
politics-as-usual, the President recently reached an agreement with the
State of California and farmers, urban interests and environmentalists to
protect the San Francisco Bay and Delta. Under the agreement, the state
will set water quality standards to protect the health of the natural
environment and the health of the region's communities. The agreement is a
boost for the regional economy, bringing a reliable water supply to water
users across the state. The agreement comes after decades of conflict over
water, most critical of Western resources. The Bay-Delta estuary supplies
drinking water to two-thirds of the state's population ,provides irrigation
water for 200 crops, including 45 percent of the nation's fruits and
vegetables, and supports 300 aquatic species in the largest wetland habitat
in the West.
Restoration of the Florida Everglades. The Administration and the State of
Florida launched an unprecedented partnership in 1993 to restore the
Everglades, Big Cypress, and Lake Okeechobee. The tourism-based economy of
South Florida depends significantly on the health of this natural
environment. The area is home to five million people and more than 50
endangered or threatened plants and animals, including the Florida Panther,
the Bald Eagle and Audobon's Crested Caracara. In recent decades, wetland
habitat areas have declined 50 percent and populations of wading birds such
as the Snail Kite and Wood Stork have declined 90 percent. Public water
supplies along the coast are increasingly vulnerable to salt water
intrusion due to losses of fresh water. Commercial and recreational
fisheries in Florida Bay have declined dramatically in recent years. This
partnership ends years of litigation and will improve both the quality and
the quantity of water -- helping to preserve these national treasures and
keep the Florida economy strong.
California Desert Protection. In October 1994, the President signed the
historic California Desert Protection Act, to preserve for future
generations a resource of extraordinary and inestimable value. It is the
first time since 1980 that the United States has set aside so rich and vast
an area public desert lands that include broad vistas, rugged mountain
ranges and unique archeological sites. The Act designates 7.7 million
acres of federal lands as wilderness and adds three million acres to the
National Park System, including magnificent lands next to the Death Valley
and Joshua Tree National Monuments, both of which now become National
Parks.
Building Sustainable Fisheries. President Clinton responded rapidly to
developing fisheries crises in New England and the Pacific Northwest. To
help communities in the short run, he is taking the unprecedented step of
providing economic adjustment assistance to several thousand people whose
jobs are affected by the crises. For the long run, the effort includes an
improved fisheries conservation program to manage the stocks and ensure
lasting work for fishermen.
Wetlands Reform. The President developed a bold reform package for the
nation's wetlands protection program that reflects the vital need for
effective protection and restoration of the nation's wetlands, and includes
much needed reforms to increase the fairness and flexibility of Federal
regulatory programs for landowners. Significantly, the reforms essentially
relieve homeowners of the need to apply for wetlands permits to build or
modify their homes. The reform also includes a more active role for
states, tribes and local governments. Finally, the Administration set a
goal not only of "no net loss" of wetlands, but also of restoring wetlands
that had been previously lost. Wetlands filter and cleanse water, buffer
against flooding, and are the most prolific ecosystems in the world; we
have lost more than one-half of the wetlands in the lower 48 states since
Colonial times.
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Case Study:
Northwest Forest Plan -
-
Economic Revitalization
"It is time to break the gridlock that has blocked action and
bring all sides together to craft a balanced approach to the
economic and environmental challenges we face."
President Clinton
March 10, 1993
When President Clinton convened the Forest Conference in
Portland, Oregon in April 1993 he did it to break the gridlock over
forest management that had tied up the region's economy for years.
His forest plan is protecting public forests for future generations
and giving new life to local communities. With the Northwest
Economic Adjustment Initiative of the forest plan, he is helping
people hurt by the forest crisis get back on their feet.
The Initiative is comprehensive. President Clinton's program
is putting people to work, providing worker training, and giving
assistance to families, communities and businesses. The result is
better government that works for people:
In Sweet Home, Oregon, dislocated timber workers are
receiving training, on-the-job experience, and family wages as they
work to restore valuable watersheds.
In Weaverville, California, Federal grants and loans are at
work building a new sewage treatment system that will protect the
community's health and provide for a more certain economic future.
In Forks, Washington, money from state sources and Federal
agencies is helping to build a secondary wood products
manufacturing center that will breathe new life into this
traditionally timber-dependent community's economy.
In Douglas County, Oregon, an area hit hard by the decline in
timber harvests, the Roberts Creek Water District has lacked an
adequate supply of treated water. As a result, the District placed
a moratorium on new development in 1992, making it hard for people
to go back to work in new jobs and making it hard for the District
to provide acceptable fire protection to the area. With assistance
from the forest plan and from the state the District will now be
able to fund the water treatment plant expansion. Already, the
Ingram Book Company has committed to locating in the District -- a
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AmeriCorps -
National Service and the Environment. Young people in
AmeriCorps, President Clinton's national service program, are giving more
than 10 million hours of direct service in environmental protection.
Nearly one-third of the 20,000 AmeriCorps members are working in urban
neighborhoods and rural landscapes to eliminate environmental hazards and
conserve natural resources.
Recovery of the Bald Eagle. On July 4, 1994, the Administration proposed
to take the bald eagle off the endangered species list. This success story
reflects 30 years of hard work to save the bald eagle -- the symbol of
America's freedom.
Strengthening the National Parks. The President is taking strong action on
behalf of America's National Parks. He proposed a funding increase of 18
percent for the Park Service in his first budget, and is pushing to reform
concession contracts to give taxpayers a fair share of the profits made by
vendors in the parks. Currently, the average concessionaire pays less than
3 percent of revenues for the exclusive right to sell products to park
visitors -- a rate far below what most businesses would be willing to pay.
Raising that rate by a small amount would bring millions into the parks.
Reform of Endangered Species Protection. Our Nation's plants and animals
are treasures we hold in trust for future generations. When environmental
protection has collided with economic growth, the cause has often been poor
administration of laws such as the Endangered Species Act. The President
is committed to innovative administration of these laws to avoid crisis
management and make them work, without burdening small landowners. For
instance, the Administration recently announced general exemptions from ESA
enforcement for most activities on single home residential tracts and for
other activities that affect less than five acres.
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Case Study:
Ruben Alarcon -
AmeriCorps
"In our own lives, in our own ways, each of us has something
to offer to the work of cleaning up America's environment.
And each of us surely. has something very personal to gain."
President Clinton
Earth Day 1993
Luis Ruben Alarcon is working in low-income areas in and
around El Paso, Texas, along the Mexican border. He is joining
other AmeriCorps members and the Retired Senior Volunteer Program
to clean up the area's water and protect his neighbors' health.
"AmeriCorps has provided me a great opportunity to get hands-
on training in the field of environmental protection," he says.
"It also allows me to participate in our community, something I
believe in firmly."
Ruben turned down a full scholarship at M.I.T. in order to
stay in El Paso and help provide for his mother, a new U.S. citizen
with a third grade education, who works at a maquiladora for the
minimum wage. He studies chemistry and engineering full-time at
the University of Texas El Paso, dedicates himself to serving his
community through AmeriCorps and holds down an additional job to
provide for his mother.
"I can't thank AmeriCorps enough for this opportunity," he
says. "I feel like I belong to something that's very important,
something that's much bigger than me."
The region's two million people rely on groundwater sources
of drinking water that are increasingly contaminated. According to
local health officials, a large number of the health problems they
see appear to be caused by polluted water. Ruben and the
AmeriCorps members are working to change that and to protect the
health of his community.
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Flood Prevention. The Administration is examining new approaches to flood
control and flood plain management, the need for which was highlighted by
the recent floods in the Midwest, the South and California. Our goal is to
protect the health and safety of all Americans in flood-prone areas and
reduce the loss of natural resources associated with floods and flood
control projects. The loss of flood plain wetlands has substantially
increased flooding problems in many areas.
9C. INTERNATIONAL LEADERSHIP
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"The nations of the world are working together to achieve
what is now called 'sustainable growth' -- growth that meets
the needs of the present without sacrificing the needs of the
future. It's an ethic as modern as microprocessors and as
old as the Scriptures."
President Clinton
Earth Day 1994
#9
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#8
Actions to Date
During his first two years, the President:
?
Expanded U.S. environmental technology exports to put
Americans to work cleaning up the global environment.
?
Helped forge international consensus on a global plan to slow
population growth.
?
Created the GLOBE program to give students a better way to
learn about science.
? Signed the Biodiversity Treaty to preserve irreplaceable
genetic resources from the world's plants and animals.
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Background
PRINTER FONT 14_POINT_ROMAN_ITALIC
"We have to work to stop famine and stabilize population growth and
prevent further environmental degradation
None of us can live
...
without fear as long as so many people must live without hope.
That's why we're working around the world to protect fresh water
resources, to preserve forests, to protect endangered species,
leading a fight for strong environmental protection in our global
negotiations on trade."
PRINTER FONT 14_POINT_ROMAN
President Clinton
Earth Day 1994
With the end of the Cold War, tension over scarce natural resources
and environmental degradation is increasin, threatening to erupt into
regional conflict that harm US interests. While computers move more than a
trillion dollars through the world's financial markets every day, one
billion of the world's citizens live in abject poverty, more than two
billion people have no access to sanitation, and every day 40,000 human
beings -- mostly children -- die of hunger, malnutrition or unsafe drinking
water.
At current rates, 90 million people will be added to the world every
year -- the equivalent of a New York City every month. Although we have
made great strides in protecting our natural environment, air and water
pollution, deforestation, declining fish catches and the loss of
biodiversity continue to be grave problems. If the poorer nations of the
world grow to match resource-use patterns of the developed world, we would
need 10 times the current amount of fossil fuel and approximately 200 times
the mineral wealth. Meanwhile, soil scientists have estimated that an area
equal in size to China and India combined have experienced soil
deterioration since World War II. In a world of increasingly scarce basic
resources, conflict is more likely. It is in every American's best
interest for the United States to assume a position of global leadership in
protecting the international environment.
The Initiatives
PRINTER FONT _14 POINT ROMAN ITALIC
"Working together, we can ensure that the world we leave to the
future holds the same promise and opportunity as the one we inherited
from the past."
PRINTER FONT 14_POINT_ROMAN
President Clinton
March 14, 1994
President Clinton and Vice Presint Gore have helped ensure that
America lead the world, not follow, on global environmental issues.
Environmental Technologies Export Strategy. For the first time, U.S. firms
can rely on support from the Federal government in opening overseas markets
for environmental technologies. The President's strategy is to work with
business, accelerate technology development, improve export financing, and
coordinate the 20 or so federal agencies who currently have roles in this
area. The strategy targets specific markets such as Mexico, where the
elimination of 20 percent tariffs on environmental technologies through
NAFTA and an urgent need for environmental solutions are creating strong
demand.
Population. At the 1994 International Conference on Population and
Development in Cairo, the United States helped forge a historic consensus
on a global program to slow population growth. The approach includes
increased availability of family planning services, a commitment to
improving women's health, the empowerment of women, and a reduction in
infant and child mortality.
GLOBE. Vice President Al Gore launched the Global Learning and
Observations to Benefit the Environment (GLOBE) program to give
schoolchildren a better way to learn about science. GLOBE will create a
worldwide network of K-12 students who will work under the guidance of
teachers to make environmental observations near their schools, report
their data to a GLOBE processing facility and view images created from
worldwide GLOBE data in their classrooms.
#8
Case Study:
Environmental Technology Exports
"There is now a $200 billion to $300 billion market for
environmentally-conscious products
Last October, we
started our strategy to help American companies, large and
small, get their share of that market. If your company makes
a product or offers a service that will protect the
environment all over the world, you can find capital,
customers and expert advice."
President Clinton
Earth Day 1994
On September 28, 1994, Radian Corporation won a $2.5 million
contract in Thailand, thanks in large part to the President's
initiative to promote environmental technology exports. With the
bid, Radian will provide equipment, systems integration and support
services for the first eight ambient air monitoring stations in
Thailand.
Radian won the contract with effective export promotion
assistance six Federal agencies combined to provide key
promotional, financial and advocacy to help them close the deal.
As a result of the contract, Radian may be able to open a Southeast
Asia regional office to expand its Asia sales.
#9
$8
Whale Conservation. The United States succeeded in gaining support to
create a whale sanctuary in the Southern Ocean around Antarctica, where
commercial whaling will be prohibited. The 11.8 million square mile area
covered by the sanctuary is adjacent to an existing Indian Ocean sanctuary;
together these two sanctuaries are home to three-quarters of the world's
whales. Programs such as these work -- the California Grey Whale was
recently removed from the Endangered Species List because the population
has returned to pre-whaling levels.
Climate Change Action Plan. The Administration is implementing a
comprehensive national strategy to reduce greenhouse gas emissions to 1990
levels in the year 2000 -- a commitment previous administrations were
unwilling to make. The Climate Change Action Plan saves government and
industry money, spurs economic growth, and creates jobs. In one Department
of Energy program, more than 800 of the nation's electric utility companies
have already signed voluntary pledges to limit greenhouse gas emissions
under the Action Plan.
Biodiversity Treaty. Winning praise from environmentalists as well as the
agriculture, pharmaceutical and biotechnology industries, the President
signed the Convention on Biological Diversity, an international agreement
to stem the extinction of species and preserve irreplaceable genetic
resources for medicines and other valuable products.
Ocean Dumping. The United States took the lead among the world's nuclear
powers and achieved a global ban on ocean dumping of radioactive waste at
the London Convention. The U.S. was the first of the nuclear powers to
advocate the ban.
NAFTA. The President negotiated a strong side agreement to protect the
environment and helped pass NAFTA with the support of a large portion of
the environmental community. The treaty sets a new environmental standard
for trade agreements. Innovative "green" provisions will help protect the
environment and improve the quality of life on both sides of the border. At
the same time, NAFTA will double the number of American jobs supported by
environmental technology exports to Mexico.
Development Financing. The United States is leading the fight for
environmental reforms in the World Bank and other multilateral financial
institutions. One result is a new World Bank policy that gives affected
people access to information and environmental assessments on major
projects. The United States also put forward the blueprint for
restructuring the Global Environmental Facility, making it more democratic
and more accountable.
Summit of the Americas. The Summit of the Americas focused on three
central themes: strengthening democracy, expanding hemispheric economic
integration, and promoting sustainable development. Economic prosperity
and social progress can only be achieved if the health of the people is
protected and natural resources are used responsibly. The President forged
historic agreements with all leaders in the Americas to achieve lasting
opportunities for all.
Desertification. On October 14 the United States signed the United Nations
Convention to Combat Desertification. The Convention marks an important
step for the U.S., France and other developed countries in our efforts to
work with Africa and other developing areas to rebuild and protect their
resources as they develop a sustainable economy.
PRINTER FONT 14_POINT_ROMAN_ITALIC
"If you think about the long-run economic development of the country,
we can only hope to continue to grow and prosper if we find a way to
do it that is friendly to the environment; that enhances our natural
resources; that permits that elusive goal we call sustainable
development."
PRINTER FONT 14_POINT_ROMAN
President Clinton
October 18, 1994
END ATTACHMENT
I
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Bruce N. Reed (REED_B) (OPD)
CREATION DATE/TIME:11-APR-1995 10:50:36.21
SUBJECT: RE: Teen Pregnancy Campaign
TO: Jeremy D. Benami
(BENAMI_J) (OPD)
READ:11-APR-1995 11:01:00.83
TEXT:
What will people say about family planning on the 800 number?
Will they discuss abortion? Will they refer people to groups that
discuss abortion? Will they refer people to groups that don't
discuss abortion? There is obvious appeal to having an 800
number, but it is difficult to reconcile with local control. This
private entity will never get off the ground if it gets anywhere
near the abortion debate.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Nancy-Ann E. Min (MIN_N) (OMB)
CREATION DATE/TIME:29-MAY-1995 11:21:44.32
SUBJECT: status of teen pregnancy thing
TO: Jeremy D. Benami
(BENAMI_J) (OPD)
READ:30-MAY-1995 11:35:29.09
TEXT:
attached is the information we got from hhs on friday evening. as
you can see, they're saying they don't have to do an official
reprogramming (requiring congressional approps committee approval,
which got us into trouble the last time), but that they'd just
check with the committees. This seems reasonable, but of course
it could also lead to a brick wall if someone on one of the
committee staffs wants to be cute. I am asking Chuck Kieffer, our
approps guru, to take a look at this and advise me tuesday what he
thinks. Generally, we have always thought it is a good idea to
informally advise committee staffs about things like this, just to
avoid misunderstandings and recriminations--but of course, we have
been working with democrats in the past. this may be one of those
"d----d if you do, d-----d if you don't" situations.
at any rate, i'll get back to you.
ATTACHMENT 1
ATT CREATION TIME/DATE:26-MAY-1995 20:50:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Barry T. Clendenin
ATT SUBJECT: Teen Pregnancy Responses from Betty James (ASMB)
ATT TO: Nancy-Ann E. Min
(MIN_N)
ATT CC: Richard J. Turman
(TURMAN_R)
TEXT:
Betty reports:
funding sources would be :
*
$50,000 from CDC Teen Pregnancy activities
*
$40,000 from HRSA Title X (family planning)
* $260,000 from HRSA Healthy Start
HHS' current thinking is that the HHS appropriations
justifications for each of the above items have sufficient mission
justification to use the Economy Act to accomplish a common
mission though a Memorandum of Understanding rather than seekng a
reprogramming up front.
Next steps:
Betty advises that if HHS is asked to move ahead on the request
that HHS would:
*
Pull together HHS technical, procurement and PSA staff needed
to organize the effort within;
*
Draft a MOU to state as precisely as possible why there is a
common mission; and,
*
Klepner would do some checking with the L/HHS committees to see
if there will be any concerns about what is planned.
Let me know if you need some additional followup.
BC
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jeremy D. Benami (BENAMI_J) (OPD)
CREATION DATE/TIME:30-MAY-1995 12:02:43.27
SUBJECT: thanks
TO: Nancy-Ann E. Min
(MIN_N) (OMB)
READ:30-MAY-1995 15:39:54.17
TEXT:
thanks for the update.
I had told Kevin I would touch base with him when you all had
reviewed and had some thoughts - and then maybe try to put
together a conference call with Kevin and Jerry (and our Leg
folks?) so we could make a decision on how to proceed.
Let me know when you have a final read on this. Thanks.
ATTACHMENT 1
ATT CREATION TIME/DATE:29-MAY-1995 11:18:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Nancy-Ann E. Min
ATT SUBJECT: status of teen pregnancy thing
ATT TO: Jeremy D. Benami
(BENAMI_J)
TEXT:
attached is the information we got from hhs on friday evening. as
you can see, they're saying they don't have to do an official
reprogramming (requiring congressional approps committee approval,
which got us into trouble the last time), but that they'd just
check with the committees. This seems reasonable, but of course
it could also lead to a brick wall if someone on one of the
committee staffs wants to be cute. I am asking Chuck Kieffer, our
approps guru, to take a look at this and advise me tuesday what he
thinks. Generally, we have always thought it is a good idea to
informally advise committee staffs about things like this, just to
avoid misunderstandings and recriminations--but of course, we have
been working with democrats in the past. this may be one of those
"d----d if you do, d-----d if you don't" situations.
at any rate, i'll get back to you.
END ATTACHMENT 1
ATTACHMENT 2
ATT CREATION TIME/DATE:26-MAY-1995 20:50:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Barry T. Clendenin
ATT SUBJECT: Teen Pregnancy Responses from Betty James (ASMB)
ATT TO: Nancy-Ann E. Min
(MIN_N)
ATT CC: Richard J. Turman
(TURMAN_R)
TEXT:
Betty reports:
-- funding sources would be :
*
$50,000 from CDC Teen Pregnancy activities
*
$40,000 from HRSA Title X (family planning)
*
$260,000 from HRSA Healthy Start
HHS' current thinking is that the HHS appropriations
justifications for each of the above items have sufficient mission
justification to use the Economy Act to accomplish a common
mission though a Memorandum of Understanding rather than seekng a
reprogramming up front.
Next steps:
Betty advises that if HHS is asked to move ahead on the request
that HHS would:
* Pull together HHS technical, procurement and PSA staff needed
to organize the effort within;
*
Draft a MOU to state as precisely as possible why there is a
common mission; and,
*
Klepner would do some checking with the L/HHS committees to see
if there will be any concerns about what is planned.
Let me know if you need some additional followup.
BC
END ATTACHMENT 2
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Christopher J. Mustain (MUSTAIN_C) (OMB)
CREATION DATE/TIME:13-JUN-1995 11:14:54.82
SUBJECT: Latest version of SAP - filename: HR4S.SAP
TO: Bruce N. Reed
(REED_B) (OPD)
READ:13-JUN-1995 11:15:05.00
TEXT:
ATTACHMENT 1
ATT CREATION TIME/DATE:13-JUN-1995 11:13:00.00
ATT BODYPART TYPE:p
ATT CREATOR: Christopher J. Mustain
TEXT:
PRINTER FONT 12_POINT_COURIER
June
13, 1995
(Senate)
H.R. 4 - Family Self
-Sufficiency Act
(Packwood (R) OR and cosponsors)
The Administration strongly supports enactment of real and
effective welfare reform that promotes the basic values of work
and responsibility. Last year, the President proposed a sweeping
welfare reform package that embodied these values. The
President's proposal would have: established tough work
requirements while providing opportunities for education, job
training, and child care to working people; imposed tough child
support enforcement measures; required teen mothers to live at
home, stay in school, and identify their child's father;
increased State flexibility and accountability; and maintained
protections for children.
