Ask the Scholar
Document scope · 1 page
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory.
For page-specific OCR and visual context, open one of the page chats.
Scholar Source Context
Document identity
localId
34429085
label
Public Liaison
core
doc
dtoType
document
citationUrl
pageCount
1
Source metadata
id
34429085
sourceUrl
contentType
document
title
Public Liaison
citationUrl
collections
Records of the First Lady's Office (Clinton Administration)
Jennifer Klein's Files
imageCount
1
hasImages
yes
source
import
hasTranscription
no
Source extras
naId
34429085
levelOfDescription
fileUnit
otherTitles
42-t-7422560-20140536S-042-007-2016
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
7551dc99142e7a5b
ocrText
January 3, 1995
MEMORANDUM TO CAROL RASCO AND BOB RUBIN
FROM:
Marilyn Yager
CC:
Jennifer Klein and Chris Jennings
I am seeking your advice regarding some wrap-up
meetings which still need to take place in regard to
healthcare reform. Although the bulk of the health
care outreach meetings which were requested and were
deemed immediately necessary have been completed, there
remains several key groups who have requested meetings,
i.e., Biomedical Industry Organization (represents
companies like Genetech), Consumer Groups (like Citizen
Action), rural groups, and women's groups.
Most efforts to schedule these remaining meetings have
been grounded for several weeks due to Bob's nomination
process (and no announced replacement), and Carol's
tight schedule as a result of welfare reform and budget
meetings. I anticipate these hurdles will continue
throughout January.
Where possible and appropriate, I have scheduled
meetings with Jennifer and Chris, and will continue to
do so to complete as many requests as possible.
However, some meetings must be done at the most senior
level (and it is politically important for us to do
so). The First Lady has declined doing further
meetings, but helped tremendously by meeting with both
labor and the supportive hospital groups before the
Holidays.
One option would be to shorten these meetings to a half
hour so that they are less time consuming.
Please advise.
Call
November 30, 1994
MEMORANDUM TO JENNIFER PALMIERI
FROM:
MARILYN YAGER
OFFICE OF PUBLIC LIAISON
CC:
Carol Rasco, Jennifer Klein, and Chris Jennings
Per our discussion yesterday regarding the invitation
from the California Association of Hospitals and Health
Systems for Leon to speak in January, I wanted to give
you some additional information. Attached is a copy of
the invitation also to Leon to speak the same week to
the American Hospital Association (Monday, January 30),
of which the California group is a state affiliate.
I strongly recommend that Leon accept the invitation
from the American Hospital Assn. Last year, the
President spoke to the group, which is always one of
the largest health provider lobbying meetings in
Washington each year. Although I would not consider
the AHA allies on the Health Security Act, they were
somewhere in the middle due to their strong support of
the employer mandate provisions, and were certainly did
not consider them opponents.
Obviously, their number one issue next year will be the
budget and Medicare cuts, and regardless of what we end
up having in our own budget proposal they view us as
moderate and reasonable voices in the "Medicare cuts
for deficit reduction" debate.
Under other circumstances, I would recommend he accept
the invitaion from the California Hospital Assn.
Chris
because they were strong supporters of the Health
Security Act and were especially active on the employer
mandate provision. However, if Leon is only able to
accept one of these invitations, then the AHA
invitation carries far more weight.
American Hospital Association
AHA
Richard J. Davidson
President
November 18, 1994
The Honorable Leon E. Panetta
Chief of Staff
Executive Office of the President
The White House
1600 Pennsylvania Avenue, NW
Washington, DC 20500
Dear Mr. Panetta:
The American Hospital Association's annual meeting draws thousands of
community leaders from across America to Washington. Given the
dramatic political changes, the January 29 to February 1, 1995 session is
expected to exceed last year's record attendance. We cordially invite you
to speak at this, our most important membership event.
The Federal Relations Symposium takes place on Monday, January 30. It
begins at 8:30 a.m., breaks for lunch and continues into mid-afternoon. At
this early planning stage, we could accommodate your schedule.
It would be important for our members to understand not only where health
care issues fit into the President's agenda for 1995, but what other priorities
the administration intends to tackle. And a sense of the prospects for White
House-Congressional cooperation would be very valuable.
Liberty Place
One North Franklin
325 Seventh Street, N.W.
Chicago, Illinois 60606
Washington, DC 20004-2802
312.422.3000
202.638.1100
The Honorable Leon E. Panetta
November 18, 1994
Page 2
If your staff has questions, your contact here is Rick Pollack, AHA's
executive vice president for Federal Relations.
I hope you can be with us. Last January, President Clinton came at the
outset of the health reform debate. He set a tone of cooperation and
communication with our members that remain firm today. Your
appearance at the Symposium would underscore the strength of that
relationship.
Sincerely,
Dich Daerdis
"CAHHS
CALIFORNIA ASSOCIATION OF
HOSPITALS AND HEALTH SYSTEMS
November 8, 1994
Mr. Leon Panetta
Chief of Staff
The White House
Washington, D.C. 20500
Dear Mr. Panetta:
On behalf of the California Association of Hospitals and Health Systems, it is with great honor
that I extend an invitation to you to be the keynote speaker at the California hospitals
delegation dinner on January 30, 1995, in the Colonial Room of the Stouffer Mayflower Hotel.