In all its welfare reform efforts, the Administration has
emphasized the basic values of work and responsibility. The
President's economic plan expanded the earned income tax credit,
which cut taxes for 15 million working families to reward work
over welfare. Last February, the President issued an Executive
Order to crack down on Federal employees and military personnel
who owe delinquent child support. In the past two years, the
Administration has granted waivers from Federal rules to 29
States to try innovative ways to promote work and responsibility.
The Administration remains committed to working with the Congress
in a bipartisan way to pass bold welfare reform legislation this
year. The Senate version of H.R. 4 represents a significant
improvement over its House counterpart. The Senate bill includes
tough child support enforcement provisions proposed by the
President and omits several provisions from the House bill that
would be very harmful to children. The Administration,
nevertheless, opposes the Senate bill because it still falls
short of the basic goals and values that most Americans want
welfare reform to promote.
WORK
There is a bi
-partisan consensus that the central goal of welfare
reform must be work. Unlike the legislation proposed by the
Administration last year, however, the Senate bill would not end
welfare as we know it by moving people from welfare to work. The
bill provides neither the resources nor the requirements for
States to prepare welfare recipients to become self
-supporting.
H.R. 4 would not ensure that adequate child care, education, and
training are provided to make work pay and give welfare
recipients the skills to hold a job. The Congressional Budget
Office estimates that the bill's lack of funding for job training
and child care would permit only six States to meet the bill's
work requirements.
In fact, H.R. 4 would repeal three child care programs that now
serve more than 640,000 children. Cutting child care for people
trying to leave welfare and for working people who are trying to
stay off welfare is contrary to the goal of achieving real
welfare reform.
Compounding the problems created by the bill's inadequate funding
is the structure of the block grant. By putting resources for
cash benefits, child care, and employment assistance into one
block grant, States would be forced to choose between (1)
providing cash benefits to families in need of assistance and (2)
meeting the bill's work requirements by providing child care and
employment assistance to a smaller population of its low
-income
citizens. States should be rewarded for putting more people to
work, not for cutting them off. The Administration strongly
recommends that cash benefits be funded separately from child
care and employment assistance.
RESPONSIBILITY
Welfare reform must send a strong message to young people that
they should not get pregnant or father a child until they are
ready to take responsibility for that child's future. The
President has called for a national campaign against teen
pregnancy that sends a clear message about abstinence and
responsible parenting. While the Senate bill wisely omits House
provisions to base State funding on an "illegitimacy ratio," the
Senate bill fails to include provisions to address teen
pregnancy.
The Administration believes that minor mothers should receive
benefits when they make a serious effort to be responsible and
turn their lives around -- by living at home, staying in school,
and identifying the child's father. In contrast, the Senate bill
would allow States to automatically punish innocent children by
denying benefits to those born to unwed parents under age 18.
This approach could deny many minor mothers the opportunity to
turn their lives around and provide a stable environment for
their child.
The Administration will continue to work with the Congress
address serious concerns about provisions of H.R. 4 that would:
o
Punish innocent children. H.R. 4 would deny cash benefits
to over ? disabled children. The bill also would cut off
children whose parents have received welfare for more than
five years, whether the parent is able to work or not. It
is essential that children are protected in reforming the
welfare system.
Leave States with inadequate resources. H.R. 4 would
replace existing programs with capped grants to States. In
contrast to the funding mechanisms now in place, funding
under H.R. 4 would not adjust adequately for an economic
downturn or for growth in a State's low
-income population.
Without such adjustments, States in recession would
encounter reduced revenues and increased caseloads. In such
times, it is the working poor who would most likely need,
but not receive, temporary assistance.
o
Provide perverse incentives for States to reduce their
commitment to welfare assistance. H.R. 4 would neither
require nor encourage States to contribute resources to
welfare reform. There is a danger that States would "race
to the bottom" to save State dollars or to deter migrants
from other States. Many States could be expected to
withdraw their own funds, cut benefits, purge large numbers
of current recipients from the rolls, and avoid the
investments needed to help people become self
-sufficient.
H.R. 4 should require States to provide matching funds or to
maintain their current level of funding. We owe it to our
children to ensure that welfare reform provides
opportunities and protects children in all the States.
In addition, the Administration understands that the Senate is
likely to adopt Agriculture Committee language to amend the Food
Stamp and other nutrition programs. The Administration strongly
supports the committee's decision to not block grant these
critical programs. The Administration, however, is concerned
about the severity of the cuts to the Food Stamp program included
in the Agriculture Committee's proposal. These programs have
produced significant and measurable improvements in health among
the many who participate in them.
The Administration supports the welfare reform proposal offered
by Senators Daschle, Breaux, and Mikulski. Unlike H.R. 4, the
proposal provides resources for child care and training to move
people to work, protects children, requires States to maintain
their committment to low
-income families, and provides adequate
adjustment mechanisms for economic downturns and population
changes. These are critical elements of real welfare reform that
should be addressed before a bill is presented to the President.
In summary, the Administration opposes H.R. 4 in its current form
because it: (1) would fail to reform welfare by moving people
from welfare to work; (2) would reduce Federal and State funding
in ways that place children and families at risk of serious
hardship; and (3) could impair the health and nutrition of
children and families.
Pay
-As
-You
-Go Scoring
H.R. 4 would reduce direct spending. However, the House and
Senate Budget resolutions specify that the budget savings from
H.R. 4 are to be included in a package of offsets designed to pay
for upcoming tax legislation. Therefore, the budget savings in
H.R. 4 would go neither toward real welfare reform nor toward
deficit reduction, but primarily to finance tax cuts for the
wealthy.
*******
(Do Not Distribute Outside the Executive Office of the President)
This position was developed by LRD (Mustain) in consultation with
HRD (), OIRA (), BASD (), GC (), HTF (), VAP (), and TCJ (). The
Departments of Health and Human Services (), Agriculture (),
Justice (), Labor (), State (), Defense (), Transportation (),
Housing and Urban Development (), the Treasury (), Veterans
Affairs (), and the Office of Personnel Management (), the Office
of National Drug Control Policy (), the Interagency Council for
the Homeless (), the Federal EBT task force (), the Domestic
Policy Council (), and the Council of Economic Advisers () agree
with this position.
On June 21, 1994, the President transmitted to Congress the "Work
and Responsibility Act of 1994." Major elements of the draft
bill would: (1) strengthen paternity establishment; (2) improve
collection of delinquent child support; (3) provide for family
planning; (4) require unwed teens with children to live with
their parents; (5) provide job search and training assistance;
(6) provide greater child care assistance to those in training;
(7) require AFDC recipients to work after two years in the
program; and (8) make the application process and eligibility
standards of the AFDC and Food Stamp programs more consistent.
On March 24, 1995, the House passed H.R. 4. Except for its child
support enforcement provisions, the House bill differs
significantly from the Administration's 1994 proposal. The bill
would end the entitlement status of many welfare assistance
programs (Food Stamps being the only major exception) and instead
provide block grants to the States. The Administration opposed
the House bill in a Statement of Administration Policy.
As ordered reported by the Senate Finance Committee, the Senate
version of H.R. 4 follows the House model of converting welfare
entitlement programs into a block grant to the States. Unlike
its House counterpart, however, the Senate bill includes fewer
restrictions on States and does not block grant foster care and
adoption assistance programs. In addition, the Senate Finance
Committee did not include provisions affecting the Food Stamp
Program, nutrition programs, and the Child Care and Development
Block Grant program (CCDBG). These programs fall under the
jurisdiction of other Committees. Proposals to reform the Food
Stamp Program, nutrition programs, and CCDBG are expected to be
adopted on the Senate floor.
Major Provisions of H.R. 4
In place of certain welfare programs, H.R. 4 would establish a
block grant to States -- the Block Grant for Temporary Assistance
for Needy Families. H.R. 4 also would impose new work
requirements, tighten eligibility for SSI, establish new child
support enforcement mechanisms, and allow States to deny benefits
to aliens. The major elements of these proposals are discussed
below.
The Block Grant for Temporary Assistance for Needy Families
(TANF) would provide funds to States in place of the following
programs: (1) Aid to Families with Dependent Children; (2) Job
Opportunities and Basic Skills (JOBS); (3) IV
-A, Transitional,
and At
-risk child care; and (4) Emergency Assistance. For these
grants, H.R. 4 would authorize appropriations of $16.8 billion in
each of FYs 1996
-2000. States would be prohibited from paying
cash benefits to a recipient for more than five years (or earlier
at State's option). States could continue to provide benefits
past the five year limit for up to 10 percent of its caseload for
hardship cases. Individuals receiving Social Security benefits,
Supplemental Security Income benefits, or foster care payments
would not be eligible for TANF benefits.
To address emergency funding needs, H.R. 4 would authorize
appropriations of $1.7 billion in FY 1996 to establish a
Supplemental Assistance for Needy Families Federal Fund. HHS
would administer the fund to provide loans to States in time of
need. Loans could not exceed 10 percent of the State's TANF
grant.
To receive a TANF block grant, H.R. 4 would require a State to
certify that it operates a JOBS program, a child support
enforcement program, child welfare programs, and an income and
eligibility verification program. HHS would be authorized to
collect penalties from States for failure to: spend funds in
accord with program requirements; submit an annual report; meet
JOBS participation rates; administer in an income and eligibility
verification program; or repay amounts borrowed from the
Supplemental Assistance for Needy Families Federal Fund. H.R. 4
would give States the option make all non
-citizens ineligible for
TANF benefits.
H.R. 4 would impose new work requirements. After two years
(whether consecutive or not), at least one parent in a recipient
family would be required to engage in work activities. The bill
also would require States to meet increased participation rates
under the JOBS program -- 25 percent of their caseload in FY 1996
and rising to 50 percent in FY 2001. Participation is defined as
at least 20 hours per week in JOBS activities (excluding job
search). For two
-parent TANF families, one parent would have to
participate in at least 30 hours of work activities. In
addition, States must meet a participation rate of 90 percent for
two
-parent families by FY 1999. States would be required to
guarantee child care for recipients with children under age six
in order to participate in JOBS activities.
The bill would restrict eligibility for SSI benefits. Under the
bill, drug and alcohol addiction would no longer be a basis for
eligibility for SSI benefits. Legal or illegal aliens would no
longer qualify for SSI benefits unless they have worked in the
United States long enough to qualify for Social Security
disability income or old age benefits. Asylees and refugees
would be eligible for SSI for up to five years after moving to
the United States. Noncitizens who served in the armed forces
(and their spouses and children) would also be eligible.
H.R. 4 also would limit SSI payments to only the most severely
disabled children by more narrowly defining what constitutes a
childhood disability. For example, the bill would (1) eliminate
a double count of maladaptive behavior under the current "Listing
of Impairments" (LOI) that determines eligibility for SSI
benefits and (2) eliminate the "individual functional assessment"
process that provides an additional and often lower standard of
eligibility than the LOI. The bill also would establish a
National Commission on the Future of Disability Programs to make
recommendations to improve Federal disability programs.
H.R. 4 includes child support enforcement provisions similar to
those proposed by the Administration. As in the Administration's
bill, H.R. 4 would: (1) require States to suspend professional
and other licenses to parents that owe delinquent child support;
(2) require States to create central case registries to track the
status of support orders; (3) establish a Federal Directory of
New Hires to help track down parents delinquent in their support
payments; (4) improve paternity establishment, (5) expand
administrative enforcement of child support orders; (6) simplify
procedures to review and adjust orders; and (7) improve
enforcement of orders by means such as the Federal income tax
refund offset.
Pay
-As
- -You
-Go Scoring
Per HRD () and BASD (), H.R. 4 is subject to the pay
-as
-you
-go
requirements of the Omnibus Budget Reconciliation Act of 1990
because it would reduce direct spending. CBO
LEGISLATIVE REFERENCE DIVISION
June 13, 1995 - 10:30 a.m.
END ATTACHMENT 1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME:19-JUN-1995 16:09:58.08
SUBJECT: RE: Family Planning reauthorization FYI
TO: Diana M. Fortuna
(FORTUNA_D) (OPD)
READ:19-JUN-1995 16:36:58.49
CC: Jeremy D. Benami
(BENAMI_J) (OPD)
READ:19-JUN-1995 16:50:03.55
CC: Christopher C. Jennings
(JENNINGS_C) (OPD)
READ:20-JUN-1995 13:18:08.98
TEXT:
I read it and actually think this is a complicated political
question. Some would argue that it is precisely the right time to
take this on. I'm not sure. Keep me posted and I'll do the same.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Diana M. Fortuna (FORTUNA_D) (OPD)
CREATION DATE/TIME:19-JUN-1995 15:43:12.77
SUBJECT: Family Planning reauthorization FYI
TO: Jeremy D. Benami
(BENAMI_J) (OPD)
READ:19-JUN-1995 16:46:48.64
CC: Christopher C. Jennings
(JENNINGS_C) (OPD)
READ:20-JUN-1995 13:17:59.49
CC: Jennifer L. Klein
(KLEIN_J) (OPD)
READ:19-JUN-1995 16:10:04.76
TEXT:
FYI: HHS wants to send a letter from Shalala to Gingrich
recommending that they reauthorized Title X the PHS Act, which is
family planning services. Apparently this hasn't been
reauthorized since 1985, presumably because of the contentious
nature of the abortion issue; yet appropriations have continued
during all this time. OMB questions whether this is the right
time and the right Congress to push this issue, and it certainly
seems to me like they have a point! I told OMB that I agree.
Supposedly Martha Foley is now considering the issue.
(Chris and Jen: you were cc'd on this, but I assume you haven't
commented.)
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Diana M. Fortuna (FORTUNA_D) (OPD)
CREATION DATE/TIME:19-JUN-1995 16:36:51.16
SUBJECT: family planning
TO: Jeremy D. Benami
(BENAMI_J) (OPD)
READ:19-JUN-1995 17:03:58.08
TEXT:
Sounds like you need to weigh in and settle this -- unless Jen is
acting in her First Lady capacity, which is certainly possible.
ATTACHMENT 1
ATT CREATION TIME/DATE:19-JUN-1995 16:06:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Jennifer L. Klein
ATT SUBJECT: RE: Family Planning reauthorization FYI
ATT TO: Diana M. Fortuna
(FORTUNA_D)
ATT CC: Jeremy D. Benami
(BENAMI_J)
ATT CC: Christopher C. Jennings
(JENNINGS_C)
TEXT:
I read it and actually think this is a complicated political
question. Some would argue that it is precisely the right time to
take this on. I'm not sure. Keep me posted and I'll do the same.
END ATTACHMENT 1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Sheryll D. Cashin (CASHIN_S) (OPD)
CREATION DATE/TIME:20-JUL-1995 12:07:26.01
SUBJECT: FYI and apologies
TO: Remote Addressee
([email protected]@INET)
READ:NOT READ
TEXT:
FYI, I understand from Jim Gatz that you are sending something over. Please
apologize to Gatz for me; he just called me and I was very abrupt with him in
giving my fax number because I had to catch a call. Perhaps you could forward
my e-mail to him. I am sorry Jim, I am quite hassled today. Thanks.
ATTACHMENT 1
ATT CREATION TIME/DATE:20-JUL-1995 11:51:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Sheryll D. Cashin
ATT SUBJECT: Carnegie Corporation Initiative
ATT TO: Remote Addressee
([email protected]@INET)
TEXT:
Per our conversation, the Carnegie Corporation would like the task force's
recommendation as to the top three EC and the top three EZ candidates for their
starting points grant initiative. They want to give additional support to
places that have already mounted initiatives that focus on very young children
(preferably ages 0-3).
They will be distributing $3 million among 8 states and communities. The money
will be flexible; it can be used for extra planning and bringing together of
stakeholders to support implementation of ready-to-go or ongoing initiatives.
They will send a letter on AUG. 1 to 20 states and localities that they have
identified as likely candidates.
They will probably focus on ECs rather than EZs for the few local grants that
they give.
Appropriate EZ/EC candidates would be those that had a strong focus on children
and families in their plan and/or any or all of the following types of
activities:
family support and parenting education
family planning
comprehensive health care services for parents and children
quality childcare services
and an existing task force or committee that is focusing on families and
children.
For each candidate, they would like a few sentences on why they were selected.
They will need an address or contact for those places as well.
Thanks. Sorry for the delay.
END ATTACHMENT
I
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Barry White (WHITE_B) (OMB)
CREATION DATE/TIME:20-JUL-1995 15:14:26.41
SUBJECT: Action to date on Labor/HHS/ED at H full committee - FYI
TO: Paul R. Dimond
(DIMOND_P) (OPD)
READ:20-JUL-1995 15:15:59.42
TO: Gaynor R. McCown
(MCCOWN_G) (OPD)
READ:20-JUL-1995 18:32:17.26
TO: Michael T. Schmidt
(SCHMIDT_MT) (OPD)
READ:20-JUL-1995 17:01:35.81
TO: Robert Gordon
(GORDON_R) (OPD)
READ:20-JUL-1995 15:15:24.19
TEXT:
ATTACHMENT 1
ATT CREATION TIME/DATE:20-JUL-1995 14:21:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Elizabeth L. Rossman
ATT SUBJECT: L/HHS/Ed -- Full Committee Markup (Markup not yet completed)
ATT TO: Barry White
(WHITE_B)
ATT TO: Larry R. Matlack
(MATLACK_L)
ATT TO: Barry T. Clendenin
( CLENDENIN_B)
ATT TO: Richard J. Turman
(TURMAN_R)
ATT TO: Mark E. Miller
(MILLER_ME)
ATT TO: Lisa B. Fairhall
(FAIRHALL_L)
ATT TO: Jonas E. Neihardt
(NEIHARDT_J)
ATT TO: Linda K. Wiesman
(WIESMAN_L)
ATT TO: Nancy-Ann E. Min
(MIN_N)
ATT TO: Kenneth S. Apfel
(APFEL_K)
ATT TO: Keith J. Fontenot
(FONTENOT_K)
ATT TO: Richard E. Green
(GREEN_R)
ATT CC: Richard P. Emery Jr.
(EMERY_R)
ATT CC: Robert E. Barker
(BARKER_R)
ATT CC: Nancy S. Ridenour
(RIDENOUR_N)
ATT CC: Charles E. Kieffer
(KIEFFER_C)
ATT CC: James I. Blount
(BLOUNT_J)
ATT CC: Barry B. Anderson
( ANDERSON_B)
TEXT:
The House Full Committee met today at 8:15 am and adjourned
subject to the call of the chair (they did not finish on the
bill).
The following actions occurred:
(1) A Porter amendment was adopted (voice vote/without
objection) that provided $40 M more to the crime prevention
programs in the bill. It provided $35 M for rape prevention an,
$4 M for "community programs(??)" and $1 M more in miscellaneous
crime funding. They were able to do this because the House
Appropriations Committee revised their 602(b) allocations once
again. $5 M was also transferred between LAE and the SSA/OIG (the
Committee said that this was done at the request of the
department.)
(2) A Porter amendment was adopted (voice vote/without
objection) that made eight changes to the bill report language
(encouraging NIH to focus on Parkinson's disease, Alzheimers, etc.
-- we will know when we get the amendment).
(3) An Obey amendment was defeated (29-18) that would have
struck eleven different legislative provisions in the bill,
including the prohibition on implementation of the Executive Order
on striker replacement, OSHA regulation modifications, and the
elimination of the Office of the Surgeon General.
(4) A Livingston amendment was adopted (28-25) that would
terminate funding for family planning ($193 M) and transfer the
funds to the Maternal and Child Health Block Grant ($116 M) and to
Community and Migrant Health Centers ($77 M).
(5) A Hoyer amendment was defeated (30-19) that would have
restored $1.1 B to various Education programs (Goals 2000,
Eisenhower program, Safe and Drug Free Schools, School-to-Work,
Voc Ed) and to Head Start. (Offset - change Federal cap on
Medicaid.)
(6) A Pelosi amendment was defeated (32-19) that would have
restored funding for various worker protection programs (OSHA, $44
M; MSHA, $14 M; ESA, $22 M; Pension protection, $4.5 M; NLRB,
$47.5 M; Dislocated workers, $232 M; NIOSH, $30 M). (Offset
change Federal cap on Medicaid.)
(7) A Lowey amendment was defeated (24-19) that would have
restored $140 M for student aid programs ($100 M for Perkins loan
program, and $40 M for SSIG). (Offset change Federal cap on
Medicaid.)
(8) A Stokes amendment was defeated (26-19) that would have
restored $1.3 B to investments in career and youth training
(School-to-Work, Dislocated Workers, partial restoration of Summer
Jobs). (Offset -- change Federal cap on Medicaid.)
(9) An Obey amendment was defeated (32-17) that would have
restored funding to 3/4 of reductions made to LIHEAP, Older
workers programs, AOA programs, Medigap counseling, Head Start,
Healthy Start and Special Education. (Offset -- change Federal
cap on Medicaid.)
(10) An Obey amendment was adopted by voice vote that would
remove offensive language in the bill (struck lines 1-9 on p. 17
-- Labor Depart, I'm not sure if they did the same for other
agencies -- we will have to wait until we get a copy of the
amendment.)
(11) It seemed as if Istook was ready to offer his abortion
amendment. However, Livingston expressed concern that whatever
the amendment was -- that it was controversial and asked that his
amendment be withdrawn.
(12) A Porter second degree amendment to a Dickey amendment
failed on a 26-26 tie. The Porter amendment would have prohibited
funds in the Act from being used to support the creation of human
embryos for research. Porter claimed that this was consistent
with the current NIH practice. The Dickey/Wicker amendment (which
was adopted 30-26) would prohibit Federal funds for being used for
embryo research outside the womb.
Full Committee is expected to continue on the bill either
tonight or tomorrow morning.
I'll keep you posted.
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Robert Gordon ( GORDON_R) (OPD)
CREATION DATE/TIME:20-JUL-1995 15:15:43.88
SUBJECT: Elena, Gene should see this.
TO: Gene B. Sperling
(SPERLING_G) Autoforward to: Elena R. Mccoy
(MCCOY_ER)
(PDONE)
READ:20-JUL-1995 15:27:55.59
TEXT:
ATTACHMENT 1
ATT CREATION TIME/DATE:20-JUL-1995 15:13:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Barry White
ATT SUBJECT: Action to date on Labor/HHS/ED at H full committee - FYI
ATT TO: Paul R. Dimond
(DIMOND_P)
ATT TO: Gaynor R. McCown
(MCCOWN_G)
ATT TO: Michael T. Schmidt
(SCHMIDT_MT)
ATT TO: Robert Gordon
(GORDON_R)
TEXT:
END ATTACHMENT I
ATTACHMENT 2
ATT CREATION TIME/DATE:20-JUL-1995 14:21:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Elizabeth L. Rossman
ATT SUBJECT: L/HHS/Ed -- Full Committee Markup (Markup not yet completed)
ATT TO: Barry White
(WHITE_B)
ATT TO: Larry R. Matlack
(MATLACK_L)
ATT TO: Barry T. Clendenin
( CLENDENIN_B)
ATT TO: Richard J. Turman
(TURMAN_R)
ATT TO: Mark E. Miller
( (MILLER_ME)
ATT TO: Lisa B. Fairhall
(FAIRHALL_L)
ATT TO: Jonas E. Neihardt
(NEIHARDT_J)
ATT TO: Linda K. Wiesman
(WIESMAN_L)
ATT TO: Nancy-Ann E. Min
(MIN_N)
ATT TO: Kenneth S. Apfel
( APFEL_K)
ATT TO: Keith J. Fontenot
(FONTENOT_K)
ATT TO: Richard E. Green
(GREEN_R)
ATT CC: Richard P. Emery Jr.
(EMERY_R)
ATT CC: Robert E. Barker
(BARKER_R)
ATT CC: Nancy S. Ridenour
(RIDENOUR_N)
ATT CC: Charles E. Kieffer
(KIEFFER_C)
ATT CC: James I. Blount
(BLOUNT_J)
ATT CC: Barry B. Anderson
( ANDERSON_B)
TEXT:
The House Full Committee met today at 8:15 am and adjourned
subject to the call of the chair (they did not finish on the
bill).
The following actions occurred:
(1) A Porter amendment was adopted (voice vote/without
objection) that provided $40 M more to the crime prevention
programs in the bill. It provided $35 M for rape prevention an,
$4 M for "community programs(??)" and $1 M more in miscellaneous
crime funding. They were able to do this because the House
Appropriations Committee revised their 602(b) allocations once
again. $5 M was also transferred between LAE and the SSA/OIG (the
Committee said that this was done at the request of the
department.)
(2) A Porter amendment was adopted (voice vote/without
objection) that made eight changes to the bill report language
(encouraging NIH to focus on Parkinson's disease, Alzheimers, etc.
-- we will know when we get the amendment).
(3) An Obey amendment was defeated (29-18) that would have
struck eleven different legislative provisions in the bill,
including the prohibition on implementation of the Executive Order
on striker replacement, OSHA regulation modifications, and the
elimination of the Office of the Surgeon General.
(4) A Livingston amendment was adopted (28-25) that would
terminate funding for family planning ($193 M) and transfer the
funds to the Maternal and Child Health Block Grant ($116 M) and to
Community and Migrant Health Centers ($77 M).
(5) A Hoyer amendment was defeated (30-19) that would have
restored $1.1 B to various Education programs (Goals 2000,
Eisenhower program, Safe and Drug Free Schools, School-to-Work,
Voc Ed) and to Head Start. (Offset -- change Federal cap on
Medicaid.)
(6) A Pelosi amendment was defeated (32-19) that would have
restored funding for various worker protection programs (OSHA, $44
M; MSHA, $14 M; ESA, $22 M; Pension protection, $4.5 M; NLRB,
$47.5 M; Dislocated workers, $232 M; NIOSH, $30 M). (Offset --
change Federal cap on Medicaid.)
(7) A Lowey amendment was defeated (24-19) that would have
restored $140 M for student aid programs ($100 M for Perkins loan
program, and $40 M for SSIG). (Offset -- change Federal cap on
Medicaid.)
(8) A Stokes amendment was defeated (26-19) that would have
restored $1.3 B to investments in career and youth training
(School-to-Work, Dislocated Workers, partial restoration of Summer
Jobs). (Offset -- change Federal cap on Medicaid.)
(9) An Obey amendment was defeated (32-17) that would have
restored funding to 3/4 of reductions made to LIHEAP, Older
workers programs, AOA programs, Medigap counseling, Head Start,
Healthy Start and Special Education. (Offset -- change Federal
cap on Medicaid.)
(10) An Obey amendment was adopted by voice vote that would
remove offensive language in the bill (struck lines 1-9 on p. 17
-- Labor Depart, I'm not sure if they did the same for other
agencies -- we will have to wait until we get a copy of the
amendment.)
(11) It seemed as if Istook was ready to offer his abortion
amendment. However, Livingston expressed concern that whatever
the amendment was -- that it was controversial and asked that his
amendment be withdrawn.
(12) A Porter second degree amendment to a Dickey amendment
failed on a 26-26 tie. The Porter amendment would have prohibited
funds in the Act from being used to support the creation of human
embryos for research. Porter claimed that this was consistent
with the current NIH practice. The Dickey/Wicker amendment (which
was adopted 30-26) would prohibit Federal funds for being used for
embryo research outside the womb.
Full Committee is expected to continue on the bill either
tonight or tomorrow morning.
I'll keep you posted.
END ATTACHMENT 2
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Sheryll D. Cashin (CASHIN_S) (OPD)
CREATION DATE/TIME:20-JUL-1995 12:05:36.23
SUBJECT: Carnegie Corporation Initiative
TO: Remote Addressee
([email protected]@INET)
READ:NOT READ
TEXT:
Per our conversation, the Carnegie Corporation would like the task force's
recommendation as to the top three EC and the top three EZ candidates for their
starting points grant initiative. They want to give additional support to
places that have already mounted initiatives that focus on very young children
(preferably ages 0-3).
They will be distributing $3 million among 8 states and communities. The money
will be flexible; it can be used for extra planning and bringing together of
stakeholders to support implementation of ready-to-go or ongoing initiatives.
They will send a letter on AUG. 1 to 20 states and localities that they have
identified as likely candidates.
They will probably focus on ECs rather than EZs for the few local grants that
they give.
Appropriate EZ/EC candidates would be those that had a strong focus on children
and families in their plan and/or any or all of the following types of
activities:
family support and parenting education
family planning
comprehensive health care services for parents and children
quality childcare services
and an existing task force or committee that is focusing on families and
children.
For each candidate, they would like a few sentences on why they were selected.
They will need an address or contact for those places as well.
Thanks. Sorry for the delay.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Nancy-Ann E. Min (MIN_N) (OMB)
CREATION DATE/TIME:24-JUL-1995 19:01:22.45
SUBJECT: RE: Shalala testifying on Family Planning
TO: Robert J. Pellicci
(PELLICCI_R) (OMB)
READ:25-JUL-1995 09:04:07.73
CC: Diana M. Fortuna
(FORTUNA_D) (OPD)
READ:24-JUL-1995 19:08:51.99
CC: Jennifer L. Klein
(KLEIN_J) (OPD)
READ:24-JUL-1995 21:09:17.72
CC: Christopher C. Jennings
(JENNINGS_C) (OPD)
READ:25-JUL-1995 15:59:29.11
CC: James Castello
(CASTELLO_J) (WHO)
READ:24-JUL-1995 19:40:02.79
CC: Barry T. Clendenin
( CLENDENIN_B) (OMB)
READ:24-JUL-1995 19:03:17.81
CC: Richard J. Turman
(TURMAN_R) (OMB)
READ:24-JUL-1995 19:16:05.48
CC: Allison H. Eydt
(EYDT_A) (OMB)
READ:25-JUL-1995 09:16:06.81
CC: Janet R. Forsgren
(FORSGREN_J) (OMB)
READ:25-JUL-1995 09:53:10.28
CC: James C. Murr
(MURR_J) (OMB)
READ:25-JUL-1995 08:09:24.92
TEXT:
when?
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Robert J. Pellicci (PELLICCI_R) (OMB)
CREATION DATE/TIME:24-JUL-1995 16:36:42.67
SUBJECT: Shalala testifying on Family Planning
TO: Nancy-Ann E. Min
(MIN_N) (OMB)
READ:24-JUL-1995 19:01:25.22
TO: Diana M. Fortuna
(FORTUNA_D) (OPD)
READ:24-JUL-1995 17:02:13.82
TO: Jennifer L. Klein
(KLEIN_J) (OPD)
READ:24-JUL-1995 17:51:43.86
TO: Christopher C. Jennings
(JENNINGS_C) (OPD)
READ:25-JUL-1995 15:03:20.85
TO: James Castello
(CASTELLO_J) (WHO)
READ:24-JUL-1995 17:48:05.72
CC: Barry T. Clendenin
(CLENDENIN_B) (OMB)
READ:24-JUL-1995 17:54:54.02
CC: Richard J. Turman
(TURMAN_R) (OMB)
READ:24-JUL-1995 17:54:46.08
CC: Allison H. Eydt
(EYDT_A) (OMB)
READ:24-JUL-1995 16:41:33.49
CC: Janet R. Forsgren
(FORSGREN_J) (OMB)
READ:24-JUL-1995 16:38:54.01
CC: James C. Murr
(MURR_J) (OMB)
READ:24-JUL-1995 16:52:32.05
TEXT:
ALERT --
Secretary Shalala has been invited and has accepted to testify
before the Senate Appropriations Subcommittee on Labor, Health and
Human Services, and Education on the Departmen'ts title X family
planning program. According to Karen Pollitz, the Secretary's
testimony will be sent to us for clearance in the morning.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Diana M. Fortuna (FORTUNA_D) (OPD)
CREATION DATE/TIME:24-JUL-1995 17:05:51.67
SUBJECT: FYI Shalala testifying on family planning
TO: Jeremy D. Benami
(BENAMI_J) (OPD)
READ:24-JUL-1995 18:42:53.37
TO: Karen R. Guss
(GUSS_K) (WHO)
READ:24-JUL-1995 17:19:59.69
TEXT:
ATTACHMENT 1
ATT CREATION TIME/DATE:24-JUL-1995 16:31:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Robert J. Pellicci
ATT SUBJECT: Shalala testifying on Family Planning
ATT TO: Nancy-Ann E. Min
(MIN_N)
ATT TO: Diana M. Fortuna
(FORTUNA_D)
ATT TO: Jennifer L. Klein
(KLEIN_J)
ATT TO: Christopher C. Jennings
(JENNINGS_C)
ATT TO: James Castello
(CASTELLO_J)
ATT CC: Barry T. Clendenin
( CLENDENIN_B)
ATT CC: Richard J. Turman
(TURMAN_R)
ATT CC: Allison H. Eydt
(EYDT_A)
ATT CC: Janet R. Forsgren
(FORSGREN_J)
ATT CC: James C. Murr
(MURR_J)
TEXT:
ALERT
Secretary Shalala has been invited and has accepted to testify
before the Senate Appropriations Subcommittee on Labor, Health and
Human Services, and Education on the Departmen'ts title X family
planning program. According to Karen Pollitz, the Secretary's
testimony will be sent to us for clearance in the morning.
END ATTACHMENT 1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME:25-JUL-1995 15:12:41.31
SUBJECT: RE: Shalala testifying on Family Planning
TO: Christopher C. Jennings
(JENNINGS_C) (OPD)
READ:27-JUL-1995 16:31:12.30
CC: Robert J. Pellicci
(PELLICCI_R) (OMB)
READ:25-JUL-1995 15:33:59.33
CC: Nancy-Ann E. Min
(MIN_N) (OMB)
READ:25-JUL-1995 17:39:18.65
CC: Diana M. Fortuna
(FORTUNA_D) (OPD)
READ:25-JUL-1995 15:14:46.05
CC: James Castello
(CASTELLO_J) (WHO)
READ:25-JUL-1995 15:27:33.23
CC: Barry T. Clendenin
( CLENDENIN_B) (OMB)
READ:25-JUL-1995 15:13:08.45
CC: Richard J. Turman
(TURMAN_R) (OMB)
READ:25-JUL-1995 16:17:09.30
CC: Allison H. Eydt
( EYDT_A) (OMB)
READ:25-JUL-1995 15:33:28.35
CC: Janet R. Forsgren
(FORSGREN_J) (OMB)
READ:25-JUL-1995 16:38:05.30
CC: James C. Murr
(MURR_J) (OMB)
READ:25-JUL-1995 15:15:57.39
TEXT:
Has anyone asked Jerry?
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Christopher C. Jennings (JENNINGS_C) (OPD)
CREATION DATE/TIME:25-JUL-1995 15:03:17.71
SUBJECT: RE: Shalala testifying on Family Planning
TO: Robert J. Pellicci
(PELLICCI_R) (OMB)
READ:25-JUL-1995 15:04:07.97
CC: Nancy-Ann E. Min
(MIN_N) (OMB)
READ:25-JUL-1995 17:39:03.44
CC: Diana M. Fortuna
(FORTUNA_D) (OPD)
READ:25-JUL-1995 15:14:30.58
CC: Jennifer L. Klein
(KLEIN_J) (OPD)
READ:25-JUL-1995 15:12:45.25
CC: James Castello
(CASTELLO_J) (WHO)
READ:25-JUL-1995 15:27:23.07
CC: Barry T. Clendenin
( CLENDENIN_B) (OMB)
READ:25-JUL-1995 15:10:54.52
CC: Richard J. Turman
(TURMAN_R) (OMB)
READ:25-JUL-1995 15:03:34.41
CC: Allison H. Eydt
(EYDT_A) (OMB)
READ:25-JUL-1995 15:05:23.14
CC: Janet R. Forsgren
(FORSGREN_J) (OMB)
READ:25-JUL-1995 16:36:28.11
CC: James C. Murr
(MURR_J) (OMB)
READ:25-JUL-1995 15:06:51.51
TEXT:
Fine by me, as long as it is fine by Nancy Ann and Jen. Not my
issue, but I thought Jerry Klepner's past position is that the
Secretary does not testify at Subcommittee level. Will this
create problems for us later on when he tries to use that excuse
when we don't want to testify?
CJ
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Nancy-Ann E. Min (MIN_N) (OMB)
CREATION DATE/TIME:25-JUL-1995 17:39:01.14
SUBJECT: RE: Shalala testifying on Family Planning
TO: Christopher C. Jennings
(JENNINGS_C) (OPD)
READ:27-JUL-1995 16:42:58.35
CC: Robert J. Pellicci
(PELLICCI_R) (OMB)
READ:25-JUL-1995 18:08:16.49
CC: Diana M. Fortuna
(FORTUNA_D) (OPD)
READ:25-JUL-1995 18:06:17.33
CC: Jennifer L. Klein
(KLEIN_J) (OPD)
READ:25-JUL-1995 17:46:26.21
CC: James Castello
(CASTELLO_J) (WHO)
READ:25-JUL-1995 19:29:09.84
CC: Barry T. Clendenin
(CLENDENIN_B) (OMB)
READ:25-JUL-1995 18:00:51.96
CC: Richard J. Turman
(TURMAN_R) (OMB)
READ:25-JUL-1995 18:43:19.18
CC: Allison H. Eydt
(EYDT_A) (OMB)
READ:26-JUL-1995 09:19:09.14
CC: Janet R. Forsgren
(FORSGREN_J) (OMB)
READ:26-JUL-1995 09:52:59.40
CC: James C. Murr
( MURR_J) (OMB)
READ:25-JUL-1995 17:45:32.06
TEXT:
yes, chris has a good point here.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Robert J. Pellicci (PELLICCI_R) (OMB)
CREATION DATE/TIME:25-JUL-1995 18:08:10.83
SUBJECT: RE: Shalala testifying on Family Planning
TO: Nancy-Ann E. Min
(MIN_N) (OMB)
READ:26-JUL-1995 08:42:11.64
CC: Christopher C. Jennings
(JENNINGS_C) (OPD)
READ:27-JUL-1995 16:43:08.31
CC: Diana M. Fortuna
(FORTUNA_D) (OPD)
READ:25-JUL-1995 18:08:21.70
CC: Jennifer L. Klein
(KLEIN_J) (OPD)
READ:25-JUL-1995 18:39:38.74
CC: James Castello
(CASTELLO_J) (WHO)
READ:25-JUL-1995 19:29:30.08
CC: Barry T. Clendenin
( CLENDENIN_B) (OMB)
READ:25-JUL-1995 18:26:24.79
CC: Richard J. Turman
(TURMAN_R) (OMB)
READ:25-JUL-1995 18:44:00.41
CC: Allison H. Eydt
(EYDT_A) (OMB)
READ:26-JUL-1995 09:20:18.67
CC: Janet R. Forsgren
(FORSGREN_J) (OMB)
READ:26-JUL-1995 09:53:43.05
CC: James C. Murr
(MURR_J) (OMB)
READ:25-JUL-1995 18:14:59.39
TEXT:
I was just advised by HHS that the family planning hearing has
been cancelled no new date has been scheduled. HHS, however,
would like to have Secretary Shalala's statement cleared in
anticipation of a future hearing. We certainly do not need to
clear the statement tomorrow. I believe by the end of this week
or early next will be fine. As soon as a new date/time is
announced I will let you know.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Robert J. Pellicci (PELLICCI_R) (OMB)
CREATION DATE/TIME: 8-AUG-1995 11:01:20.90
SUBJECT: Secretary Shalala's Family Planning Statement
TO: Nancy-Ann E. Min
(MIN_N) (OMB)
READ: 8-AUG-1995 14:59:08.92
TO: James Castello
(CASTELLO_J) (WHO)
READ: 8-AUG-1995 11:36:51.53
TO: Martha Foley
(FOLEY_M) (OMB)
READ: 8-AUG-1995 11:16:09.82
TO: Jennifer L. Klein
(KLEIN_J) (OPD)
READ: 8-AUG-1995 11:25:25.00
TO: Janet Murguia
(MURGUIA_J) (WHO)
READ: 8-AUG-1995 13:06:08.52
TO: Barbara C. Chow
(CHOW_B) (WHO)
READ: 8-AUG-1995 13:08:18.84
CC: Barry T. Clendenin
( CLENDENIN_B) (OMB)
READ: 8-AUG-1995 11:11:10.30
CC: Richard J. Turman
(TURMAN_R) (OMB)
READ: 8-AUG-1995 11:06:07.99
CC: William G. White
(WHITE_W) (OMB)
READ: 8-AUG-1995 11:04:17.95
CC: Nani A. Coloretti
(COLORETTI_N) (OMB)
READ: 8-AUG-1995 11:01:39.51
CC: Elizabeth L. Rossman
(ROSSMAN_E) (OMB)
READ: 8-AUG-1995 11:01:39.64
CC: Lydia Muniz
(MUNIZ_L) (OMB)
READ: 8-AUG-1995 11:02:11.75
CC: Janet R. Forsgren
(FORSGREN_J) (OMB)
READ: 8-AUG-1995 13:19:51.99
CC: James C. Murr
(MURR_J) (OMB)
READ: 8-AUG-1995 11:46:06.52
TEXT:
Earlier this morning I circulated for your review and sign-off HHS
Secretary Shalala's testimony for Thursday's hearing before Sen.