The dinner will begin at 7:30 p.m. and we would like you to begin your remarks at
approximately 8:00 p.m.
Our delegation will consist of over 150 leaders of the California hospital community who will
be in Washington, D.C. in conjunction with the American Hospital Association's Annual
Membership Meeting. You may recall that you made a similar presentation to this group in
1991.
Throughout the recent national debate on health reform, California hospitals were a
consistent supporter of the President's goals of achieving universal coverage of 2 standard
benefit package. In addition, by word and deed WC provided strong support for employer
paid benefits as the best foundation to achieve universal coverage.
We are proud of the prominent role you have assumed in the Clinton Administration. As a
familiar and respected voice on the issues of importance to California hospitals, we believe
your perspective on the future of health reform, the federal budget and other major issues
would be the highlight for those who will participate in our annual visit to the nation's
capitol.
Thank you for your consideration and response to this invitation. If 1 can assist you or your
staff with logistics surrounding this request, please contact me at 916-552-7545.
Sincerely
Decon
C. Duane Dauner
President
CDD:dmm
Representing California Hospitals and their Health Systems
1201 K Screet, Suite 800
Post Office Box 1100
Sacramento. CA 95812-1100
916.443.7401
Fax 916.552.7596
TO:
Melanne
FROM:
Jen
DATE:
12/1/94
RE:
Outreach Meetings
Marilyn Yager, Chris and I suggest that HRC meet with the
following groups:
Supportive hospital groups
Allied health groups (mental health, social workers and
substance abuse groups)
Children's health groups
Consumer groups (Citizen Action, etc.)
Women's groups
Farm groups
Religious groups
We have not included labor because Bob plans to use one of
his regularly scheduled meetings with them to discuss health care
reform.
Marilyn will work with Patti to begin to set these up. It
might be helpful if you could let Patti know that these are a
priority.
November 22, 1994
MEMORANDUM TO CAROL RASCO AND BOB RUBIN
FROM:
MARILYN YAGER
CC:
CHRIS JENNINGS AND JENNIFER KLEIN
Following conversations this afternoon with both Jeremy
Ben Ami and Linda McLaughlin, it is clear that both of
your schedules through December 22 are now filling up
with lengthy internal budget, health, and welfare
reform meetings.
This jeopardizes our ability to continue the outreach
meetings with our health care allies and other key
health care players. I have already cancelled two key
meetings this week with allies (supportive hospital
groups, and mental health and social workers) due to
the addition of these key internal meetings.
My concern is that with this unfolding problem we are
likely to make internal decisions regarding health care
and how it will be treated in the budget and in turn
how we will treat it regarding reform before we have
been able to meet with several key allies on health
care (and in fact many of these meetings are now going
to have be scheduled in January).
It would be a serious political mistake to have made
these decisions without having touch all these
political bases. Many of these groups (who contribute
to our electoral base) are feeling especially isolated
in the new political environment because they were so
closely identified with the Clinton health proposal,
i.e., Catholic Health Assn and the Mental Health
community. Others, like the veterans groups, it would
clearly be a mistake regardless of their past
activities regarding health care reform.
In reviewing the options of continuing the outreach
meetings without the full participation of each of you
over the next four weeks (although we would continue
your scheduled meetings where possible), I have
concluded that Mrs. Clinton would be the most
acceptable option.
All of these groups would be happy to meet with Mrs.
Clinton and they would obviously be confident that
their comments would be shared internally at the most
senior levels and their policy suggestions would be
understood.
Chris Jennings and Jennifer Klein would continue to
staff the meetings as well, allowing us to remain on
schedule having covered our political bases regardless
of any final decisions about our direction on health
care reform.
EXECUTIVE OFFICE OF THE PRESIDENT
08-Dec-1994 11:35am
TO:
Jennifer L. Klein
TO:
Linda J. McLaughlin
TO:
Julie E. Demeo
FROM:
Barbara D. Woolley
Public Liaison
SUBJECT:
Health Meeting Response
FYI, I called to regret for both Bob and Carol an invitation to
meet with the Business Coalition for Affordable Health Care before
the Holidays. This Coalition represents small business groups
that opposed items in the Clinton plan. We will probley meet with
them after the holidays.
BRASM
THE WHITE HOUSE
WASHINGTON
November 21, 1994
MEMORANDUM
to
TO:
Distribution
FROM:
Mike Lux
make ted you sine had
RE:
Health Care
Since I have handed off my role in health care outreach into the
extremely capable hands of Marilyn Yager, this could well be the
last memo I write on health care policy for a long time.
However, I thought I should give you my thoughts before signing
off on the issue entirely.
Here are my working assumptions on our health care proposal:
1. That most of what we propose is unlikely to become
law, which means our proposal should be a symbolic
political document rather than a serious, comprehensive
policy proposal.
2.
That whatever we propose should try to help repair
some of the damage done by the successful
misinformation campaign of the previous two years.
3. That whatever we propose should be exceedingly simple,
since what we suffered from the most last year was
complexity.
4.
That what we propose should be an effort to develop
some themes we can build on in running for re-election and
in trying to pass more serious health care reform in 1997 if
we and Democratic Congressional majorities win the '96
elections.
WHAT WE SHOULD DO
Given the above assumption, I think we should propose a short
number of symbolic, easy to understand changes in the current
system that highlight what's wrong and, in some cases, serve as
potential "wedge" edges against the Republicans. Two suggestions
I have for these symbolic wedge issues:
1. Require firms who offer health insurance to offer a fee-for-
service plan/require HMOs to have a point of service option.
What people feared most about health reform in 1993-94 was that
it would take away their choice of doctor. Let's highlight this
issue, and become the biggest champion of guaranteeing choice of
doctor. This is a wedge issue, because the Republicans would
never pass it due to opposition from business and the managed
care industry. Let's make them explain why they don't want to
guarantee choice of doctor. I know business and the managed care
industry won't like this, but they are going to stay very close
to the Republicans this year anyway.
2. Strengthen consumer protection provisions, especially for
managed care. Again, it's us fighting for the consumer, and
again, the GOP would never pass it. In a changing health care
environment, people fear being abused by the system.
In addition to those kind of visible issues that highlight
looking out for the consumer, I would:
3. Tax cigarettes to pay for two things: a) subsidies for
home/community based care, and b) 100% deduction for the self-
employed. The Cigarette tax is the only popular tax there is,
and the two things I mentioned are both extremely popular and
important to key constituencies (seniors/disabled and small
business). And if the Republicans do anything on health care, it
will include the self-employed deduction, so we might as well
take credit for it.
4. Do very modest insurance reform: portability and pre-
existing conditions. Let's keep it very simple, very modest,
easy to remember. Republicans will probably propose this too, so
again, we might well take credit for it. And it's a symbolic
issue that highlights what's wrong with the current system,
hopefully helping us set the stage for the future.
I wouldn't do much more than that. I really believe that short
and simple is the way to go for this year, although I hope there
is some rhetoric in the State of the Union about how these are
only first steps toward solving the problem, which can never be
solved without universal coverage. This package is a short list
of easy to understand, highly symbolic and extremely popular
issues that appeal both to swing voters and the Democratic base.
WHAT WE SHOULD AVOID
In general, here are the things I feel we should definitely not
do:
1.
Propose some sort of "son of mainstream" proposal. The
mainstream proposal was too complicated, probably has even less
support in the new Congress than it did in the old one, and--
based on last year's experience--will be violently opposed by
both Democratic base groups and most of the business community.
The only political plus I see is that a few inside the beltway
pundits might praise us for being thoughtful and moderate. My
feeling is that we win "moderate points" by proposing something
modest, and should try to score politically by proposing some
things middle class voters can understand and where they see a
benefit to themselves.
2. Tort reform. I won't go into detail on some of the obvious
reasons not to do this, other than to point out that business is
going to be very cozy politically with the new Congressional
leadership. Conventional wisdom does not give us very good odds
on winning re-election, and we are going to have to rely very
heavily on old friends for support in the next two years.
3. Large-scale Medicare cuts. Protecting Medicare is one of
the few cutting issues we have in the coming
legislative/electoral cycle, and I would hate to sacrifice it as
an issue. In the last cycle, our deep cuts in Medicare, even
though they went to pay for popular new programs, were one of the
things most damaging to us. Even with new long-term care and
prescription drug programs, we never recovered support among
seniors because of the scare we produced with the large Medicare
cut numbers. I would be against any Medicare cuts, but if we
have to do it, please keep it modest.
Best of luck to all of you working on this issue. I know that
you're getting tons of advice, and whatever you do will probably
displease most people, so keep your spirits up.
Distribution:
Harold Ickes
Alexis Herman
George Stephanopoulos
Carol Rasco
Bob Rubin
Gene Sperling
Ira Magaziner
Chris Jennings
Melanne Verveer
Marilyn Yager
EXECUTIVE OFFICE OF THE PRESIDENT
05-Dec-1994 08:35am
TO:
Linda J. McLaughlin
FROM:
Marilyn Yager
Office of Public Liaison
CC:
Jennifer L. Klein
SUBJECT: Response on Meetings
Got your e-mails about:
1).
I will respond to the request from the Business Coalition
for Affordable health Care (Kevin Kearns) after I have seen the
request letter.
2).
I arranged for Chris Jennings to do the Bob Fiondella with
Phoenix Life Meeting. Bob definitely did not need to do this
meeting -- I ran it by you becaus I thought Bob knew him. We are
all set.
3).
Bob should not meet with the New York Hospital folks (jack
Rowe) before Christmas. Those hospitals are represented by the
American Hospital Association and the AAMC (represent the academic
medical centers), and both of these groups are coming in next week
for meetings. We should not be doing individual hospitals or
state hospital groups before we get all of the other must do group
meetings done. I know Ken Raske with Greater New York Hospital
Assn (HANYS) well, as well as the VP for Government Relations at
Mt Sinai and would be glad to call them both to indicate that "we
would like to do the meeting but due to all the budget meetings,
it will be difficult to schedule before the Holidays." Let me
know if you want me to handle.
4).
The next meeting I have scheduled for Bob is the HIAA
meeting on December 16 at 11:00am in Room 472.
5).
Did you schedule a meeting for Tony Burns and BRT tomorrow?
December 1994
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
Michigan
Healthcare
Roundtable
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
November 1994
January 1995
S M T W T F S
S M T W T F S
1 2 3 4 5
1 2 3 4 5 6 7
6 7 8 9 10 11 12
8 9 10 11 12 13 14
13 14 15 16 17 18 19
15 16 17 18 19 20 21
20 21 22 23 24 25 26
22 23 24 25 26 27 28
27 28 29 30
29 30 31
11/17/1994
January 1995
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Barnara to do memo to Lavel
Washington, D.C.