Spector's Senate Appropriations Subcommittee on the title X family
planning program. The deadline for comments was listed as 10 a.m.
tomorrow. Secretary Shalala has requested that, if at all
possible, we provide our comments to the Department by this
evening. I told her staff that we would try.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Nancy-Ann E. Min (MIN_N) (OMB)
CREATION DATE/TIME: 8-AUG-1995 14:59:04.34
SUBJECT: RE: Secretary Shalala's Family Planning Statement
TO: Robert J. Pellicci
(PELLICCI_R) (OMB)
READ: 8-AUG-1995 15:09:26.15
CC: James Castello
(CASTELLO_J) (WHO)
READ: 8-AUG-1995 16:41:14.13
CC: Martha Foley
(FOLEY_M) (OMB)
READ: 8-AUG-1995 17:40:14.29
CC: Jennifer L. Klein
(KLEIN_J) (OPD)
READ: 8-AUG-1995 15:00:30.89
CC: Janet Murguia
(MURGUIA_J) (WHO)
READ: 8-AUG-1995 16:44:30.96
CC: Barbara C. Chow
(CHOW_B) (WHO)
READ: 8-AUG-1995 21:16:14.71
CC: Barry T. Clendenin
( CLENDENIN_B (OMB)
READ: 8-AUG-1995 14:59:52.75
CC: Richard J. Turman
(TURMAN_R) (OMB)
READ: 8-AUG-1995 14:59:40.58
CC: William G. White
(WHITE_W) (OMB)
READ: 8-AUG-1995 14:59:58.53
CC: Nani A. Coloretti
(COLORETTI_N) (OMB)
READ: 8-AUG-1995 16:08:59.50
CC: Elizabeth L. Rossman
(ROSSMAN_E) (OMB)
READ: 8-AUG-1995 15:29:07.84
CC: Lydia Muniz
(MUNIZ_L) (OMB)
READ: 8-AUG-1995 15:06:25.69
CC: Janet R. Forsgren
(FORSGREN_J) (OMB)
READ: 8-AUG-1995 16:53:30.31
CC: James C. Murr
(MURR_J) (OMB)
READ: 8-AUG-1995 15:05:27.93
TEXT:
thanks, bob--but i haven't even seen it yet and doubt i will be
able to before 6 PM or so tonight at the earliest.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Karen R. Guss ( (GUSS_K) (WHO)
CREATION DATE/TIME:10-AUG-1995 12:19:07.75
SUBJECT: repro rts talking points
TO: Jeremy D. Benami
(BENAMI_J) (OPD)
READ:10-AUG-1995 12:29:56.53
TEXT:
I looked at your edits -- I think everything looks good.
I want to change the last paragraph to say:
"It is clear that the Congressional majority is paying back the
religious right for its support at the polls last November.
Republicans have embraced the Christian Coalition's "Contract with
the American Family," which contains provisions attacking
reproductive rights, including funding for family planning
programs. The Contract also proposes "constitutional and
statutory protection for the unborn child" -- a thinly disguised
call for a total ban on abortion.
What do you think?
Also, I am running the talking points past Jake Siewert to see
what he thinks, Julia says he needs to see all the talking points
that do or can go out of here.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Julie E. Demeo (DEMEO_J) (OPD)
CREATION DATE/TIME:23-AUG-1995 11:13:10.36
SUBJECT: Yesterday's DPC memo
TO: Patsy Fleming
(FLEMING_P) (DOJ)
READ:23-AUG-1995 11:15:18.07
TEXT:
PRINTER FONT 12_POINT_COURIER
August 22, 1995
DAILY BRIEFING MEMORANDUM FOR THE PRESIDENT
FROM: DOMESTIC POLICY COUNCIL
SUBJECT:
Daily Briefing on DPC Issues
Immigration Enforcement
The Border Patrol arrested 32 illegal aliens in Orlando who had
used fraudulent documents to gain employment and social services.
The individuals were employed in construction at the county
courthouse and the action was taken pursuant to complaints from
citizens and union officials that illegal aliens were taking jobs
from American workers at the site. The arrested individuals were
returned voluntarily to Mexico.
Discipline for Children with Disabilities
How to discipline students with disabilities is the most
controversial issue in the reauthorization of the law governing
special education, the Individuals with Disabilities Education
Act (IDEA). A group of six organizations representing school
boards, principals, and teachers argue there is a double standard
for students with disabilities because it is more difficult to
remove them from the classroom for disciplinary reasons than
students without disabilities. Disability advocates argue
vociferously that the discipline issue is a false one that has
been used as a smokescreen to exclude children with disabilities.
Last year Congress moved in the direction of the school boards by
passing the Jeffords amendment, which allows immediate suspension
for up to 45 days of a child who brings a gun to school. In its
IDEA reauthorization proposal, the Department of Education
proposes to extend this to any type of weapon and to allow
schools to go before a hearing officer rather than to court to
remove a student against parents' wishes. However, the group of
six organizations proposes to go further and allow local school
districts to determine when to remove a child, while the Senate
will consider whether to let schools remove students with
disabilities who are considered disruptive.
The six organizations are the American Federation of Teachers,
National Education Association, National School Boards
Association, American Association of School Administrators,
National Association of Elementary School Principals, and the
National Association of Secondary School Principals. This group
also objects to the Education Department's proposals on placement
of students with disabilities in regular classrooms, resolution
of disputes between parents and schools, and new requirements
imposed on schools.
Mid South Foundation Initiatives
Carol Rasco has attended two programs of the Mid South
Foundation. One is a group they have formed of the Enterprise
Communities located in La., Ark., Miss. in the EZ/EC program.
The group will meet quarterly and had their first meeting in DC
some months ago. Carol along with representatives from HUD and
USDA attended the second meeting recently in Louisiana. Also
present were some of the evaluators hired by USDA; included among
the evaluators was Pam Moore whom you may remember worked
extensively on the Delta Commission report.
A second meeting was a conference "Black Churches' Role in
Community Development" convened after a year's work by a Task
Force on the topic. It was held in New Orleans and attended by
Carol Rasco. This large meeting of area laity and clergy was to
begin to achieve grassroots "buy
-in" for a long term program to
be led by the Foundation.
Norplant
The FDA announced that the contraceptive implant Norplant remains
safe and effective. Norplant was first approved by the FDA in
1990. More than 200 lawsuits have been filed against Norplant's
manufacturer; the plaintiffs in the lawsuits claim that they were
not warned about Norplant's side effects, that Norplant is
painful to remove, or that Norplant is defective in other ways.
Family Planning
The U.S. Naval Academy changed its policy towards midshipmen
expecting the birth of a child. Now midshipmen will be allowed
to return to school after taking a 1 year leave of absence if
they have given up custody of their child or children. In the
past, pregnant midshipmen would have been expelled or would have
to obtain an abortion. Male midshipmen would have been expelled
if they acknowledged paternity. Even under the new policy,
midshipmen of both sexes cannot marry or support families.
AIDS Care
The current fiscal crisis facing Los Angeles County may threaten
AIDS care. Facing a deficit of $677 million, the county has
ordered cuts in the public health system that will close 29 of 38
community health centers and all 6 comprehensive health centers.
Fortunately, the AIDS clinic at County/USC Hospital (largest AIDS
clinic in the U.S.), will stay open in order to retain Ryan White
CARE Act funds. White House AIDS Policy Director Patsy Fleming
visited County/USC Hospital (Aug 18). The County is also seeking
a Medicaid waiver to allow establishment of a demonstration
program that would bring new Federal dollars into the County.
Farm Bill
The Farm Bill will get serious after Labor Day. The question now
at USDA is which strategy to pursue, veto or compromise. The
over
-whelming preference is compromise. The expectation is that
this is possible.
Farm Credit
It is the understanding of USDA that we should pursue changes in
farm credit along the lines previously discussed. This would be
expanding the role of Farm Credit. The Secretary will work on
more specifics with the committees.
Reinventing Government
More than four out of five community national bankers who
responded to a recent servuey by the Office of the Comptroller of
the Currency said streamlined examination procedures put in place
last year have helped reduce regulatory burden.
The OCC's survey of community national banks stemmed from a June
1994 initiative that streamlined exams for "non
-complex"
community national banks -- those with less than $1 billion in
assets and which met other criteria.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jeremy D. Benami ( BENAMI_J) (OPD)
CREATION DATE/TIME:27-SEP-1995 09:08:30.77
SUBJECT: Choice issue in Foreign Ops bill
TO: Carol H. Rasco
(RASCO_C) (OPD)
READ:27-SEP-1995 09:37:56.46
TEXT:
The State Dept called late last night about an issue in the
Foreign Ops Appropriations bill - relating to the reversal of the
Mexico City executive order re funding for intl family planning
orgs that provide abortion services with other money. The
reversal of the Bush policy was one of the early EOs we signed.
The House (Chris Smith) included a provision in the bill
overturning the EO. The Senate did not. The Senate actually has
statutory language that supports the EO. This difference could be
the single issue remaining in the conference. State wanted
guidance as to how hard to push back on this - i.e., veto line or
no.
I spoke to Leg Affairs late last night and to State. I understand
this came up at 7:30 and I raised it at 8:15. The instruction I
derived from Leon was that State should send a very strong signal
that we are committed to this policy. George told me after that
he thought maybe a meeting with you, Pat, him, Nancy Ann and me
might be a good idea - just 15 minutes to go over this. I
personally would add people from the State Dept who know the
exact language at issue!
I have asked State exactly what the timing of this is. If it will
be moot by noon, then there's no need to meet. If this may drag
for a day or two, I will let you know.
Thanks.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Nancy-Ann E. Min (MIN_N) (OMB)
CREATION DATE/TIME: 4-OCT-1995 16:33:54.79
SUBJECT: More on Medicaid/Senate Finance/ Abortion
TO: Martha Foley
(FOLEY_M) (WHO)
READ: 4-OCT-1995 16:35:43.01
TO: Barbara C. Chow
(CHOW_B) (WHO)
READ: 4-OCT-1995 16:40:48.38
TO: Jeremy D. Benami
(BENAMI_J) (OPD)
READ: 5-OCT-1995 14:51:52.65
TEXT:
ATTACHMENT 1
ATT CREATION TIME/DATE: 4-OCT-1995 16:07:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Nani A. Coloretti
ATT SUBJECT: Senate Reconciliation Plan Set; Abortion Issue Looms
ATT TO: Nancy-Ann E. Min
(MIN_N)
ATT TO: Barry T. Clendenin
( CLENDENIN_B)
ATT TO: Elizabeth L. Rossman
(ROSSMAN_E)
ATT TO: William G. White
( WHITE_W)
TEXT:
BUDGET
Senate Reconciliation Plan Set; Abortion Issue Looms
The Senate Republican budget reconciliation plan will be
completed and ready to be sent to the CBO for scoring as soon as
Thursday, a Republican aide said today. So far, the aide said,
Republican estimates show the package would exceed the GOP's
original savings target for 2002 by "several billion dollars" --
perhaps allowing Republicans to cut less from entitlement
programs like Medicare and Medicaid.
Meanwhile, the thorny issue of abortion -- already
complicating the resolution of half a dozen FY96 appropriations
bills now may threaten the reconciliation bill as well. The
Medicaid provisions of the reconciliation proposals approved by
the House Commerce Committee Sept. 22 and the Senate Finance
Committee last Friday include language that would "codify" the
so-called Hyde amendment language prohibiting the use of federal
funds to pay for abortion except in cases of life endangerment,
rape or incest. And while the language seems certain to clear the
House floor, procedural tactics could see it struck in the
Senate, setting up yet another source of discord between the two
chambers.
The prospect of writing into permanent law the abortion
funding ban, which has until now been fought year by year in
appropriations bills, raises the stakes for those on both sides.
Because appropriations riders "are a disfavored form of
legislation," said Douglas Johnson, legislative director of the
National Right to Life Committee, "We think it's necessary that
if there's going to be a major rewrite of Medicaid, that this be
written into the fabric of the legislation." That is exactly what
abortion rights backers fear, according to NARAL President Kate
Michelman, who said, "This policy will institutionalize the
discrimination inherent in the Hyde amendment."
Finance members appeared to have reached a truce during markup
last week. By a 11-9 vote, members Friday refused to strike the
abortion ban language from the bill. But at the insistence of
Sen. John Chafee, R-R.I., who offered the amendment to remove the
ban -- and who reportedly threatened to withhold his vote for the
entire package over the issue -- the panel late Friday night
adopted an amendment requiring states to cover "pre-pregnancy
family planning services and supplies." Both the abortion
language and the family planning amendment, however, could well
fall victim to the "Byrd rule" -- which bars inclusion of
"extraneous" matters in reconciliation bills -- when the bill
reaches the Senate floor. Any senator may raise a point of order
that a provision violates the rule, and if the parliamentarian
agrees, the provision needs 60 votes to remain in the bill. While
Chafee has not said if he would seek to strike the ban on Byrd
rule grounds on the floor, a Chafee aide today said, "I'd be
shocked if there was not" an attempt by someone.
The Congress Daily Wednesday October 4, 1995
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jeremy D. Benami ( BENAMI_J) (WHO)
CREATION DATE/TIME:19-DEC-1995 12:29:41.81
SUBJECT: Issues for women's meeting
TO: Betsy Myers
(MYERS_B) (WHO)
READ:19-DEC-1995 12:48:19.26
TO: Barbara D. Woolley
(WOOLLEY_B) (WHO)
READ:19-DEC-1995 13:52:46.59
CC: Deborah L. Fine
(FINE_D) (OPD)
READ:19-DEC-1995 13:11:51.65
TEXT:
Attached is the revised version of the issues attachment for your
briefing on tomorrow's meeting.
Please let me know if you need anything else.
Thanks.
ATTACHMENT 1
ATT CREATION TIME/DATE:19-DEC-1995 12:27:00.00
ATT BODYPART TYPE:p
ATT CREATOR: Jeremy D. Benami
TEXT:
PRINTER FONT 12_POINT_ROMAN
ATTACHMENT
Key Issues for Meeting with Women's Leaders
I. Medicaid/Medicare/Budget
Concern: Generally, women's groups have been strong
supporters of the administration's position in the budget
debate. They do, however, have some concerns: (1) defense
of Medicaid as an entitlement; (2) the ultimate size of the
Medicare cut; and (3) the adminstration's communications
strategy, which they believe has not articulated how
strongly proposed budget cuts affect women.
Potential Responses: (1) Medicaid: You should provide a
strong reaffirmation of your commitment to the Medicaid
entitlement; (2) Medicare: You should restate your
commitment to hold line on Medicare cuts; (3)
Communications: You can indicate that the administration
will be doing more to highlight the impact of Republican
proposals on women and to work more closely with women's
groups to get our message out.
II. Welfare Reform
Concerns: (1) AFDC Entitlement: The groups have been vocal
opponents of any effort to rescind the AFDC entitlement.
They question why we defend the Medicaid entitlement on the
one hand but not AFDC on the other;
(2) Family Cap: These groups have been particular opposed
to the Family Cap and will likely argue for vetoing the bill
on this issue alone;
(3) Welfare Generally: The groups have been disappointed
with the administration's welfare proposals since the
campaign which they feel have not been sensitive to the
needs of women. They will press strongly for a commitment
to veto the Congressional welfare reform proposal.
Potential Responses:
?
General: You are likely to oppose any Congressional
proposal that undermines fundamental protections, but
you have reserved judgment on a veto pending the
outcome of the Conference. You have pressed for more
child care money, greater protection for bad economic
times through a contingency fund, and for meaningful
work provisions.
?
Family Cap: The administration has supported making
this a state option. The current Congressional
proposal is to allow states to opt out of a national
rule, and while we might prefer it to be "opt
-in," this
is unlikely to be a veto issue.
?
Entitlement: It would be best to avoid any commitment
on this issue. You should move the conversation to how
detrimental cuts in Medicaid and EITC will be to real
welfare reform.
III. Choice
Concerns: (1) Appropriations: A number of the
appropriations bills (Treasury/Postal, Defense, and now DC)
contained provisions that restrict abortion rights, yet for
various reasons we have had to sign them. The groups will
express concern about these bills and about provisions in
Foreign Ops and Labor/HHS that are still to be sent to the
White House.
(2) HR1833: The groups will be looking for a commitment to
veto the bill which criminalizes certain abortions. [Note on
language: While the bill is called the Partial Birth
Abortion bill, it is best to refer to it as "the bill which
would criminalize certain abortions." The language is
important to the debate.]
Potential Responses:
(1) Appropriations: It would be helpful to note your concern
with the provisions in the bills already signed and to
restate your opposition to provisions in the pending bills
that would cut off funding to international family planning
organizations (Foreign Ops) and to allowing states not to
fund Medicaid abortions under the Hyde rules (Labor/HHS).
(2) HR1833: Administration staff have indicated that they
would recommend a veto of the bill, but there has been no
explicit Presidential statement yet on the bill. It would
be helpful to indicate your personal feelings on the bill
and to indicate that you will veto the bill if presented as
passed by the Senate.
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME:29-DEC-1995 16:52:21.88
SUBJECT: Medicaid Document
TO: Pauline M. Abernathy
(ABERNATHY_P) (OPD)
READ:29-DEC-1995 16:57:56.25
TEXT:
PRINTER FONT 12_POINT_ROMAN
MEDICAID KEY POINTS
1.
SAVINGS/EXPENDITURES/GROWTH RATE
Key Point: The magnitude of the Republican cuts and the way
they are distributed over time are unacceptable. Their cuts
would force states to deny coverage for millions of people.
?
Based on CBO data, their annual growth rate averages less
than 2% per person over seven years, which is over 70%
below the private sector growth rate. In 2001, spending
per person would actually decrease by 1.7%.
?
The President's Medicaid plan limits the per person growth
rate to 5.5% -- already more than 20% below the private
sector growth rate of about 7%.
?
Republicans will claim that states could reduce their
costs if given more flexibility, but they have never
shown how states could achieve this level of savings
without denying eligibility or reducing benefits.
Medicaid payments to providers are already low, and there
is little evidence that managed care would significantly
reduce spending on older and disabled Americans, who
account for more than two
-thirds of Medicaid spending.
CBO already assumes that more than 33% of poor children
and their families are already in managed care.
2.
PROGRAM STRUCTURE: BLOCK GRANT V. PER CAPITA CAP
Key Point: Under a block grant, states would be liable for
100% of the additional costs caused by circumstances beyond
their control (e.g., economic downturn, inflation, changes in
population, natural disaster). A per capita cap would allow
us to restrain the growth in federal Medicaid outlays,
without penalizing states and reducing coverage for people
with low
-incomes during these circumstances.
?
Rainy Day Fund. Republicans will say that they can
address this issue by creating a "rainy day fund" that
will be available to states experiencing downturns or
other circumstances beyond their control. While they have
not outlined the specifics, we expect that there will be
less than $20 billion in this fund.
?
Insufficient Funds. No rainy day fund could fully
protect states or respond quickly enough to states'
needs. If several regions of the country experience a
recession at the same time, costs due to enrollment
increases could easily be much higher than the amount
in the fund. Also, states would have to go through an
administrative process that could delay funding.
?
Unfunded Mandates. They will also argue that our per
capita cap is an unfunded mandate.
?
Protects States Financially. Our per capita cap is
not an unfunded mandate because, under the President's
Medicaid plan, federal funding is not fixed but
instead responds to state financial needs. In
addition, the President's plan offers significantly
more funding per beneficiary than the Republican plan.
?
Scoring of Per Capita Cap. Republicans will say that CBO
will not score a per capita cap. CBO has given
preliminary estimates of significant savings under a per
capita cap to Congressional staff. CBO has said that it
did not score the President's per capita cap because the
wording was not explicit enough and wrote instructions on
how to fix it. We are making changes and anticipate that
CBO will score savings.
3.
FEDERAL GUARANTEE
Key Point: The Republican plan ends the individual
entitlement under Medicaid, eliminating the guarantee of
meaningful coverage.
?
Coverage Loss. According to the Urban Institute,
Lewin
-VHI, and HHS, millions of people will be denied
meaningful coverage under the Republican plan.
??
While Republicans claim to cover poor children under the
age of 13, pregnant women, and people with
disabilities, states would have nearly complete
discretion to determine the level of benefits provided
and to define the eligible disabilities. The only
required benefits would be immunizations and limited
family planning. The block grant "set asides", or
required spending, cover less than half of state
Medicaid spending for these groups.
??
While Republicans claim to cover Medicare premiums under
Medicaid for poor Medicare beneficiaries, they
eliminate the guarantee and set aside less than half
of the amount required to pay premiums alone. (See #6
Benefits for more details.)
?
States will be forced to cut benefits. States will not be
able to save enough through increased use of managed care
because CBO already assumes expansion of managed care for
poor children and their families and because there is no
evidence that managed care produces significant savings
for elderly and disabled populations. In addition,
provider payments under Medicaid are already low. As a
result, states will be forced to cut benefits in order to
absorb the federal spending reductions.
4.
ENFORCEMENT/PRIVATE RIGHT OF ACTION
Key Point: A key element of maintaining the guarantee under
Medicaid is retaining the right of individuals to go to court
to enforce their rights.
?