Assn Maternal & Child Health State Dir Mtg
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
California
Hospital Assn
wash, D.C.
Chris J. to do
Leon to do
American Hospital Assn Annual Mtg
December 1994
February 1995
S M T W T F S
S M T W T F S
1 2 3
1
2
3
4
4 5 6 7 8 9 10
5 6 7 8 9 10 11
11 12 13 14 15 16 17
12 13 14 15 16 17 18
18 19 20 21 22 23 24
19 20 21 22 23 24 25
25 26 27 28 29 30 31
26 27 28
12/1/1994
February 1995
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
American
Hospital Assn
Annual Mtg
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Group Health
Assn of
America
January
March
S M T W T F S
S M T W T F S
1 2 3 4 5 6 7
1
2
3
4
8 9 10 11 12 13 14
5
6
7
8
9
10
11
15 16 17 18 19 20 21
12 13 14 15 16 17 18
22 23 24 25 26 27 28
19 20 21 22 23 24 25
29 30 31
26 27 28 29 30 31
12/1/1994
March 1995
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
5
6
7
8
9
10
11
Employers
Washington
Council on
Business
Flexible
Group on
Compensation
Health
Conf.
12
13
14
15
16
17
18
Assn. of
Maternal &
Child Health
Prog Conf.
American Rehabilitation Assn.
19
20
21
22
23
24
25
26
27
28
29
30
31
February
April
S M T W T F S
S M T W T F S
1
2
3
4
1
5 6 7 8 9 10 11
2 3 4 5 6 7 8
9 10 11 12 13 14 15
12 13 14 15 16 17 18
16 17 18 19 20 21 22
19 20 21 22 23 24 25
23 24 25 26 27 28 29
26 27 28
30
11/17/1994
April 1995
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
St Anthony
Consult Grp/
Healthcare
Symp.
30
March
May
S M T W T F S
S M T W T F S
1
2
3
4
1
2
3
4
5
6
5 6 7 8 9 10 11
7 8 9 10 11 12 13
12 13 14 15 16 17 18
14 15 16 17 18 19 20
19 20 21 22 23 24 25
21 22 23 24 25 26 27
26 27 28 29 30 31
28 29 30 31
11/17/1994
Updated
December 1, 1994
PENDING HEALTH CARE REQUESTS
1.
Association of Maternal and Child Health Programs
Catherine A. Hess, Executive Director (Individual Group
Meeting)
TO DO
2.
National Association of Medical Equipment Services
Marilyn
Walt Patterson (Individual Group Meeting)
Discuss: Medical equipment supplies provision
Cost of living adjustments and revenue substitute
measures
OFFICE OF PUBLIC LIAISON
THE WHITE HOUSE
ROUTE SLIP
TO:
ACTION:
Jennifer
Please Call/Write
For Your Information
Go Ahead, Schedule
Request
We Have Acknowledged
We Are Holding For
Future Scheduling
Your Call (No
Recommendation)
FROM:
DATE:
Marilyn Yager
Barbara Woolley
6X2930
REMARKS:
GENERAL ACKNOWLEDGEMENT OF HEALTH CARE LETTER
Dear:
Thank you for writing about health care reform. Few issues
are of greater importance to the lives and well-being of
Americans.
As you know, Congress was unable to pass health care
legislation this year. We are pleased, however, that we have
come further than ever before in the effort to reform our health
care system. We look forward to continuing our efforts to make
health security a reality for the American people.
Again, I appreciate hearing from you.
GENERAL ACKNOWLEDGEMENT OF HEALTH CARE LETTER FOR SUPPORTIVE
GROUPS
Dear:
Thank you for writing about health care reform. Only with
the support and hard work of organizations like (insert
organization's name) will we give health security to those
millions of Americans who lack health insurance or the millions
who risk losing it.
As you know, Congress was unable to pass health care
legislation this year. We are pleased, however, that we have
come further than ever before in the effort to reform our health
care system. We look forward to continuing our efforts to make
health security a reality for the American people.
Again, I appreciate hearing from you.
REGRET REQUEST LETTER
Dear:
Thank you for your request to meet with (insert name) to
discuss (insert issue) We welcome your interest in the health
care reform initiative, however, we regret that (Rasco/Rubin)
schedule does not permit her/him to meet with you at this time.
We appreciate your efforts to contribute to the debate on
health care reform. Thank you again for your letter.