The Republicans, like the Republican Governors (and to
some extent the Democratic Governors), strongly support
eliminating the right of individuals to sue in federal
court. Because we are sympathetic to their concerns about
lawsuits, the President's plan repeals the Boren Amendment
(that requires that payment to providers be "reasonable"),
which is one of the primary sources of suits against
states in federal courts.
?
We have not reached consensus within the Administration on
our final position on the individual right of action.
However, we have conducted meaningful discussions with the
Democratic Governors to examine alternatives that would
help address their concerns. We anticipate having some
substantive options available for internal review by early
next week. We therefore believe that discussion should be
deferred until that time if at all possible.
5.
ELIGIBILITY
Key Point: The Republican plan does not guarantee Medicaid
eligibility to older Americans, people with disabilities
deemed ineligible by their state, and many children. While
we strongly support maintaining current eligibility, you can
signal some flexibility.
Our Position: We maintain the current categories of
eligibility, and we allow states to cover anyone up to 150%
of poverty within the per capita cap. We can signal interest
in: (1) simplifying eligibility rules (e.g. simplifying
processes for determining eligibility, consolidating small
eligibility groups into broader categories); and (2)
considering options for states dealing with Medicaid coverage
under a new welfare program.
Republican Position:
?
Children. While Republicans claim to cover children,
their bill actually repeals guaranteed coverage for
children under age 6 between 100
-133% of poverty. In
addition, it ends Medicaid's phased
-in coverage of
children aged 13
-18.
?
People with Disabilities. Under the Republican plan,
states would determine which disabilities would make
someone eligible, so people with disabilities would not be
guaranteed coverage - meaningful or not.
?
Older Americans. Republicans eliminate the guarantee of
any coverage for older Americans, including nursing home
coverage.
?
QMBs and SLMBs: Low
-Income Older and Disabled Medicare
Beneficiaries. Republicans eliminate the guarantee of
Medicaid coverage of Medicare premiums, deductibles, and
copayments for Medicare beneficiaries under 100% of
poverty (Qualified Medicare Beneficiaries or QMBs) and of
coverage of Medicare premiums for those below 120% of
poverty (Specified Low
-Income Medicare Beneficiaries or
SLMBs). Elimination of this coverage may deny poor
elderly and disabled people access to the Medicare Part B
program.
6.
BENEFITS
Key Point: There must be a guarantee of meaningful benefits.
While there is room for some increased flexibility, you
should not get into a discussion of specifics now.
Our Position: We maintain the current benefit package. We
allow states to set up home and community
-based care programs
without waivers (as is currently required). You can signal
that we are willing to discuss additional flexibility,
particularly in the category of optional benefits.
Republican Position:
?? No Minimum Benefits Package. The Republican plan does not
guarantee anyone meaningful benefits. The only
required benefits under the Republican plan are
immunizations and limited family planning. States
would have nearly complete discretion to set benefits,
and the deep federal spending reductions would force
states to reduce benefits to save money.
?? Cost Sharing. The Republican plan removes all
restrictions on how large a share of the costs of
medical care states could require from eligible
individuals other than children and pregnant women.
These increased copayments could discourage low
-income
people from seeking medical care. The President's
plan continues current law that requires copayments to
be nominal and exempts particularly vulnerable
populations from copayments.
??
QMBs: Medicaid Coverage of Poor Older and Disabled
Americans' Medicare Premiums, Deductibles and
Copayments. Republicans eliminate the guarantee of
Medicaid coverage of poor Medicare beneficiaries'
premiums, deductibles, and copayments. Elimination of
this coverage may deny poor elderly and disabled
people access to the Medicare Part B program.
??
No Set
-Aside for Deductibles and Copayments. The
Republican plan eliminates the guarantee to
any coverage of copayments and deductibles,
and does not set aside any funding for
copayments and deductibles.
??
Inadequate Set
-Aside for Premiums. While Republicans
claim to cover Medicare premiums for poor
Medicare beneficiaries, they set aside less
than half of the amount required to pay
premiums. While they set aside 90% of 1993-
1995 state spending on mandated services for
mandatory eligibles, this amounts to less
than half of current Medicaid spending on
premiums.
?
Comparability of Benefits Across Eligibility Groups.
The Republican plan eliminates the current requirement
that states provide comparable services to all
beneficiaries and provide protections against
discrimination. This could lead to a sharp reduction
in benefits for certain needy but politically weak
populations, such as poor children and people with
AIDS, in order to protect other more powerful
populations.
??
Statewideness: Comparability of Benefits in All Regions
in a State. The Republican plan eliminates the
current requirement that states provide comparable
services across geographic areas of the state, which
could lead some states to short
-change certain needy
but politically weak regions and shift benefits to
others.
Other Issues:
?
Abortion. The Administration supports current law, but
any discussion of this issue should begin at the staff
level before going to the level of advisors or principals.
?
Assisted Suicide. The Administration does not currently
have a position on this issue. Discussion of it should
begin at the staff level before going to the level of
advisors or principals.
7.
FAMILY FINANCIAL PROTECTION
Key Point: The Republican plan ends the guarantee of meaningful
coverage, potentially shifting costs of care to families who can
ill afford them. It also repeals financial protections that are
important not only to the poor, but also to a larger group of
middle class families that depend on Medicaid to provide
long
-term care for their parents. We should insist on current
law.
Our Position: The President's plan and all the other Democratic
plans retain both the federal guarantee of meaningful benefits
and current financial protections.
Republican Position:
?
Loss of Guarantee. Under the Republican plan, people who no
longer qualify for medical assistance would be faced with
paying all their medical costs themselves, or seeking help
from relatives or charity. In the worst cases, families
would have to mortgage or sell their homes to be able to pay
for care, or elderly people needing long
-term care would have
no choice but to turn to their children for help.
?
Spousal Impoverishment. The Republicans claim that they have
retained spousal impoverishment protections -- which require
states to protect minimum amounts of a couple's income and
assets for the at
-home spouse when the other spouse enters a
nursing home or other institution for a long
-term stay.
Despite appearances, the Republican plan fails to adequately
protect spouses of persons in nursing homes from being
impoverished by the high cost of long
-term care because: (1)
the infirm spouse may not qualify for benefits in the first
place; (2) they repeal procedural safeguards and
beneficiaries? rights to judicial redress if the state has
acted improperly; and (3) federal tools for enforcing state
compliance are severely weakened.
?
Homes, Family Farms, and Liens. Republicans repeal current
federal law that protects the home, family farm, and certain
other assets by prohibiting states from counting their value
to determine eligibility for Medicaid.
The Republican plan would give states unlimited license to
decide whether and how to: (1) use liens on people?s homes
and other property; (2) recover before or after a
beneficiaries (or spouse?s) death; (3) adjust the state?s
payments for care based on home equity. States could use
this flexibility to require a person to sell or mortgage a
home and use the proceeds either to repay the state or to
finance the cost of their care even while they, a spouse, or
child is still living in the home. Under current law, states
are restricted from imposing liens on real property of
Medicaid beneficiaries under most circumstances.
?
Adult Children of Nursing Home Patients. The Republicans
would also allow states to impose financial costs on the
adult children of nursing home patients if they had income
above the median state income for the first time under
Medicaid.
8.
NURSING HOME STANDARDS
Key Point: The Republicans claim to retain the federal nursing
home quality standards, but they undermine these standards by
repealing federal enforcement and repeal key standards. We
should insist on current law, including federal enforcement.
Our Position: The President's plan and all the other Democratic
plans retain the 1987 bipartisan standards and enforcement
models.
?
Since the 1987 reforms were implemented, nursing home
quality has improved dramatically. The use of physical
restraints has declined 25%; dehydration has declined 50%;
hospitalization rates have declined 31% (Research
Triangle Institute; HCFA).
Republican Position: The Republicans claim to maintain these
standards, but they undermine them by repealing federal
enforcement and some key standards.
?
No Federal Enforcement. The federal government would have
no way to ensure that States enforce the standards. Most
recently, federal surveyors found 14% of nursing homes out
of compliance with the federal standards. (Source: HCFA.)
?
States Could Leave Enforcement to Private Organizations.
States could turn over their survey and enforcement
responsibilities to private accreditation organizations
with no Federal review, thereby reducing accountability
and increasing variations in quality and enforcement.
?
Inadequate Resources to Enforce Standards. States would
have to set and enforce quality standards with
significantly less Medicaid funding than they receive
under current law. While States may want to maintain
nursing home quality, inadequate resources combined with
repeal of Federal enforcement could lead them to fail to
set and enforce adequate quality standards.
?
Quality May Decline With Payments. Nursing homes may find
it difficult or impossible to maintain the current quality
with significantly reduced Medicaid payments. Nursing
homes would have to significantly lower their costs, lower
services and quality, drop out of the Medicaid program, or
shift costs to residents and their families, diminishing
Medicaid beneficiaries' access to quality care.
?
Elimination of Key Federal Quality Standards. The
Republican proposal repeals key Federal quality
standards, allowing the States to set their own standards
within broad Federal guidelines. For example, Federal law
would no longer guarantee that nursing homes provide
services to "attain or maintain the highest practicable
physical, mental, and psychosocial well being of each
resident." As a result, residents could be denied skilled
nursing and rehabilitative services necessary to improve
their ability to function.
9.
VACCINES FOR CHILDREN
Key Point: For the purposes of this discussion, it is
important only to signal that VFC is important to the
Administration but that we are willing to make significant
changes to the program.
?
Our Position. There has been significant opposition to
the VFC program. Our strategy is to work with Senators
Bumpers and Breaux and Congressmen Dingell and Waxman to
change the program so that states are given more
flexibility to tailor the program to their needs while
guaranteeing funding for vaccines for needy children.
?
Republican Position. The Republicans may suggest that
because states are required to cover immunizations, there
is no need to continue the VFC program. However:
??
VFC provides guaranteed funding for three groups of
children not covered by Medicaid: American Indians,
uninsured, and underinsured (at federally qualified
health centers).
??
In addition, under the Republican Medicaid plan, states
decide which vaccines to cover. There is no guarantee
that the range of medically recommended vaccines
delivered under VFC will be provided.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME: 4-JAN-1996 07:56:36.14
SUBJECT: Older Women Document
TO: Pauline M. Abernathy
(ABERNATHY_P) (OPD)
READ: 4-JAN-1996 09:55:22.16
TEXT:
Here is the latest draft of the older women document for your
review. Thanks.
ATTACHMENT 1
ATT CREATION TIME/DATE: 4-JAN-1996 07:55:00.00
ATT BODYPART TYPE:p
ATT CREATOR: Jennifer L. Klein
TEXT:
PRINTER FONT 18_POINT_ROMAN
DRAFT
THE HEALTH OF AMERICA'S OLDER WOMEN:
A WHITE HOUSE REPORT
ON CURRENT STATUS AND
THE IMPACT OF REPUBLICAN BUDGET CUTS
December 20,
1995
PRINTER FONT 12_POINT_ROMAN
ADD EXECUTIVE SUMMARY
TABLE OF CONTENTS
A PROFILE OF AMERICA'S OLDER WOMEN
DEMOGRAPHIC TRENDS
FINANCIAL STATUS
HEALTH STATUS
MEDICAL NEEDS AND EXPENSES
WOMEN AS CAREGIVERS
OLDER WOMEN'S DEPENDENCE ON MEDICARE AND MEDICAID
THE IMPACT OF THE REPUBLICAN CUTS IN MEDICARE AND MEDICAID
MEDICARE
REDUCES BENEFITS AND INCREASES MEDICARE COSTS
INCREASES COSTS FOR BENEFICIARIES WITHOUT EXPANDING
BENEFITS OR PREVENTION
MEDICAID
ENDS GUARANTEE OF COVERAGE UNDER MEDICAID
LOSS OF MEDICAID COVERAGE
WOMEN PUSHED INTO POVERTY
WEAKENS NURSING HOME QUALITY STANDARDS
WEAKENS PROTECTION AGAINST SPOUSAL IMPOVERISHMENT
PRINTER FONT 14_POINT_ROMAN
A PROFILE OF AMERICA'S OLDER WOMEN
PRINTER FONT 12_POINT_ROMAN
DEMOGRAPHIC TRENDS
PRINTER FONT_12_POINT_ROMAN_ITALIC
The aging of the American population has significant implications
for women. Women represent a majority of older Americans and an
even larger proportion of the very old, those aged 85 and over.
PRINTER FONT 12_POINT_ROMAN
The Population is Aging. Currently, 13% of the total population
in the United States, or 33.2 million Americans, are 65 or older.
In the next 35 years, the number of Americans over the age of 65
will more than double, reaching 20% of the total population or 70 million.U.S. Bureau of the Census, Statistical
Abstract of the
United States, 1995.
The Number of Older Women is Growing. About 20 million, or 8% of
Americans aged 65 or older, are women. In the next 35 years,
that number will nearly double, to 38 million or 10% of the population.Id
?
Life expectancy for women has increased steadily. In 1960,
life expectancy at birth for females was about 73. By 1994,
life expectancy increased to 79 years. Average life
expectancy is shorter for men than for women. In 1994, when
life expectancy at birth was 79 for a female, it was 72.3 for a male.U.S. Department of Health and Human Services,
PHS,
Monthly Vital Statistics Report, October 23, 1995.
Women Over 85 Are One of the Fastest Growing Segments of Society.
The number of people over the age of 85 is growing quickly, and
women represent an even larger proportion (72%) of this group.
Today, 2.5 million are women over 85, a figure that will more than double to 5.7 million by 2030. Statistical Abstract
of the United States, 1995.
Older Women Are Far More Likely Than Men to Live Alone.
Forty
-two percent of women aged 65 and over lived alone in 1992,
compared with just 16% of older men. The proportion of women
living alone increases dramatically with age. About one
-third
(34%) of women aged 65 to 74 lived alone, compared to over half of women aged 85 and over. National Institute on
Aging, Profiles of America's
Elderly, Novermber 1993. Because women have longer life expectancies and many women
marry men who are older, the life expectancy for widowed women in
the United States is about 17 years beyond the death of their
spouses -- years in which increased frailty or disability are generally endured alone.C. Costello and A.J. Stone eds.
The American Woman
1994
-1995, Women's Research and Education Institute,
1994.
FINANCIAL STATUS
PRINTER FONT_12_POINT_ROMAN_ITALIC
Older women are typically poorer than older men, and women over
85 and minority women are even more likely to be poor. The most
vulnerable group is elderly women living alone.
PRINTER FONT 12_POINT_ROMAN
Older Women Are Poorer Than Older Men. The median income for
women 65 or older is $8,600 a year. The median income for men is about $15,000, 76% higher than the median for
women.U.S. Bureau of the Census, Current Population Reports,
Series P
-60
-188, Income, Poverty and Valuation of
Noncash Benefits: 1993.
Fifteen percent of older women live in poverty, compared with 8%
of older men. Twenty
-one percent of women over age 85 have incomes below the federal poverty level.Id. Forty
-one percent of women aged 65 to 74 and 57% of women over 75 live on incomes below twice the poverty line
($14,000).Id.
Minority Women Are Poorer Still. Minority women have
substantially lower incomes. In 1992, the median income of
elderly white women ($8,600) was 38% higher than the median
income of black women ($6,200), and 44% higher than the median income of Hispanic women ($6,000).U.S. Bureau
of the Census, Current Population Reports,
Series P
-60
-184, Money Income of Households, Families
and Persons in the United States: 1992.
Poverty Rates Among Women Living Alone Are Higher. Poverty
rates are higher at every age for women who live alone than for
men, and the disparity increases with age. In 1993, over 26% of
women 65 and over living alone were in poverty (income of about
$6,900), compared to 13.9% of men. Another 15.6% of these women
were near poor (income of $8,700). And the picture was even
worse for minority women; 44% of black women and 47% of Hispanic
women 65 and older living alone were poor, as compared with 24% of white women.U.S. Bureau of the Census, 1993.
Widowhood often drives women into poverty. A study by the
National Bureau of Economic Research found that half of poor widows were not poor when their husbands were
alive.David Wise and Michael Hurd, Elderly People Living
Alone: Aging and the Prospects of Poverty: Executive
Summary, report prepared for The Commonwealth Fund
Commission on Elderly People Living Alone (National
Bureau of Economic Research, 1987).
Half of All Women on Social Security Would be Poor Without It.
As of 1990, 33% of unmarried women age 65 or older who received
Social Security depended on it for at least 90% of their income;
more than 18% had no other income. American Association of Retired Persons (AARP) Fact
Sheet, Facts About Older Women: Income and Poverty,
1995. Half of all women beneficiaries would be poor if they did not receive a Social Security benefit.R. O'Grady
-LeShane. Economic Security for Midlife and
Older Women. Background paper prepared for the
Conference on Women and Aging: An Agenda for Action
(sponsored by PHS Office on Women's Health and the
National Policy and Resource Center of Women and Aging,
Brandeis University), October 30, 1995.
HEALTH STATUS
PRINTER FONT_12_POINT_ROMAN_ITALIC
Despite living, on average, seven years longer than men, women
have poorer health outcomes and are more likely to have chronic
diseases and disability than men.
PRINTER FONT 12_POINT_ROMAN
Women Suffer from Chronic Health Conditions. Women age 65 or
older are more likely than men to suffer from serious chronic
conditions. For example, 41% of women over 75 [OR 75 OR OLDER] and only 30% of men suffer from
hypertension.NCHS, "Trends in the Health of Older Americans: United
States, 1994," Vital and Health Statistics, Series 3,
No. 30, April 1995. In addition, 64% of women 75 or older and only 36% of men have diabetes. National Health
Interview Survey, 1993. Older women are also more likely to experience
non
-life
-threatening chronic health conditions. Fifty
-five
percent of women 65 and over suffer from arthritis, compared with 39% of men.NCHS, "Trends in the Health of Older
Americans: United
States, 1994," Vital and Health Statistics, Series 3,
No. 30, April 1995. These conditions may contribute to a loss of functioning,
particularly as women age.
Women 85 And Older Are Even More Vulnerable. These problems
become more serious with increasing age. Women over the age of
85 are extremely vulnerable. More than half of all women over
age 85 have problems managing basic daily activities like bathing and eating, as compared to only 34% of men in the
same age group. Health Care Financing Administration (HCFA), Medicare:
A Profile, February 1995. In addition, because women generally live longer than men,
they are more likely to get diseases associated with very old
age, including Alzheimer's and complications arising from
osteoporosis.
The following table illustrates the prevalence and risks of
particular diseases faced by older women.
[JASON -- INSERT TABLE HERE]
MEDICAL NEEDS AND EXPENSES
PRINTER FONT 12 POINT ROMAN ITALIC
While all older Americans spend a significant portion of their
incomes on health care, elderly women who live alone face the
greatest financial burden.
PRINTER FONT 12_POINT_ROMAN
Older Americans Spend A Significant Portion of Their Incomes On
Health Care. Older Americans currently spend 21% of their incomes on health care. "Coming Up Short: Increasin Out
-of
-Pocket Health
Spending By Older AMericans," prepared by AARP Public
Policy Institute and the Urban Institute, updated
February 1995. Does not include long
-term nursing home
costs.
NO WOMEN V. MEN?
Older Women Rely More Than Men On Long
-Term Care. Twenty
-two
percent of women 65 or older either live in an institution or need help to live at home, compared with 15% of
.Guralnik and Simonsick, "Physical Disability in Older
Americans, J. Of Gerontology, Vol. 48 (special issue):
3
-10, 1993.
?
Home Care. Older women living alone are major users of paid
home care services. HHS FILL IN: HOW MUCH HOME CARE DO
THEY USE? HOW MUCH DOES IT COST?] About 62% of all women
receiving paid home care live alone; another 28% live with
adult children or others. Only 10% of women receiving home care are married. Diane Rowland and Karen Davis.
Caring for Women in
Older Age, An Unfinished Revolution: Women and Health
Care in America, DATE????.
?
Nursing Home Care. Over 75% of nursing home residents are
women. Roughly 28% of all women over 85 live in nursing homes, compared with 16% of men in this age
group. Bureau of the Census and National Institute on Aging,
Profiles of America's Elderly, No. 4, November 1993. The average cost of nursing home care is $38,000 per year --
more than four times the median income for older women. On
average, women remain in nursing homes a year longer than men.P. Kemper, et al. A Lifetime Perspective on
Proposals
for Financing Nursing Home Care, Inquiry 28(4):333
-344,
Winter 1991.
WOMEN AS CAREGIVERS
PRINTER FONT_12_POINT_ROMAN_ITALIC
Women are the primary caregivers for their spouses and parents
and also provide a vast majority of the paid long
-term care in
this country.
PRINTER FONT 12_POINT_ROMAN
?
Today, more than 7 million Americans are unpaid caregivers
who provide about 75% of all non
-medical care to the frail elderly. Paper presented by Fernando Torres
-Gil, Assistant
Secretary for Aging, at the Conference on Women and
Aging: An Agenda for Action, October 30, 1995. Seven out of ten of these caregivers are women.House Select
Committee on Aging, Exploding the Myths:
Caregiving in America, January 1987. The typical unpaid caregiver is a woman in her middle or older
years (average age of 57) providing care to a parent, spouse
or other relative. Women provide the care that has helped
to alleviate the need for formal supportive services and
health care and to forestall costly institutional care for
loved ones.