Revised
11/22
SCHEDULING CALENDAR
DATE/TIME
BOB'S MEETINGS
CAROL'S MEETINGS
November 14
Senior Groups
10-11 am
November 14
Families, USA
3:30 - 4:30pm
November 15
Nat. Assn. of Home Care
1:00 - 2:00 pm
November 15
Nurses
3:00 - 4:00 pm
November 17
Business Allies (lobbyists)
4:00 - 5:00 pm Room180
November 21
Consortium of Citizens with
3:30 - 4:30 pm Rm. 476
Disabilities
November 21
Insurance Allies
2:15-3:15 pm Rm. 230
November 22
NARD/NACDS
2:00 pm - 3:00 pm Rm 472
Chris
November 22
Group Health Assn. of Am
4:00 - 5:00 pm Rm 476
Chrus
November 29
Physician Groups
1:00 - 2:00pm Rm 472
Jennifer
November 29
Allied Health - Mental
2:00 - 3:00pm Rm 476
health, NASW, substance
abuse Jennifer
November 30
Pharmaceutical Manufacturers
10:00 - 11:00am Rm 476
Assn Chns
December 2
Nat. Leadership Coalition on
10:00 - 11:00am Rm 476
Health Reform (Simmons
Group) Gene
December 2
General Base
1:00 - 2:00pm Rm476
Jennifer
December 5
Alliance for Managed Care
3:00 - 4:00pm
Jennifer
December 9
Small Business Coalition
3:30pm - 4:30pm, Rm
Chris
December 13
AHA
11:00- 12:00noon
Chris
December 13
Blue Cross/Blue Shield
4:00pm-5:00pm
December 14
AMA
1:00 - 2:00pm
Jennifer
December 15
Veterans Groups
11:00 - 12:00noon, Rm 180
Jennifer
December 16
HIAA
11:00 - 12:00noon Rm 472
Chris
Yet to be scheduled:
Hospitals Group Mtg (reschedule)
Labor (reschedule)
NAM (Alexis)
Alexis Chamber of Commerce/NFIB (Alexis and Erskine)
Atkins Group (Caren )
General Small Business (Sm. BUs. United, etc.) (Erskine, Lader)
A lesses African American Groups (Herman)
Women's Groups (Rasco)
Farm Groups
Military Coalition
Hispanic
Religious
Federal Employees
November 18, 1994
MEMORANDUM FOR CAROL RASCO
FROM:
Debbie Fine, Office of Public Liaison
SUBJECT: Meeting with Consortium of Citizens with Disabilities
DATE/TIME:
Monday, November 21, 1994
3:30PM to 4:30PM
LOCATION:
Room 476, OEOB
BACKGROUND:
As you know, health care reform is a top legislative priority for
people with disabilities. The current health care system provides a
strong disincentive for employment for people with disabilities, who
are either not hired because of the insurance 'risk' they pose or who
may choose not to work because they fear losing the health benefits
they now get through Medicaid.
Issues to Highlight
The aspects of comprehensive reform that were most important to
the disability community in the recent health care debate were:
universal coverage with no pre-existing conditions and no life-
time limits;
a defined comprehensive benefits package;
home and community-based long-term care with personal
assistance services; and
state single payer option.
Health Care Activity
The disability community was very active in the health care debate
and was eventually strongly supportive of the administration's
approach to reform, although initially much of the community was
more sympathetic to the single payer approach. I would note
starting in May, following a statement from the President at the
White House to representatives of the community, the level of
activity markedly increased to the point where the disability
community became leaders of the allied coalition's efforts in the
debate in many ways.
I would also note here that the coalition that funded and organized
most of the activity was called Real Health Care For All. This
coalition was predominantly funded by Justin Dart (attending this
meeting), and consisted of the CCD grassroots network in addition
to local disability rights activists in every state.
Consortium of Citizens with Disabilities (CCD)
CCD is a Washington based coalition of over 100 national
consumer, advocacy, provider and professional organizations, which
advocates on behalf of people of all ages with physical and mental
disabilities and their families. CCD's Health Task Force provided
most of the substantive analysis for the disability community during
the health care reform debate, and their Ad Hoc Grassroots
Committee (eventually merging into the Real Health Care For All
Coalition) organized a program to educate and activate the
grassroots.
From a political perspective I would note that there is not one
existing organization that is recognized as representing all people
with disabilities and there is not a clear hierarchy as in many other
constituency groups. CCD, as an umbrella coalition, comes the
closest to playing that role.
Additional Political Background
Leaders in the disability community are currently assessing
strategies to pursue in light of both the present political climate and
of their increasing strength as a political force. Although the
community has traditionally had good relationships with both
Democratic and Republican Members of Congress, they are worried
about attacks on existing programs and legislation affecting people
with disabilities (particularly the ADA), in addition to the future of
health care reform. As a result of the elections last week, they now
need to step back and educate the new Members on a more basic
level about disability issues.
PARTICIPANTS: Consortium of Citizens with Disabilities (CCD)
Allan Bergman, Co-Chair Long Term Services Task Force and
Director of State-Federal Relations for the United Cerebral
Palsey Association
Justin Dart, former Chair of the President's Committee on
Employment of People with Disabilities; Co-Chair of Real
Health Care for All Coalition
Martha Ford, Co-Chair of the CCD Long Term Services Task Force
and Assistant Director of the Arc
Joseph Manes, Co-Chair of CCD Long Terms Services and Director
for Government Relations for Bazelon Center for Mental
Health
Paul Marchand, Chair of CCD and Director of Government Affairs
at the Arc
Kathleen McGinley, Co-Chair of CCD Health Task Force and
Assistant Director of the Arc
Christina Metzler, Co-Chair of CCD Long Term Services Task
Force and Senior Legislative Representative at American
Occupational Therapy Association
Rebecca (Becky) Ogle, Co-Chair of CCD Rights Task Force; Co-
Chair of Real Health Care for All Coalition and Director of
Project Accessability at NAMES
Janet O'Keeffe, Co-Chair of CCD Health Task Force; Acting
Director of Public Policy Office and Assistant Director for
Public Interest Policy at American Psychological Association
Peter Thomas, Co-Chair of CCD Health Care Task Force
Tony Young, Co-Chair of CCD Long Term Services Task Force and
Director of Residential Services for the American
Rehabilitation Association
Staff
Carol Rasco
Jennifer Klein
Marilyn Yager
Debbie Fine
Bob Sevigny, Deputy Director of Public Liaison at DNC
AGENDA/TALKING POINTS:
Introductions
Thank them for coming and for their tremendous work and
active support for the Health Security Act.
Overview Comments
1. Briefly comment on the administration's legislative/policy
priorities for the coming year.
2. Describe/comment on the new health care team structure.
3. Describe the process you anticipate for outreach, in
addition to the time-frame for decision-making, to the extent
you are comfortable.
4. Open it up for discussion, reiterating that the purpose of
this meeting is to listen and learn from them.
(NOTE: As indicated on previous memoranda, CCD is
prepared to (1) give their assessment of the new political
environment and its impact on reform; (2) describe what, if
any, incremental reform they would support and which
incremental reforms they feel would be detrimental; (3) de-
brief on what they have learned about the capabilities of
their own membership from the last two years, in addition to
which reforms would find support on the grassroots level and
which would not.)
Can't be small market reform (100 or less) Need insurance reform
Need Public education
be Clear about who you are helping
be clear about what you are doing and not doing
Carol - - look at this as consumer education
Managed care protection
87d benefit package - use FEHBP with some modifications e.g. durable
medical equipment
Congenital conditions - problem w/ FEHBP
not nu. mandated, but expected to offer
what does this mean?
Medicard waiver program
should address needs of vulnerable
populations e.y disabled children, should address specialized care)
yurckeepers
31915 b protections don't necessarily apply to 1115 waivers
support tax credits for working people who cover own
Oppose Products tax credits for LTC insurance - they exclude expenses certain groups, bad
WHITE HOUSE OFFICE OF PUBLIC LIAISON
BRIEFING MEMORANDUM
TO:
Bob Rubin
FROM:
Caren Wilcox
DATE:
November 17, 1994
BRIEFING:
Business Allies for Health Care
DATE/TIME:
Thursday, November 17, 1994
4:00 pm - 5:00 pm
LOCATION:
Room 476, OEOB
AGENDA:
* Introductions
*
Thank them for coming and for their work and
support for the President's health reform
principles.
*
Overview Comments:
1. Comment briefly on the broader Administration
priorities for next year, i.e. welfare reform,
trade etc.
2. Comment on the new health care team headed by
you and Carol Rasco.
3. Describe how we plan to proceed on health
care, i.e. meetings with allies and key health
players before any decisions are made.
4. Indicate we are using the next three to four
weeks to listen and learn from our allies, hence
the purpose of this meeting.
NOTE: You are likely to be asked whether we are
planning to propose health care reform as part
of our FY96 budget.
The most important message we can send, is that
we wish to have frank discussions with friends
and allies about our current thinking and hear
their views from their companies' perspective,
and their opinions about political realities of
health care reform.
BACKGROUND:
The groups and companies represented here all
supported the five principles of the president's
health care plan. Many of them still want
universal coverage and employer responsibility
because they offer coverage now for employees, and
know they are at a competitive disadvantage
against companies which do not cover employees.
Most are unionized companies.
They were unhappy with funding mechanisms in the
Mitchell bill which would have placed taxes on
their premiums or on them while not mandating that
competitors or other employers pay premiums for
employee insurance. They viewed this as an
incentive to drop coverage whenever possible. You
may wish to discuss cost containment with them as
well.
Some of these companies signed on initially
because of provisions related to early retirement.
I believe they realize that benefit is unlikely to
reoccur in this Congress. ERISA is also important
to many of these companies.
The list indicates the company or lobbying firm
these people represent.
PARTICIPANTS: Approximately 15 Representatives from
Associations and Corporations who are part of our
base group of business health care supporters.
See attached list.
ATTACHMENT:
List of attendees.
cc: Alexis Herman
Steve Hilton
Marilyn Yager
Chris Jennings
Gene Sperling
Letitia Chambers
Chambers Associates
Formed a coalition in support of the President's Principles.
Bill Sweeney
EDS
Dr. Henry Simmons
National Leadership Coalition
A combined group of business and labor who advocate health care
reform.
Peter Hernandez
American Iron and Steel Institute
Benjamin Boylston - former Human Resources V.P.
Bethlehem Steel Corp.
Larry Levinson - V.P.
Viacom
George Peapples
General Motors
William Wickert, Jr. - V.P.
Bethlehem Steel Corp.
Walter Maher - Health Care expert for Chrysler
Chrysler
Thomas Dennis - V.P.
Southern California Edison Company
Terry Straub - V.P.
USX Corp.
Anne Wexler
The Wexler Group
Put together a letter from numerous businesses in support of
employer responsibility.
Phil Schneider
NACDS
Helped form the Small Business Coalition. His large chain
drugstores benefitted from pharmaceutical buying formulas in our
former bill.
EXECUTIVE OFFICE OF THE PRESIDENT
14-Nov-1994 06:22pm
TO:
Rosalyn A. Miller
FROM:
Marilyn Yager
Office of Public Liaison
CC:
Jennifer L. Klein
SUBJECT:
Thank you notes
The following are the names and addresses for the "thank you for
coming" notes Carol wishes to send to the individuals we met with
today:
Monday, November 14, 10:00am Seniors Meeting
1).