?
The role of "unpaid caregiver" has important consequences
for women's health. Caregiving can be a significant
financial drain, and it is likely to have an even greater
emotional and physical impact, particularly as the woman
gets older. The stresses and strains of care giving,
including the inability to have a break from
responsibilities, can lead to depression, reduced immunity levels, poor general health, and lower quality of life.U.S.
Public Health Service, Office on Women's Health,
Fact Sheet on Older Women's Health, 1995.
?
The majority of paid home care workers are also women. [OR
IS THIS NURSING HOME AIDES TOO?] According to estimates
based on the 1989 Current Population Survey, approximately
197,049 persons work as home care aides. The overwhelming
majority (90%) are female [and they are disproportionately from minority groups].S.J. Williams, series ed. The
Continuum of Long
-Term
Care: An Integrated Systems Approach, Albany, N.Y.:
Delmar Publishers Inc., 1996.
OLDER WOMEN'S DEPENDENCE ON MEDICARE AND MEDICAID
PRINTER FONT_12_POINT_ROMAN_ITALIC
Because they are generally poorer and use more health services
than men, women depend more on Medicare and Medicaid for critical
health services.
PRINTER FONT 12 POINT ROMAN
Number of Women Covered
?
Medicare. Of the 37 million Medicare beneficiaries, over 20
million, or 57% are women. There are twice as many female beneficiaries over age 85 than men.HCFA, Medicare: A
Profile, February 1995.
?
Medicaid. Over 4 million older Americans are covered by Medicaid. 60% of all Medicaid beneficiaries are
women.HCFA, Medicaid: On Overview, September 1995.
Dependence on Medicare and Medicaid
Older Women Are More Likely to Rely on Medicare and Medicaid.
Because elderly women typically have lower socioeconomic status
and more limited retirement benefits than elderly men, they are
more likely than men to be either solely dependent on Medicare or
to have coverage under Medicaid, which serves as supplemental
insurance to Medicare for eligible low
-income elderly people.
?
5 million, or 23% of women age 65 or older, have only
Medicare to cover their medical bills.
?
An additional 2 million (11%) of older women rely on Medicaid in addition to Medicare. Current Population
Survey, March 1995.
Medicare and Medicaid Provide Critical Services for Older Women.
?
Medicare covers a range of medical services, including
hospital stays, physician visits, skilled nursing care, and
some home health care.
?
Medicaid also covers essential services for older women,
including some that are not covered by Medicare -- like
prescription drugs, dental care, eyeglasses, hearing aids,
and more extensive long
-term care.
?
Medicaid will pay an average of over $800 for
prescription drugs for an older woman on Medicaid in 1995. Department of Health and Human Services estimates
from aged National Medical Expenditure Survey data,
1995. [HHS average = $585?]
?
Approximately 68% of the nation's one million nursing
home residents rely on Medicaid to pay for some or all their care.HCFA, Medicaid: An Overview, September, 1995.
Over 75% of nursing home residents are women. Profiles of America's Elderly, November 1993.
?
Medicaid pays Medicare premiums for about 4 million
elderly women in poverty. Most of these beneficiaries
also receive Medicaid coverage for Medicare coinsurance and deductibles. Estimates based on data from: HCFA, Office
of
Legislation and Intergovernmental Affairs; the 1994
Greenbook, Tables B
-11 and 5
-1; and G. Chulis et al.,
"Health Insurance and the Elderly: Data from the MCBS,"
Health Care Financing Review, Spring 1993: Voume 14,
Number 3, pp. 163
-181.
PRINTER FONT 14_POINT_ROMAN
THE IMPACT OF THE REPUBLICAN CUTS
IN MEDICARE AND MEDICAID
MEDICARE
PRINTER FONT 12_POINT_ROMAN
REDUCED BENEFITS AND INCREASED MEDICARE COSTS
The Republican Medicare Plan Will Reduce Benefits and Increase
Health Care Costs for Older Women. The Republican budget cuts
Medicare by an unprecedented $[200] billion. These cuts will
reduce the benefit provided by Medicare while increasing direct
and indirect costs for beneficiaries.
?
Cuts Benefits. Federal Medicare spending per beneficiary
will be $[1,700] less than under current law in 2002.
?
Increases Premiums. The Republican budget increases
premiums from 25% of Part B program costs to 31.5%. In 1996
alone, this change will increase costs for elderly couples
by $[264] and elderly individuals by $[132]. The
President's balanced budget plan maintains current policy
and permanently sets premiums at 25% of program costs.
?
Over 19 million elderly women, more than a third of
whom are at or near poverty, are currently enrolled in
the Medicare Part B program.
?
Over 20%, or $10.4 billion, of the increase would come
from elderly women with incomes below 200% of poverty ($15,000?).ld
?
Allows Doctors to Overcharge. Under current law, Medicare
limits the amount doctors can charge beneficiaries above
Medicare payment rates. The Republican Medicare plan
creates new, private fee
-for
-service plans that are similar
to Medicare but that allow doctors to overcharge --
so
-called "balance billing."
?
Ends Financial Protection for Poor Medicare Beneficiaries.
As many as [----] poor elderly women will lose funding for
their Medicare premiums -- just when these premiums are
being increased. [NEED TO MAKE CONSISTENT WITH INFO ABOVE.]
?
Medicaid currently pays all Medicare premiums,
coinsurance and deductibles for people below 100% of
poverty (known as QMBs) -- two million of whom are
elderly women -- and premiums for people with incomes
between 100% and 120% of poverty. The Republican
proposal completely eliminates coverage of coinsurance
and deductibles for these poor elderly and disabled
people. And while Republicans claim to cover premiums,
they set aside less than half of the money needed to
cover their premiums in 2002, denying premium coverage
to as many as [------] poor elderly and disabled women.
?
Could Force the Poor to Leave Fee
-For
-Service Plans.
Without assistance with premiums, copayments and
deductibles, poor Medicare beneficiaries may be forced
to leave their fee
-for
-service plan and enroll in an
managed care plan that does not require cost sharing --
if one exists in their area.
INCREASES COSTS FOR BENEFICIARIES WITHOUT EXPANDING BENEFITS OR
PREVENTION
?
The Republican budget increases beneficiary costs while
adding only one new benefit -- coverage of oral nonsteroidal
antiestrogen for the treatment of breast cancer.
?
Currently, Medicare does not cover the array of preventive
benefits now offered by many private plans, particularly
managed care plans. These preventive benefits can both
increase beneficiary's helath and reduce costs.
?
President Clinton's balanced budget proposal updates the
Medicare benefit package to make it more comparable to
private sector benefit packages, including:
?
Mammography. The President's proposal eliminates cost
sharing for mammography services and provides annual
screening mammograms.
?
Certain Colorectal Screening. Early detection of
cancers and other serious conditions can result in less
costly treatment, enhanced quality of life and, in some
cases, a greater likelihood of cure. The President's
proposal provides coverage for some colorectal
screening.
?
Preventive Injections. The President's proposal would
increase payments for certain preventive injections
provided in physician offices which will encourage
providers to immunize beneficiaries.
?
Respite Benefit for Families of Beneficiaries with
Alzheimer's Disease. The President's plan creates a
Medicare respite benefit for families of beneficiaries
with Alzheimer's disease or other irreversible
dementia, covering up to 32 hours of care per
beneficiary per year, administered through home health
agencies or other entities. Services could be provided
in the home or in a day care setting.
PRINTER FONT 14_POINT_ROMAN
MEDICAID
PRINTER FONT 12_POINT_ROMAN
ENDS GUARANTEE OF COVERAGE UNDER MEDICAID
The Republican plan cuts [$117] billion from Medicaid and repeals
the program, replacing it with a "block grant." The plan
completely eliminates Medicaid's guarantee of defined, meaningful
coverage for Americans who are sick, elderly, poor or disabled.
?
Because the block grant constrains spending growth per
beneficiary to 1.6% per year, providing 28% less funding
than under current law by 2002, states will be forced to
significantly reduce Medicaid eligibility and benefits.
?
Under current law, all states are required to cover a
minimum set of services, including hospital, physician, and
nursing home services. states have the option of covering
an additional 31 services, including prescription drugs,
hospice care and personal care services. Under the block
grant, states could eliminate almost any benefit covered by
Medicaid. The only required services would be immunizations
and limited family planning.
LOSS OF MEDICAID COVERAGE
The reduction in Federal support of [$116 billion] in Medicaid
spending could force states to deny meaningful coverage for [over
8 million] Americans in 2002 alone, according to estimates by the
Department of Health and Human Services.
These people include:
?
[650,000] older women
?
[330,000] nursing home residents -- about 75% of whom are likely to be women.Department of Health and
Human Services, 1995.
WOMEN PUSHED INTO POVERTY
[CHECK -- Over 185,000] women over age 65 would be thrown into
poverty, largely as a result of the cuts in Medicare and Medicaid, according to the Department of Health and
Services. Department of Health and Human Services, December
1995. Note: In this analysis, poverty is defined more
broadly than in official poverty statistics from the
Census Bureau. This broader definition includes the
effects of Federal tax policies (including the Earned
Income Tax Credit), near
-cash in
-kind assistance
programs such as food stamps and housing programs, and
out
-of
-pocket health spending.
WEAKENS NURSING HOME QUALITY STANDARDS
The Republican budget takes away key protections and enforcement
of nursing home quality standards put in place by the Reagan
Administration with bipartisan support.
?
Nursing Home Laws Have Resulted in Dramatic Progress. The
landmark nursing home reform law of OBRA '87, approved with
bipartisan support during the Reagan Administration, sought
to address at times deplorable treatment in nursing homes --
including unjustified physical restraints and gross
negligence in caring for nursing home residents -- by
establishing federal quality standards. Prior to the OBRA
'87 reforms, the Institute of Medicine reported that all
states had some facilities with serious deficiencies in nursing home quality of care PRINTER FONT
12_POINT_ROMAN_ITALIC
Improving the Quality of Care in Nursing Homes,
Washington, D.C.: National Academy Press, 1986.
PRINTER FONT 12_POINT_ROMAN
Since OBRA '87, nursing home quality has improved
dramatically. The use of physical restraints has declined
25%; dehydration has declined 50%; hospitalization rates have declined 31%. Research Triangle Institite and HCFA,
1995.
?
Federal Enforcement and Protections Would be Repealed. The
Republican bill takes away federal protections and
enforcement and leaves responsiblity for ensuring nursing
home quality with states. While states may want to maintain
these guarantees, inadequate resources could lead them to
fail to set and enforce quality standards that protect
elderly and disabled people in nursing homes.
?
States could turn over their survey and enforcement
responsibilities to private accreditation organizations
with no federal review, therby reducing accountability
and increasing variations in quality and enforcement.
?
Nursing homes would not longer be required to provide
services to "attain or maintain the highest practicable
physical, mental and psychosocial well being of each
resident." Without this protection, residents could be
denied skilled nursing and rehabilitative services
necessary to improve their ability to function.
?
Residents would no longer be guaranteed the same
comprehensive assessment of their health and functional
status now required nationally.
?
Uniform data collection would not be required, making
monitoring more difficult.
?
Federal training requirements for hands
-on caregivers
would be eliminated; each state could determine who
would be trained and how.
WEAKENS PROTECTION AGAINST SPOUSAL IMPOVERISHMENT
The Republican budget undermines protections against spousal
impoverishment that were signed into law by President Reagan in
1987. Since this federal law went into effect in 1989, it has
protected about 450,000 spouses of nursing home residents. Most of these spouses are women. Department of Health
and Human Services, 1995.
?
Current federal law ensures that spouses of people needing
nursing home care do not have to lose everything they have
in order for their spouse to quality for Medicaid.
?
Because the Republican budget repeals the guarantee of
nursing home coverage, it also effectively eliminates any
protection from spousal impoverishment. If an individual
were denied coverage for nursing home care altogether, their
spouse could be forced bear the burden of paying for that
care.
?
The Republican budget also repeals the right of individuals
to enforce spousal impoverishment protections in court when
they believe they have been wrongfully denied, making the
protections unenforceable.
How many individuals in nursing homes have a living spouse?
Percentage of men V. women?
Add family financial protections?
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Pauline M. Abernathy (ABERNATHY_P) (OPD)
CREATION DATE/TIME:10-JAN-1996 11:21:24.95
SUBJECT: Draft medicaid 2-pager for review
TO: Jennifer L. Klein
(KLEIN_J) (OPD)
READ:10-JAN-1996 12:04:42.06
CC: Jason S. Goldberg
(GOLDBERG_JS) (OPD)
READ:10-JAN-1996 12:38:39.78
CC: Aaron J. Rappaport
(RAPPAPORT_A) (OPD)
READ:10-JAN-1996 12:20:38.68
TEXT:
Attached is a 2-pager on Medicaid for your review. Aaron is working on one on
Medicare. Marilyn Yager asked Gene for something to give the groups ASAP.
Let me know what you think. Thanks.
Pauline
ATTACHMENT 1
ATT CREATION TIME/DATE:10-JAN-1996 11:18:00.00
ATT BODYPART TYPE:p
ATT CREATOR: Pauline M. Abernathy
TEXT:
PRINTER FONT 12_POINT_ROMAN
MEDICAID: WHAT IS AT STAKE IN THE BUDGET NEGOTIATIONS
January 10, 1996
THE MEDICAID GUARANTEE OF MEANINGFUL HEALTH BENEFITS
?
Republicans are insisting on ending the Medicaid guarantee to
meaningful health benefits and replacing it with a deeply
underfunded block grant that will deny meaningful health
benefits to millions of disabled Americans, pregnant women,
poor children, and older Americans in need of nursing home
care. The only required benefits would be immunizations and
restricted family planning, and the depth of the Medicaid
cuts could force States to significantly reduce benefits and
eligibility.
?
President Clinton is standing firm on retaining the guarantee
of meaningful Medicaid health benefits for disabled
Americans, pregnant women, poor children, and older Americans
in need of nursing home care.
DEPTH OF THE CUTS
?
Republicans want to cut Federal Medicaid funding to States by
up to $117 billion. As a result, funding per person would
increase by less than the rate of inflation and about 70%
below projected private health care spending growth. Because
States would be allowed to cut their spending significantly
as well, the total cuts in Medicaid could be more than double
the Federal cuts.
?
President Clinton's balanced budget achieves $52 billion in
savings by capping spending growth per beneficiary, giving
States incentives to reduce costs without denying anyone
health care coverage.
A BLOCK GRANT THAT LEAVES STATES VULNERABLE
?
Republicans are insisting on block granting Medicaid, which
will leave States vulnerable to economic downturns,
inflation, and natural disasters. States would be
responsible for 100% of the additional costs from these
circumstances beyond their control.
?
President Clinton is standing firm on maintaining the 30
-year
Federal partnership with States, protecting States from
circumstances beyond their control while increasing State
flexibility.
FEDERAL NURSING HOME QUALITY STANDARDS
?
Republicans want to repeal Federal enforcement of the nursing
home quality standards that have dramatically improved the
quality of nursing home care. While States may want to
maintain the quality of nursing homes, deep Federal Medicaid
cuts combined with the elimination of Federal standards and
monitoring may lead to their failure to set and enforce
adequate quality standards.
?
President Clinton's balanced budget retains the current
Federal nursing home quality standards and enforcement.
FINANCIAL PROTECTIONS FOR FAMILIES, THEIR HOMES AND FARMS
?
Republicans would let States force the adult children of
people needing nursing home care to pay for their care, if
their income is above the State median income. They would
repeal laws that protect families from having to sell their
home or family farm in order to qualify for Medicaid, and
would repeal the laws that restrict the placing of liens on
homes and family farms of Medicaid recipients.
?
President Clinton's balanced budget maintains current
financial protections.
POOR ELDERLY AND DISABLED AMERICANS' ACCESS TO MEDICARE
?
Republicans are insisting on repealing the current guarantee
that Medicaid will pay poor older and disabled American's
Medicare premiums, deductibles, and copayments. They do not
set aside any Medicaid block grant funding for deductibles
and copayments, and set aside less than half of the funds
needed to cover poor elderly and disabled people's Medicare
premiums -- at the same time that they increase Medicare
premiums.
?
President Clinton's balanced budget retains the guarantee of
access to Medicare physician services for poor older and
disabled Americans.
SPOUSAL IMPOVERISHMENT PROTECTIONS
?
Republicans would undermine protections for spouses of
nursing home residents from impoverishment by repealing the
guarantee of nursing home coverage, making it more difficult
for the Federal government to ensure that States enforce
spousal impoverishment protections, and repealing the right
of spouses to seek redress in Federal court if they are
wrongly denied protection.
?
President Clinton's balanced budget retains current spousal
impoverishment protections.
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: William G. White (WHITE_W) (OMB)
CREATION DATE/TIME:11-JAN-1996 17:58:12.59
SUBJECT: Your Questions on Family Planning
TO: Deborah L. Fine
(FINE_D) (OPD)
READ:11-JAN-1996 18:00:14.17
CC: Nancy-Ann E. Min
(MIN_N) (OMB)
READ:12-JAN-1996 13:27:41.66
CC: James I. Blount
(BLOUNT_J) (OMB)
READ:16-JAN-1996 10:00:09.87
CC: Barry T. Clendenin
( CLENDENIN_B) (OMB)
READ:11-JAN-1996 18:00:04.31
CC: Richard J. Turman
(TURMAN_R) (OMB)
READ:11-JAN-1996 18:22:05.73
TEXT:
Richard Turman asked me to respond to the questions regarding
Title X Family Planning grants in your attached e-mail. The table
and text below should answer your questions.
Funding for Title X Family Planning
(BA -- $ in Millions)
FY95
FY96
FY96
FY96
FY96
House
Pres. Approp. House Senate
Enacted Budget Committee Final Committee
Family
Planning
193
199
0
193
193
The President's FY96 Budget included a $6 million (3 percent)
increase over FY95 for Family Planning grants. The House
Appropriations Committee recommended zeroing out this activity in
FY96. However, it was restored to its FY95 level of $193 million
on the House Floor. The Senate Appropriations Committee
recommended $193 million for Family Planning in FY96. The Senate
The Senate L/HHS bill has not yet been acted upon by the full
Senate.
Please let us know if you have any additional questions.
ATTACHMENT
1
ATT CREATION TIME/DATE:11-JAN-1996 17:45:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Richard J. Turman
ATT SUBJECT: Please Prepare a Response
ATT TO: William G. White
(WHITE_W)
TEXT:
END ATTACHMENT 1
ATTACHMENT 2
ATT CREATION TIME/DATE:11-JAN-1996 10:47:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Deborah L. Fine
ATT SUBJECT: family planning
ATT TO: Richard J. Turman
(TURMAN_R)
TEXT:
Hi. I think we spoke several weeks ago about Family Planning
because Nancy Ann had sent a copy of a document I put together on
reproductive health to you to check a bullet on the
Administration's record on proposed appropriations for the Family
Planning program.
I am not sure if you are the right person to ask the following
questions, so just let me know if you're not.
It is my understanding that the House Republican proposal in
Labor/HHS had restored Family Planning funds some time ago -- but
I am not sure by how much, etc.
So, I am trying to find out how much their proposal cuts the
Family Planning Program. (As far as I know it funds it with $193
million, but I don't know what percentage a cut that is from FY
1995 or by how much.) I also wanted to find out how much we
proposed to fund it for FY96.
I would appreciate any help you can give me. (But if you are
facing deadlines with respect to the budget negotiations now, just
let me know. This is obviously much less important.) Thanks a
lot.
END ATTACHMENT 2
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Pauline M. Abernathy (ABERNATHY_P) (OPD)
CREATION DATE/TIME:16-JAN-1996 16:54:17.52
SUBJECT: mEDICAID what is at stake
TO: Jennifer L. Klein
(KLEIN_J) (OPD)
READ:16-JAN-1996 17:54:17.23
TEXT:
attached is the medicaid 2-pager signed off by HHS. Chris is still waiting to
hear from HHS about Medicare. We are also working on side-by-side tables on
medicare and medicaid issues - medicare is on Jason's computer and HHS drafted
the Medicaid one and chris is sending them back comments.
Give me a call about the older women's income stat.
ATTACHMENT 1
ATT CREATION TIME/DATE:16-JAN-1996 16:51:00.00
ATT BODYPART TYPE:p
ATT CREATOR: Pauline M. Abernathy
TEXT:
PRINTER FONT 12_POINT_ROMAN
MEDICAID: WHAT IS AT STAKE IN THE BUDGET NEGOTIATIONS
January 15, 1996
MEDICAID GUARANTEE. Republicans are insisting on ending the
Medicaid guarantee to meaningful health benefits for millions of
disabled Americans, pregnant women, poor children, and older
Americans in need of nursing home care -- even though it is not
necessary to balance the budget.
?