John Rother, Director, Legislation and Public Policy
American Association of Retired Persons
601 E. Street, NW, A6-300
Washington, DC 20049
(also attending from AARP were Tricia Smith and Marty
Corry)
2).
Larry Smedley, Executive Director
National Council of Senior Citizens
1331 F. Street, NW
Washington, DC 20004-1171
(also attending from NCSC were Dan Schulder and Jon
Lawniczak)
3).
Steve McConnell, Senior Vice President, Public Policy
Alzheimer's Assn.
1319 F. Street, NW, Suite 710
Washington, DC 20004
(also attending from the Alzheimer's Assn. were Judy Riggs
and Mike Splaine).
4).
Debra Shollenberger
National Council on the Aging, Inc.
409 Third Street, SW
Washington, DC 20024
(Note: Debra was attending on behalf of Dan Thursz, and for
that reason she did not speak. She plans to share with Dan
and others at NCOA what was discussed, so that we may
continue the dialogue with them).
Monday, November 14, 3:30 pm meeting with Families, USA
1) .
Ron Pollack, Executive Director
1334 G. Street, NW
Washington, DC 20005
(also attending for Families, USA were Judith Waxman and
Phyllis Torda) .
EXECUTIVE OFFICE OF THE PRESIDENT
15-Nov-1994 05:08pm
TO:
Rosalyn A. Miller
FROM:
Marilyn Yager
Office of Public Liaison
CC:
Jennifer L. Klein
SUBJECT:
Thank You notes From Meetings
As my note to you yesterday indicated, following each meeting
Carol does I will forward the names and addresses for "thank you
for coming" notes. The names below cover the two meetings today:
1).
Tuesday, November 15, 1:00pm
Val Halamandaris
President
National Association for Home Care
519 C. Street, NE
Stanton Park
Washington, DC 20002-5809
(too many other Homecare staffers joined him to mention by
name)
2).
Tuesday, November 15, 3:00pm
Virginia (Ginnie) Trotter Betts, JD, MSN, RN
President
American Nurses Assn.
600 Maryland Avenue, SW
Suite 100W
Washington, DC 20024-2571
(joining Ginnie were Geri Marullo, Chris DeVries, & Cheryl
Peterson)
3).
Tuesday, November 15, 3:00pm
Glenda LeMaitre
Vice President, Greater Washington BNA
National Black Nurses' Association, Inc.
1511 K. Street, NW
Suite 415
Washington, DC 20005
4).
Patricia Tompkins
Immediate Past Vice President
National Black Nurses Association, Inc.
1511 K. Street, NW
Suite 415
Washington, DC
20005
EXECUTIVE OFFICE OF THE PRESIDENT
16-Nov-1994 08:56am
TO:
Rosalyn A. Miller
FROM:
Marilyn Yager
Office of Public Liaison
CC:
Jennifer L. Klein
SUBJECT:
Update on Health Meetings
I could not find Julie's name in the E-Mail system, so I am
sending this to you with the hope that she will see it. I wanted
to provide a quick update of what is scheduled for Carol:
Monday, November 21
3:30-4:30pm
Room 476
Consortium of Citizens with Disabilities
Tuesday, November 22 1:00-2:00pm
Room 476
Hospital Groups
Tuesday, November 22 2:00pm-3:00pm Room 472 (note room change)
Small Business Coalition
Tuesday, November 29 1:00pm-2:00pm Room 476
Physician Groups
As I discussed with Julie on Monday, I would appreciate having
another group of time slots for the first two weeks of December.
EXECUTIVE OFFICE OF THE PRESIDENT
16-Nov-1994 08:48am
TO:
Linda J. McLaughlin
FROM:
Marilyn Yager
Office of Public Liaison
CC:
Jennifer L. Klein
SUBJECT:
Business Health Meetings
1).
I will have the briefling paper and list of participants to
you by 5:00pm today for tomorrow's meeting at 4:00pm in Room 476
OEOB this is the the meeting with business health allies, it
will be a group of about ten lobbyists.
2).
I will not be using the time slot at 2:00pm on Friday,
November 18.
3).
The Insurance health allies meeting is now in place for
Monday, November 21 at 4:30pm. This will be a group of 10
insurance executives, including four insurance company CEOs. I am
prepared to move this meeting foward to 2:30pm, should we need to
per our earlier conversation.
4).
Group Health Association of America is tentatively
scheduled for Tuesday, November 22 at 4:00pm -- I shall firm that
up today.
5).
When you have a chance, I would appreciate three to four
more appointment time slots to be used between November 29 and
December 16. I know the Summit of the Americas falls in there,
but if we could do one more meeting before the summit and the rest
after that would be helpful. I am specifically looking for a time
on December 15, 16, or 21 for a meeting with HIAA they have
asked for one of those dates.