Republicans want to replace the Medicaid guarantee with a
deeply underfunded block grant that would deny meaningful
health benefits to millions of Americans, including more than I
million children. The only required benefits would be
immunizations and limited family planning -- hardly what one
would call "coverage." Moreover, the depth of the Medicaid
cuts could force States to significantly reduce coverage,
increasing the number of uninsured people, uncompensated care,
and cost
-shifting to people with private insurance.
?
President Clinton is refusing to go backwards on coverage by
insisting on retaining the guarantee of meaningful Medicaid
health benefits for disabled Americans, pregnant women, poor
children, and older Americans in need of nursing home care.
DEPTH OF THE CUTS. Republicans want to cut Federal Medicaid
funding to States by $85 billion in order to pay for an excessive
tax cut for the well
-off.
?
In order to fund an excessive tax cut, Republicans are
insisting on reducing annual spending growth per person more
than 50% below projected private health care spending growth.
Because States would be allowed to cut their spending
significantly as well, the total cuts in Medicaid would be more
than double the Federal cuts.
?
President Clinton's balanced budget achieves $52 billion in
savings by capping spending growth per beneficiary, giving
States incentives to reduce costs without denying anyone health
care coverage while providing States with unprecedented
flexibility to operate their programs and pay providers.
LEAVES STATES VULNERABLE. Republicans are insisting on block
granting Medicaid, which will leave States vulnerable to economic
downturns, inflation, demographic changes, and natural disasters --
even though it is not necessary to balance the budget.
?
Under a block grant, States would be responsible for 100% of
the additional costs from circumstances beyond their control.
According to analysis by the Center on Budget and Policy
Priorities, if inflation were just 1 percentage point higher
than projected over 7 years, States would have to spend about
$65 billion more, or cut eligibility, benefits, or establish
waiting lists.
?
President Clinton is standing firm on maintaining the 30
-year
Federal partnership with States, protecting States from
circumstances beyond their control and increasing State
flexibility.
NURSING HOME QUALITY STANDARDS. Republicans want to repeal Federal
enforcement of the nursing home quality standards that have
dramatically improved the quality of nursing home care even
though it is not necessary to balance the budget.
?
Excessive Medicaid cuts combined with the elimination of
Federal enforcement of nursing home quality standards may lead
to inadequate and inconsistent enforcement of quality.
?
President Clinton's balanced budget retains Federal quality
standards and enforcement. Since these Federal standards were
signed into law by President Reagan, there has been a 50%
reduction in dehydration among nursing home residents, a 31%
reduction in hospitalization rates, and a 25% reduction in the
use of physical restraints.
FINANCIAL PROTECTIONS. Republicans want to repeal financial
protections for families, their homes and farms even though this
is not necessary to balance the budget.
?
Republicans would repeal the laws that prevent States from
forcing adult children to have to pay for their parents'
nursing home care, if their income is above the State median
income -- even though it is not necessary to balance the
budget. They would repeal laws that protect families from
having to sell their home or family farm in order to qualify
for Medicaid, and would repeal the laws that restrict the
placing of liens on homes and family farms of Medicaid
recipients.
?
President Clinton's balanced budget maintains current financial
protections.
POOR ELDERLY AND DISABLED AMERICANS' ACCESS TO MEDICARE.
Republicans are insisting on repealing the guarantee that Medicaid
pay poor older and disabled American's Medicare premiums,
deductibles, and copayments.
?
The Medicaid guarantee of assistance with Medicare premiums,
deductibles, and copayments ensures that more than 5 million
poor older and disabled Americans can afford Medicare physician
services. Yet Republicans do not set aside any Medicaid block
grant funding for Medicare deductibles and copayments, and set
aside less than half of the funds needed to cover premiums.
Hundreds of thousands of poor and near poor elderly and
disabled people could lose funding for their Medicare premiums
-- at the same time that Republicans would increase Medicare
premiums.
?
President Clinton's balanced budget maintains the guarantee of
this critical assistance.
SPOUSAL IMPOVERISHMENT PROTECTIONS. Republicans would undermine
protections for spouses of nursing home residents from
impoverishment even though it is not necessary to balance the
budget.
?
Republicans undermine these spousal impoverishment protections
by repealing the guarantee of nursing home coverage, making it
more difficult for the Federal government to ensure that States
enforce spousal impoverishment protections, and repealing the
right of spouses to seek redress in Federal court if they are
wrongly denied protection.
?
President Clinton's balanced budget maintains the current
spousal impoverishment protections which have protected about
450,000 spouses of nursing home residents since they went into
effect. Most of these spouses are women.
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Michael T. Schmidt (SCHMIDT_MT) (OPD)
CREATION DATE/TIME:19-JAN-1996 16:02:19.78
SUBJECT: More ed tech formulations
TO: Gaynor R. McCown
(MCCOWN_G) (OPD)
READ:19-JAN-1996 18:35:26.50
TEXT:
Here is a slightly different take on the ed tech language for
whatever you are putting together. Hope it helps.
ATTACHMENT 1
ATT CREATION TIME/DATE:19-JAN-1996 16:01:00.00
ATT BODYPART TYPE:p
ATT CREATOR: Michael T. Schmidt
TEXT:
PRINTER FONT 12 POINT_ROMAN
Background on the Clinton Administration's Approach to Sex
Education
?
The Administration believes that the content and structure
of education programs dealing with sex, family planning, and
other controversial topics must be determined by individual
communities-
-in light of their values and beliefs.
?
Today young people face many serious problems such as
violence, drug abuse, sexually transmitted diseases
including HIV infection, unintended pregnancy, school
dropout, low literacy, and disrupted family and home
situations. These require innovative solutions supported by
all segments of society, including our health and education
systems.
?
Schools are the only public institution that can reach
nearly all youth; therefore schools are in a unique position
to improve not only the educational status but also the
health status of young people throughout the nation.
?
The federal government can play an important role in
supporting the development and evaluation of various types
of sexuality education programs, abstinence education
programs, and programs focused on the prevention of
adolescent pregnancy and sexually transmitted diseases.
?
The federal government can support local efforts to find the
right approaches for their own communities by making
information on promising approaches available to them.
Examples of such support are:
Adolescent Family Life Program: Last year, HHS's Adolescent
Family Life Program awarded 15 grants totaling $4.2 million
dollars for comprehensive demonstration programs aimed at
preventing early teenage sexual activity and reducing teenage
pregnancies. These programs feature innovative ways to emphasize
abstinence as the best way to prevent adolescent pregnancy and
encourage the involvement of parents in these discussions with
their children.
Family Planning: Family Planning funds clinics that provide
contraceptive counseling, birth control, health services,
information and education, which many tailor to adolescents'
needs. We strongly supported this program and fought to preserve
its funding in this year's budget.
School Health Program: Through the Centers for Disease Control
and Prevention, the federal government provides approximately $20
million to state education agencies in every state and to school
districts in 18 of the largest cities to promote healthy
behavior. These agencies use the money from CDC for a range of
services, such as: to work on HIV prevention activities; to train
teachers; to provide schools with guidance about curriculum
development and implementation; and to monitor risk behaviors of
youth. It is unclear how much of CDC's funding directly goes
towards sex education, but it is estimated to be a small a
portion.
In addition to funding, the School Health Program collects
information and provides data and guidance to state agencies so
that they can make effective programming decisions.
PRINTER FONT 10_POINT_ROMAN_ITALIC
January 19, 1996
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Pauline M. Abernathy (ABERNATHY_P) (OPD)
CREATION DATE/TIME:25-JAN-1996 17:08:24.03
SUBJECT: 1/23/96 medicaid 2-pager attached
TO: Jennifer L. Klein
(KLEIN_J) (OPD)
READ:25-JAN-1996 17:09:50.21
TEXT:
ATTACHMENT I
ATT CREATION TIME/DATE:25-JAN-1996 17:07:00.00
ATT BODYPART TYPE:p
ATT CREATOR: Pauline M. Abernathy
TEXT:
PRINTER FONT 12_POINT_ROMAN
MEDICAID: WHAT IS AT STAKE IN THE BUDGET NEGOTIATIONS
January 23, 1996
MEDICAID GUARANTEE. Republicans are insisting on ending the
Medicaid guarantee to meaningful health benefits for millions of
people with disabilities, pregnant women, poor children, and older
Americans in need of nursing home care -- even though it is not
necessary to balance the budget.
?
Republicans want to replace the Medicaid guarantee with a
deeply underfunded block grant that could deny health benefits
to 3
-6 million Americans in 2002, including more than 1 million
children. And the only required benefits would be
immunizations and limited family planning -- hardly what one
would call "coverage." The depth of the Medicaid cuts could
force States to significantly reduce coverage, increasing the
number of uninsured people, uncompensated care, and
cost
-shifting to people with private insurance.
?
President Clinton is refusing to go backwards on coverage,
insisting on retaining the guarantee of meaningful Medicaid
health benefits for people with disabilities, pregnant women,
poor children, and older Americans in need of nursing home
care.
DEPTH OF THE CUTS. Republicans want to cut Federal Medicaid
funding to States by $85 billion in order to pay for an excessive
tax cut for the well
-off.
?
Republicans are insisting on $85 billion in Medicaid cuts --
45% more then the President largely to fund an excessive tax
cut. They would cut spending growth per person to rates
one
-third below inflation. And the total Medicaid cuts would
more than triple if States only spent the minimum required.
?
President Clinton's balanced budget achieves $59 billion in
savings by capping spending growth per beneficiary, giving
States incentives to reduce costs without denying anyone health
care coverage while providing States with unprecedented
flexibility to operate their programs and pay providers.
LEAVES STATES VULNERABLE. Republicans are insisting on block
granting Medicaid, which will leave States vulnerable to economic
downturns, inflation, demographic changes, and natural disasters --
even though it is not necessary to balance the budget.
?
Under a block grant, States would be responsible for 100% of
the additional costs from circumstances beyond their control.
According to analysis by the Center on Budget and Policy
Priorities, if inflation were just 1 percentage point higher
than projected over 7 years, States would have to spend about
$65 billion more, or cut eligibility, benefits, or establish
waiting lists.
?
President Clinton is standing firm on maintaining the 30
-year
Federal partnership with States, protecting States from
circumstances beyond their control and increasing State
flexibility.
NURSING HOME QUALITY STANDARDS. Republicans want to repeal Federal
enforcement of the nursing home quality standards that have
dramatically improved the quality of nursing home care even
though it is not necessary to balance the budget.
?
Excessive Medicaid cuts combined with the elimination of
Federal enforcement of nursing home quality standards may lead
to inadequate and inconsistent enforcement of quality.
?
President Clinton's balanced budget retains Federal quality
standards and enforcement. Since these Federal standards were
signed into law by President Reagan, there has been a 50%
reduction in dehydration among nursing home residents, a 31%
reduction in hospitalization rates, and a 25% reduction in the
use of physical restraints.
FINANCIAL PROTECTIONS. Republicans want to repeal financial
protections for families, their homes and farms even though this
is not necessary to balance the budget.
?
Republicans would repeal the laws that prevent States from
forcing adult children to have to pay for their parents'
nursing home care, if their income is above the State median
income -- even though it is not necessary to balance the
budget. They would repeal laws that protect families from
having to sell their home or family farm in order to qualify
for Medicaid, and would repeal the laws that restrict the
placing of liens on homes and family farms of Medicaid
recipients.
?
President Clinton's balanced budget maintains current financial
protections.
POOR ELDERLY AND PEOPLE WITH DISABILITIES' ACCESS TO MEDICARE.
Republicans are insisting on repealing the guarantee that Medicaid
pay poor older Americans and people with disabilities' Medicare
premiums, deductibles, and copayments.
?
The Medicaid guarantee of assistance with Medicare premiums,
deductibles, and copayments ensures that more than 5 million
poor older Americans and people with disabilities can afford
Medicare physician services. Yet Republicans do not set aside
any Medicaid block grant funding for Medicare deductibles and
copayments, and set aside less than half of the funds needed to
cover premiums. Hundreds of thousands of poor and near poor
older Americans and people with disabilities could lose funding
for their Medicare premiums -- at the same time that
Republicans would increase Medicare premiums.
?
President Clinton's balanced budget maintains the guarantee of
this critical assistance.
SPOUSAL IMPOVERISHMENT PROTECTIONS. Republicans would undermine
protections for spouses of nursing home residents from
impoverishment -- even though it is not necessary to balance the
budget.
?
Republicans undermine these spousal impoverishment protections
by repealing the guarantee of nursing home coverage, making it
more difficult for the Federal government to ensure that States
enforce spousal impoverishment protections, and repealing the
right of spouses to seek redress in Federal court if they are
wrongly denied protection.
?
President Clinton's balanced budget maintains the current
spousal impoverishment protections which have protected about
450,000 spouses of nursing home residents since they went into
effect. Most of these spouses are women.
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME:12-MAR-1996 10:18:22.32
SUBJECT: Post editorial
TO: Deborah L. Fine
(FINE_D) (OPD)
READ:12-MAR-1996 10:30:46.84
TEXT:
I just wanted to make sure that you had seen the editorial in the
Post about family planning. It sounds as bad as you and I
thought!
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME:28-MAR-1996 10:32:34.78
SUBJECT: RE: cr/abortion/family planning
TO: Deborah L. Fine
(FINE_D) (OPD)
READ:28-MAR-1996 10:34:58.82
TEXT:
No, Debbie. I think you've asked the exact right questions.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Seth E. Masket (MASKET_S) (WHO)
CREATION DATE/TIME: 1-APR-1996 15:08:17.08
SUBJECT: Abortion w/revisions
TO: Deborah L. Fine
(FINE_D) (OPD)
READ: 1-APR-1996 16:34:50.68
TEXT:
[Here's the new draft. What do you think? -Seth]
Dear
:
Thank you for your message regarding a woman's right to choose.
I appreciate knowing your views on this extremely complex issue.
I have always maintained that the decision to have an abortion is
personal and private, and should be made solely between a woman,
her doctor, her conscience, and her faith. It simply wrong for
politics to interfere with such a deeply personal decision. I
also firmly believe that legal abortions -- those protected by
Roe V. Wade -- should be safe and rare.
Since I took office, I have worked to protect a woman's right to
choose. My Administration reversed the "gag rule," which
prevented women from discussing abortion with health
professionals. Additionally, we repealed the "Mexico City"
policy, which banned the distribution of family planning funding
overseas. I was also pleased to sign the Freedom of Access to
Clinic Entrances Act to protect women seeking family planning
advice from violence or intimidation.
I believe that we should work to create a society in which fewer
abortions are needed. Since I became President, 1 have fought
for improved and expanded family planning services and education
programs. I have also worked to prevent teenage pregnancies by
promoting efforts to teach young people about personal
responsibility and help them make the right choices. It is by
advancing these efforts and by encouraging adoption, rather than
criminalizing women and their doctors, that we can create a
better future for our children.
Though some of our efforts are being fought by Congress, I am
continuing our work to protect women's reproductive health and
their constitutional right to choose while working to reduce the
numbers of unwanted pregnancies. I am grateful for your
perspective on this issue and am glad you took the time to write.
Sincerely,
Bill Clinton
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Seth E. Masket (MASKET_S) (WHO)
CREATION DATE/TIME:12-APR-1996 12:22:39.76
SUBJECT: Women's group
TO: Betsy Myers
(MYERS_B) (WHO)
READ:12-APR-1996 13:39:53.48
TO: Lynn C. Ross
(ROSS_L) (OMB)
READ:15-APR-1996 09:01:17.29
TO: Deborah L. Fine
(FINE_D) (OPD)
READ:15-APR-1996 09:22:48.99
TEXT:
Have any of you dealt much with the Global Fund for Women in Menlo
Park, CA? They've written to the President express concern over
Congress' attempts to hurt the US international family planning
program.
I'd like to just do a letter expressing our commitment to family
planning and reproductive freedom, but I don't know how close we
are with this group. What do you think? How specific should we
be?
-Seth
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME:23-APR-1996 19:34:25.57
SUBJECT: RE: family planning
TO: Deborah L. Fine
(FINE_D) (OPD)
READ:23-APR-1996 19:36:13.46
TEXT:
Sounds fine. If he's that important maybe we should have Nancy-
Ann meet with him too.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME:23-APR-1996 19:47:12.05
SUBJECT: RE: family planning
TO: Deborah L. Fine
(FINE_D) (OPD)
READ:23-APR-1996 19:47:23.92
TEXT:
Great.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Diana M. Fortuna (FORTUNA_D) (OPD)
CREATION DATE/TIME:22-MAY-1996 11:17:00.07
SUBJECT: south carolina medicaid waivers
TO: Remote Addressee
([email protected]@INET@EOPMRX )
READ:NOT READ
TO: Remote Addressee
([email protected]@INET@EOPMRX)
READ:NOT READ
CC: Remote Addressee
([email protected]@INET)
READ:NOT READ
TEXT:
I just had a conversation with the very frustrated Medicaid
director of South Carolina. (I got directed to her after Carol
spent some time with her and some other folks there about a month
ago.)
She says they have had 2 minor waivers, which do good things for
high-risk women and family planning, pending for a year. I think
the 1915/high risk one may have just been approved (I'm not
sure), but with a contingency that they study its cost
effectiveness, which they see as already demonstrated. She said
they have been on the verge of just canning both of them out of
frustration over the amount of effort they have had to put in, and
that it is difficult for that state to continue pursuing these
initiatives under such adverse circumstanes.
These are expansions or modifications of existing waivers.
I am sure there is a whole history here (I have heard a little
from Lloyd Bishop and John), but since these sound like good
concepts at least, that HCFA previously endorsed through the
initial waivers, that must have gotten bogged down, perhaps in the
crush of trying to deal first with the big, state-wide waivers. I
reinforced with her that budget neutrality is a very important
feature of waivers to this administration. But her point is that
the whole process adds up to being incredibly frustrating and
ultimately not worth it to the state.
Anyway, I think it would be appropriate for one of you to give her
a chance to tell her story to you. She says she recognizes that
HCFA is at least beginning to talk in terms of customer service,
which is good, but that on the ground there are still big
problems.
Her name is Debbie Francis, and she is at 803-253-6119.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME:30-MAY-1996 17:31:06.68
SUBJECT: RE: family planning
TO: Deborah L. Fine
(FINE_D) (OPD)
READ:30-MAY-1996 18:05:06.11
TEXT:
Can we do it at 1:15?
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jill Pizzuto (PIZZUTO_J) (OPD)
CREATION DATE/TIME:19-JUN-1996 12:18:59.66
SUBJECT: Nancy-Ann Min
TO: Carol H. Rasco
(RASCO_C) (WHO)
READ:19-JUN-1996 13:03:06.86
TEXT:
Nancy called for you. She's asking if you have any time to talk w/ her (via
phone) today re: Family Planning Amendments. She needs advice from you on
WHERE the POTUS stands on some of these; they will be submitting something
tonight for tomorrow's (meeting or hearing).
her number: 5-5178 -- however, she's in and out of meetings today, will have her
beeper and asked if you could beep her, probably better way to get her.
let me know if I need to help you w/ this. jmp.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Lyndell Hogan (HOGAN_L) (OPD)
CREATION DATE/TIME:24-JUN-1996 10:33:10.79
SUBJECT: Appropriations bills
TO: Deborah L. Fine
(FINE_D) (OPD)
READ:24-JUN-1996 10:36:22.76
TEXT:
Debbie,
What sort of process did you use/who did you talk to you to track
abortion/family planning riders to appropriations bills? I've always tracked or
worked on authorization langauage, not the appropriations process.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Lyndell Hogan (HOGAN_L) (OPD)
CREATION DATE/TIME:24-JUN-1996 10:54:56.16
SUBJECT: RE: Appropriations bills
TO: Deborah L. Fine
(FINE_D) (OPD)
READ:24-JUN-1996 10:55:12.21
TEXT:
So you don't talk directly with those in Appropriations or analyze approps
legislation looking for abotion/family planning riders?
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Lyndell Hogan (HOGAN_L) (OPD)
CREATION DATE/TIME:28-JUN-1996 12:50:31.77
SUBJECT: Appropriations Update
TO: Nancy-Ann E. Min
(MIN_N) (OMB)
READ: 1-JUL-1996 13:43:55.23
TO: Jeremy D. Benami
(BENAMI_J) (WHO)
READ:28-JUN-1996 17:57:01.00
TO: Jennifer L. Klein
(KLEIN_J) (OPD)
READ: 6-JUL-1996 14:00:38.55
CC: Betsy Myers
(MYERS_B) (WHO)
READ:28-JUN-1996 14:28:20.47
CC: Elizabeth E. Drye
(DRYE_E) (OPD)
READ:28-JUN-1996 18:10:06.43
CC: Dorothy L. Karayannis
(KARAYANNIS_D) (OPD)
READ:28-JUN-1996 14:07:38.50
TEXT:
Carrie Wofford and I would like to set up a briefing for about 15 key women's
group leaders on the state of abortion and family planning riders to
appropriations bills.
We are hoping to have Betsy, Jeremy, Nancy Ann, myself and Carrie there as White
House representatives.
We'd like to set up an 1 1/2 meeting on July 16 preferably from 4 p.m.-5:30 at
708 Jackson Place.
Nancy--This date and time work with Betsy's and Jeremy's schedules. Does it
work for you?
Let me know.
Thanks!
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Lyndell Hogan (HOGAN_L) (OPD)
CREATION DATE/TIME: 1-JUL-1996 16:47:21.76
SUBJECT: Approps bills affecting women
TO: Betsy Myers
(MYERS_B) (WHO)
READ: 1-JUL-1996 17:29:22.32
CC: George Stephanopoulos
(STEPHANOPO_G) Autoforward to: Laura Capps
(CAPPS_L
) (WHO)
READ: 1-JUL-1996 18:04:04.74
CC: Marilyn Yager
(YAGER_M) (WHO)
READ: 2-JUL-1996 08:55:53.46
CC: Elizabeth E. Drye
(DRYE_E) (OPD)
READ: 1-JUL-1996 17:32:53.60
CC: Deborah L. Fine
( FINE_D) (OPD)
READ: 1-JUL-1996 17:45:54.46
CC: Nancy-Ann E. Min
(MIN_N) (OMB)
READ: 1-JUL-1996 18:50:58.91
CC: John P. Hart
(HART_J) (WHO)
READ: 2-JUL-1996 11:18:39.79
CC: Katharine M. Button
(BUTTON_K) (WHO)
READ: 8-JUL-1996 10:38:19.37
CC: Todd Stern
(STERN_T) (WHO)
READ:NOT READ
CC: Elena Kagan
(KAGAN_E) (WHO)
READ: 2-JUL-1996 09:00:12.19
CC: Douglas B. Sosnik
(SOSNIK_D) (WHO)
READ: 1-JUL-1996 16:50:11.95
CC: Karen L. Hancox
(HANCOX_K) (WHO)
READ: 1-JUL-1996 17:23:43.01
CC: Jeremy D. Benami
(BENAMI_J) (WHO)
READ: 1-JUL-1996 18:28:12.78
CC: Peter Jacoby
(JACOBY_P) (WHO)
READ: 1-JUL-1996 17:17:48.49
CC: Martha Foley
(FOLEY_M) (WHO)
READ: 2-JUL-1996 07:53:48.55
CC: Carol H. Rasco
(RASCO_C) (WHO)
READ: 3-JUL-1996 13:39:29.50
TEXT:
FYI, please see attached list and description of recent and pending action on
appropriations legislation and other current issues affecting women.
ATTACHMENT 1
ATT CREATION TIME/DATE: 1-JUL-1996 16:40:00.00
ATT BODYPART TYPE:p
ATT CREATOR: Lyndell Hogan
TEXT:
PRINTER FONT 14_POINT_COURIER
MEMORANDUM
PRINTER FONT 12_POINT_COURIER
To:
Those Interested
From: Lyn Hogan
Domestic Policy Council
Date: July 1, 1996
PRINTER FONT 14_POINT_COURIER
Status of Appropriations and Other Legislation
Affecting Women
PRINTER FONT 12_POINT_COURIER
FY '97 Labor, Health and Human Services Appropriations
Human Embryo Research
?
On June 25, 1996, during Committee mark
-up of the HHS/Labor
Appropriations bill, Reps. Dickey (R
-AZ) and Wicker (R
-MS)
offered an amendment to reinstate the ban on human embryo
research. The amendment passed 25
-20.
?
Rep. Lowey (D
-NY) is expected to offer on the floor an
amendment to strike the ban and codify the NIH guidelines
which allowed research on extra embryos that were created
for in vitro fertilization, but did not allow the creation
of embryos solely for research. Rep. Lowey successfully
offered this amendment in the subcommittee mark
-up.
Abortion/Family Planning
The week of July 8 Rep. Istook (R
-OK) is expected to offer on the
floor the following amendments to the Labor/HHS appropriations
bill:
?
An amendment allowing states to deny Medicaid coverage for
abortions to low
-income women who are victims of rape or
incest.
?
An amendment that would prohibit Title X funds from being
used to provide services to teenagers without parental
consent. Those services include providing contraceptives as
well as testing for sexually transmitted diseases. States
would be allowed to opt out of the federal mandate but, in
doing so, would be required to enact new laws allowing
minors to consent to sensitive health services. Currently,
49 states have allows that allow minors to consent for
screening and treatment of sexually transmitted diseases and
23 states have laws allowing minors to consent for
contraceptive services.
FY '97 Treasury, Postal and General Government Operations
Appropriations bill
Abortion
?
The week of July 8 Rep. Hoyer (D
-MD) is expected to offer on
the floor an amendment to strike the restrictive language
written into law in last years' appropriations bill, that
prevents federal employees form selecting a health care plan
that provides abortion coverage. Rep. Hoyer offered this
amendment during committee debate. However, it failed
16
-22.
FY '97 Foreign Operations Appropriations bill
Abortion/Family Planning
During subcommittee consideration of this appropriations bill,
Sen. Leahy (D
-VT) offered an amendment striking the Mexico City
Policy language (Mexico City language denies all funding for
overseas family planning organizations that perform abortions or
speak out about reproductive choice, even with private money, a
policy Pres. Clinton reversed when he came into office) and
striking funding cuts to population assistance programs attached
by the House. The Leahy amendment also restores a separate
account for population assistance within the development
assistance programs and increases population assistance to $410
million. The Leahy amendment passed 8
-5. Senate floor action is
expected after the July 4 recess.
Welfare/Medicaid Legislation
On June 26 in the Senate Finance Committee, Sen. Chafee offered
an amendment to strike from the welfare/Medicaid legislation
language that permits states to deny coverage for abortion
services except in the cases of life, rape or incest. The Chafee
amendment failed 10
-10.
FDA and the Morning After Pill
After holding a hearing on Friday June 28, the FDA decided to
publish in the Federal Register a notice that says ordinary oral
contraceptives can be safely and effectively used as "morning
after pills." However, because of concerns over liability
litigation and anti
-abortion protests, no manufacturer has filed
an application to market the pills specifically as "morning after
pills." Without an application, the FDA cannot formally approve
the new use. Instead, the FDA will use the Federal Register
announcement to inform people of this use of birth control pills,
and will continue to hope a manufacturer applies.
END ATTACHMENT 1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Betsy Myers (MYERS_B) (WHO)
CREATION DATE/TIME: 1-JUL-1996 16:00:45.24
SUBJECT: RE: Family Planning/Abortion Riders to Approps
TO: Lyndell Hogan
(HOGAN_L) (OPD)
READ: 1-JUL-1996 16:48:15.67
TEXT:
Thanks -- we think you're probably right. Carrie is going to make a few calls
to choice groups to see what's best for them. (sometimes they prefer to come
in for a meeting). Will let you know today.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Lyndell Hogan (HOGAN_L) (OPD)
CREATION DATE/TIME: 1-JUL-1996 10:40:29.33
SUBJECT: Family Planning/Abortion Riders to Approps
TO: Betsy Myers
(MYERS_B) (WHO)
READ: 1-JUL-1996 11:24:17.41
TO: Jeremy D. Benami
(BENAMI_J) (WHO)
READ: 1-JUL-1996 11:47:28.60
TO: Elizabeth E. Drye
(DRYE_E) (OPD)
READ: 1-JUL-1996 11:10:56.74
TEXT:
FYI,
The Istook and Livingston family planning riders will be offered on the floor to
the HHS/Labor approps bill, probably next Wedn or Thurs. The amendments were
not offered in committee because the votes weren't there.
There are also several other amendments that will be offered to approps bills
next week and the week after.
Betsy/Carrie,
This means that the July 16 briefing we had planned will be too late. As an
alternative, what about a conference call next Tuesday morning??
Please advise.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Jennifer L. Klein (KLEIN_J) (OPD)
CREATION DATE/TIME: 6-JUL-1996 14:06:52.19
SUBJECT: RE: Press Clips--Follow-Up
TO: Lyndell Hogan
(HOGAN_L) (OPD)
READ: 7-JUL-1996 15:54:09.66
TEXT:
Here are a list of issues in my areas: Medicare, Medicaid,
Kassebaum-Kennedy, health care costs, managed care, health care
coverage/uninsured, women's health, abortion/family planning.
Thanks.
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Alice E. Shuffield (SHUFFIELD_A) (OMB)
CREATION DATE/TIME:12-JUL-1996 11:17:55.79
SUBJECT: Labor/HHS - 7th and FINAL message
TO: Dennis Burke
(BURKE_D) (OPD)
READ:12-JUL-1996 11:28:11.24
TEXT:
ATTACHMENT 1
ATT CREATION TIME/DATE:12-JUL-1996 09:36:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Elizabeth L. Rossman
ATT SUBJECT: L/HHS/Ed Passed House Last Night (216-209)
ATT TO: Jacob J. Lew
(LEW_J)
ATT TO: Kenneth S. Apfel
(APFEL_K)
ATT TO: Nancy-Ann E. Min
(MIN_N)
ATT TO: Charles E. Kieffer
(KIEFFER_C)
ATT TO: Charles S. Konigsberg
(KONIGSBERG_C)
ATT TO: Lisa Kountoupes
(KOUNTOUPES_L)
ATT TO: Barry B. Anderson
( ANDERSON_B)
ATT TO: Richard P. Emery Jr.
(EMERY_R)
ATT TO: Robert E. Barker
(BARKER_R)
ATT TO: Nancy S. Ridenour
(RIDENOUR_N)
ATT TO: Barry White
( WHITE_B )
ATT TO: Lisa B. Fairhall
(FAIRHALL_L)
ATT TO: Larry R. Matlack
(MATLACK_L)
ATT TO: Carole Kitti
(KITTI_C)
ATT TO: Barry T. Clendenin
( CLENDENIN_B)
ATT TO: Michelle L. Hanson
(HANSON_M)
ATT TO: Thomas M. Reilly
(REILLY_T)
ATT TO: Richard J. Turman
(TURMAN_R)
ATT TO: Mark E. Miller
(MILLER_ME)
ATT TO: Richard E. Green
(GREEN_R)
ATT TO: Alice E. Shuffield
(SHUFFIELD_A)
ATT TO: Mary 1. Cassell
(CASSELL_M)
ATT TO: Christine B. Ellertson
(ELLERTSON_C)
ATT TO: Ann M. Burget
(BURGET_A)
TEXT:
An Obey substitute to the the Istook family planning
amendment was adopted, 232-193. The Obey language states that a
family planning entity would have to certify that it encouraged
family participation in family planning decisions made by minors
as a condition of receiving Title X money. Apparently, this is
similar to language in existing regulation, except that it
requires "certification."
The Istook language, as amended by Obey, was approved
421-0.
I should have copies of the Congressional Record early this
afternoon if you would like to see any amendments.
END ATTACHMENT 1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Alice E. Shuffield (SHUFFIELD_A) (OMB)
CREATION DATE/TIME:12-JUL-1996 11:13:19.58
SUBJECT: Labor/HHS - 3rd message
TO: Dennis Burke
(BURKE_D) (OPD)
READ:12-JUL-1996 11:26:17.02
TEXT:
ATTACHMENT 1
ATT CREATION TIME/DATE:11-JUL-1996 15:18:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Elizabeth L. Rossman
ATT SUBJECT: L/HHS/Ed House Floor Action (cont'd)
ATT TO: Jacob J. Lew
(LEW_J)
ATT TO: Kenneth S. Apfel
(APFEL_K)
ATT TO: Nancy-Ann E. Min
(MIN_N)
ATT TO: Charles E. Kieffer
(KIEFFER_C)
ATT TO: Charles S. Konigsberg
(KONIGSBERG_C)
ATT TO: Lisa Kountoupes
(KOUNTOUPES_L)
ATT TO: Barry B. Anderson
( ANDERSON_B)
ATT TO: Richard P. Emery Jr.
(EMERY_R)
ATT TO: Robert E. Barker
(BARKER_R)
ATT TO: Nancy S. Ridenour
(RIDENOUR_N)
ATT TO: Barry White
( WHITE_B)
ATT TO: Lisa B. Fairhall
(FAIRHALL_L)
ATT TO: Larry R. Matlack
(MATLACK_L)
ATT TO: Carole Kitti
(KITTI_C)
ATT TO: Barry T. Clendenin
( CLENDENIN_B)
ATT TO: Michelle L. Hanson
(HANSON_M)
ATT TO: Thomas M. Reilly
(REILLY_T)
ATT TO: Richard J. Turman
(TURMAN_R)
ATT TO: Mark E. Miller
( MILLER_ME)
ATT TO: Richard E. Green
(GREEN_R)
ATT TO: Alice E. Shuffield
(SHUFFIELD_A)
ATT TO: Mary I. Cassell
(CASSELL_M)
ATT TO: Christine B. Ellertson
(ELLERTSON_C)
TEXT:
Amendments adopted:
(1) Mica amend (agreed to by voice vote) that would increase
funding for Education for the Disadvantaged concentration grants
by $20 M. Offset -- program admin (educ??)
(2) Deal amend (voice vote) to increase funding for Education
for the Disadvantage by $1 M. Offset unknown.
(3) Porter technical amend (agreed to by voice vote) --
language on Impact Aid. Porter noted COB said this amend had no
scoring impact.
(4) Fox amend (adopted by voice vote) would restore $1.9 M for
the Foster grandparent program. Offset -- DoEd S&E.
(5) A Lowey amend (294-129) that would add $2 M for the Women's
Educational Equity Act program. Offset unknown.
Amendments Defeated:
(1) An Obey amendment (198-227) that would have added $1,246 M
(as an advance appropriation) to education and training programs
in the bill (I think that this would have been the distribution):
- $450 M, Title I, Education for the disadvantaged
- $100 M, Dislocated workers
- $70 M, Head Start
- $250 M, GOALS 2000
- $25 M, Safe and drug free schools
- $233 M Eisenhower grants
- $93 M, Perkins loans
- $25 M, Summer Youth
Amendments withdrawn:
(1) Lee amend that would have transferred $10 M from Impact
Aid to Bilingual and immigrant education.
Action for Tonight:
At 6:50 PM, Mr. Porter rose and read 15 amendments that
would be considered by the House later tonight -- these included
the Lowey embryo research amend, and an Istook family planning
amend.
Mr. Porter said debate would be over at 11:00 PM -- the end
is in sight
END ATTACHMENT
1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Alice E. Shuffield (SHUFFIELD_A) (OMB)
CREATION DATE/TIME:12-JUL-1996 11:14:54.22
SUBJECT: Labor/HHS - 5th message
TO: Dennis Burke
(BURKE_D) (OPD)
READ:12-JUL-1996 11:27:12.27
TEXT:
ATTACHMENT I
ATT CREATION TIME/DATE:11-JUL-1996 22:47:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Elizabeth L. Rossman
ATT SUBJECT: L/HHS/Ed House Floor Action Since 10:45 PM
ATT TO: Jacob J. Lew
(LEW_J)
ATT TO: Kenneth S. Apfel
(APFEL_K)
ATT TO: Nancy-Ann E. Min
(MIN_N)
ATT TO: Charles E. Kieffer
(KIEFFER_C)
ATT TO: Charles S. Konigsberg
(KONIGSBERG_C)
ATT TO: Lisa Kountoupes
(KOUNTOUPES_L)
ATT TO: Barry B. Anderson
(ANDERSON_B)
ATT TO: Richard P. Emery Jr.
( EMERY_R)
ATT TO: Robert E. Barker
(BARKER_R)
ATT TO: Nancy S. Ridenour
(RIDENOUR_N)
ATT TO: Barry White
( WHITE_B)
ATT TO: Lisa B. Fairhall
(FAIRHALL_L)
ATT TO: Larry R. Matlack
(MATLACK_L)
ATT TO: Carole Kitti
(KITTI_C)
ATT TO: Barry T. Clendenin
(CLENDENIN_B)
ATT TO: Michelle L. Hanson
(HANSON_M)
ATT TO: Thomas M. Reilly
(REILLY_T)
ATT TO: Richard J. Turman
(TURMAN_R)
ATT TO: Mark E. Miller
( MILLER_ME)
ATT TO: Richard E. Green
(GREEN_R)
ATT TO: Alice E. Shuffield
(SHUFFIELD_A)
ATT TO: Mary I. Cassell
(CASSELL_M)
ATT TO: Christine B. Ellertson
(ELLERTSON_C)
ATT TO: Ann M. Burget
(BURGET_A)
TEXT:
A message just flashed across my machine that said that the
e-mail system was shutting down at midnight. I will send a final
e-mail tomorrow morning if I am not able to send it tonight.
-- ACTION SINCE 10:45 PM --
Pending votes:
-- Istook amend on family planning (parental consent)
-- Obey substitute to Istook amend (encouraging parental
consultation)
-- final passage of bill
Amendments adopted:
(1) Bunting amend (421-3) that would bar Medicare and Social
Security trust funds from being used for union activity. Bunting
cited that approximately $8.1 M was being used to pay civil
servants that work at SSA and work full-time on union activities.
Amendments defeated:
(1) Hefley amend (205-219) that would have reduced the $250 M
appropriation for the Corp for Public Broadcasting by $1 M.
Reduction was directed at Pacifica Radio network.
(2) Sanders amend (180-242) that would require HHS to consider
the appropriateness of a reasonable pricing clause when it gives a
private entity the exclusive right S to market drugs developed by
NIH at taxpayer expense.
(3) Lowey amend ( (167-256) that would strike the ban on Federal
funding for embryo research in instances where the embryo was not
specifically created for the research.
(4) Hoyer substitute to Bunting amend (see #(1) listed above)
(201-220) that would amend the Bunting amend to say that union
representation of SSA employees could not be denied.
END ATTACHMENT 1
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Diana M. Fortuna (FORTUNA_D) (OPD)
CREATION DATE/TIME:23-JUL-1996 13:56:26.34
SUBJECT: Abortion letter and adoption; I'll forward you my response
TO: Jeremy D. Benami
(BENAMI_J) (WHO)
READ:23-JUL-1996 17:28:44.15
TO: Lyndell Hogan
(HOGAN_L) (OPD)
READ:23-JUL-1996 14:02:11.83
TEXT:
ATTACHMENT 1
ATT CREATION TIME/DATE:23-JUL-1996 13:30:00.00
ATT BODYPART TYPE:B
ATT CREATOR: Seth E. Masket
ATT SUBJECT: Abortion form letter
ATT TO: Elizabeth E. Drye
(DRYE_E)
ATT TO: Diana M. Fortuna
(FORTUNA_D)
TEXT:
I'm trying to insert a little bit of adoption language into our
form letter on abortion. Currently, we have a paragraph that
looks like the following:
"We have also worked to help reduce the number of abortions.
Since I became President, I have fought for improved and expanded
family planning services andeducation programs. I have also
worked to prevent teenage pregnancies by promoting
efforts to teach young people about personal responsibility
and help them make the right choices. It is by advancing
these efforts and by encouraging adoption, rather
than criminalizing women and their doctors, that we can create a
better future for our children."
Can I revise it to look like this?
"We have also worked to help reduce the number of abortions.
Since I became President, I have fought for improved and expanded
family planning services and education programs. I have also
worked to prevent teenage pregnancies by promoting
efforts to teach young people about personal responsibility
and help them make the right choices. I am additionally committed
to breaking down the barriers to adoption, which is one of the
most important things we can do to strengthen America's families
and give more children what every young person in America
deserves -- loving parents and a healthy home. By advancing these
efforts, rather than criminalizing women and their doctors, we can
create a better future for our children."
Please let me know.
Thanks,
Seth
END ATTACHMENT
I
RECORD TYPE: PRESIDENTIAL (ALL-IN-1 MAIL)
CREATOR: Seth E. Masket (MASKET_S) (WHO)
CREATION DATE/TIME:23-JUL-1996 13:42:18.23
SUBJECT: Abortion form letter
TO: Elizabeth E. Drye
(DRYE_E) (OPD)
READ:23-JUL-1996 20:39:44.38
TO: Diana M. Fortuna
(FORTUNA_D) (OPD)
READ:23-JUL-1996 13:52:23.48
TEXT:
I'm trying to insert a little bit of adoption language into our
form letter on abortion. Currently, we have a paragraph that
looks like the following:
"We have also worked to help reduce the number of abortions.
Since I became President, I have fought for improved and expanded
family planning services andeducation programs. I have also
worked to prevent teenage pregnancies by promoting
efforts to teach young people about personal responsibility
and help them make the right choices. It is by advancing
these efforts and by encouraging adoption, rather
than criminalizing women and their doctors, that we can create a
better future for our children."
Can I revise it to look like this?
"We have also worked to help reduce the number of abortions.
Since I became President, I have fought for improved and expanded
family planning services and education programs. I have also
worked to prevent teenage pregnancies by promoting
efforts to teach young people about personal responsibility
and help them make the right choices. I am additionally committed
to breaking down the barriers to adoption, which is one of the
most important things we can do to strengthen America's families
and give more children what every young person in America
deserves -- loving parents and a healthy home. By advancing these
efforts, rather than criminalizing women and their doctors, we can
create a better future for our children."
Please let me know.
Thanks,
Seth