THE WHITE HOUSE
WASHINGTON
Marilyn following up
November 4, 1994
MEMORANDUM FOR JENNIFER KLEIN
MARILYN YAGER
FROM:
Rosalyn Miller
ram
SUBJECT:
Health Care Meetings
Carol has received requests to meet separately with two Arkansans
who have been long-time personal and professional friends both at
the state and federal levels. I list their names and ask for
guidance on the appropriate time for her to meet with them:
Walt Patterson (requested December 6 or 7)
(501) 374-4151
Sarah Shuptrine & Associates (requested December 5, 6, or 7)
2725 Devine Street
P.O. Box 5345
Columbia, SC 29250
(803)779-2607
My response to each of them was that Rasco and Rubin are not yet
ready to set up meetings on health care and when appropriate, the
health care scheduling staff would be in touch with them. I
await your responses.
Thanks.
November 3, 1994
MEMORANDUM TO CAROL RASCO, BOB RUBIN, AND ALEXIS HERMAN
FROM:
MARILYN YAGER
cc:
Chris Jennings, Jennifer Klein, Debbie Fine, Steve
Hilton, Ben Johnson, Mike Lux, Ira Magaziner, Janet
Murguia, Doris Matsui, Melissa Murray, Caren Wilcox,
Barbara Woolley
DISCUSSION OUTLINE FOR INTERIM ON HEALTH ACTIVITIES
I.
CLOSEOUT ACTIVITIES FROM LAST CONGRESS
A.
Thank you letter from the President to groups and
individuals (OPL - Barbara Woolley)
B.
Health Care additions to White House Holiday Card List
(OPL - Flo McAfee)
C.
Thank you Reception with the President and First Lady.
A reception has been scheduled for November 10 at
4:00pm in the State Dining Room. OPL health staff has
submitted a list to the Social Secretary's office for
invitations (OPL - Mike Lux).
II. 104TH CONGRESS PLANNING
A.
OPL health care staff liaisons are informally calling
contacts on health care to learn what they are hearing
from both their membership and around town.
B.
Tentative list for meetings has been compiled
(attached). This list of 22 meetings includes 'must
see' health care supporters, as well as key players in
the health care debate and groups who have requested
meetings. This is by no means to be viewed as an all-
inclusive list. As other requests come in they will be
handled accordingly.
C.
Schedule meetings (tentative schedule attached). .
1. I have contacted each OPL Health staffer with their
potential time slots and they will be making the
meeting arrangements and providing background
information prior to the meeting.
2. Either Chris Jennings or Jennifer Klein will staff
the meetings from a policy perspective and as
appropriate, include other staff.
3. We have tried to schedule key allies earlier in the
process than others. Although some meetings will need
to be individual group meetings, where possible
meetings will comprise several like-minded
associations.
D.
Meetings Agenda
1.
To listen to their thoughts prior to the beginning
of Administration policy and strategy development.
2.
More specifically to learn what forms of
incremental reform they would support, and what
incremental provisions would they oppose.
3.
Since many of these groups are allies it would
probably be helpful if the meetings were begun by
outlining the new health care structure at the
White House, and touching briefly on the other key
Presidential initiatives for the next Congress,
i.e., welfare reform, deficit reduction, etc.
E.
Followup to Consultative Meetings
1.
OPL health staff will summarize concerns expressed
at each meeting to circulate among appropriate
White House staff.
2.
OPL health staff will send thank you letters
(depending on who led the meeting) to each group,
thanking them for their input.
3.
OPL health staff will also follow-up with phone
call to each group indicating how helpful the
meeting was for the White House team.
These mtgs are not firm. Use for
1/3/94
internal planning purposes only!
SCHEDULING CALENDAR
DATE/TIME
BOB'S MEETINGS
CAROL'S MEETINGS
November 2
BRT Breakfast Meeting
8:00am
November
//To behanged.
AFL-CIO
1:30 pm
November 14
Senior Groups
10-11 am
November 14
Families, USA
3:30 - 4:30pm
November 15
Nat. Assn. of Home Care
1:00 - 2:00 pm
November 15
Nurses
3:00 - 4:00 pm
November 17
Business Allies (lobbyists)
4:00 - 5:00 pm
November 18
Insurance Allies
2:00 - 3:00 pm
November 21
Hospital Groups
3:30 - 4:30 pm
November 21
Group Health Assn. of Am
4:30-5:30 pm
November 22
Consortium on Disabilities
1:00 - 2:00 pm
November 22
Small Business Coalition
2:00 pm - 3:00 pm
November 22
ECFC, ERIC, APPWP
4:00 - 5:00 pm
November 29
Physician Groups
1:00 - 2:00pm
November 29
Allied Health - Mental
2:00 - 3:00pm
health, NASW, substance
abuse
Yet to be scheduled:
Pharmaceutical Man. of Am (Rubin)
HIAA (Rubin)
Alliance for Managed Care (Rasco or Rubin)
Simmons Group (Alexis) (gene)
NAM (Alexis)
Chamber of Commerce/NFIB (Alexis and Erskine)
Atkins Group (Caren )
General Small Business (Sm. BUs. United, etc.) (Erskine, Lader)
General Base (Rasco)
Women's Groups (Rasco)
AHA (Rasco)
AMA (Rasco)
THE WHITE HOUSE
WASHINGTON
October 25, 1994
MEMORANDUM TO CAROL RASCO, BOB RUBIN, AND ALEXIS HERMAN
FROM:
MARILYN YAGER
CC:
Chris Jennings, Jennifer Klein
DISCUSSION OUTLINE FOR INTERIM OUTREACH ON HEALTH
I.
CLOSEOUT ACTIVITIES FROM LAST CONGRESS
A.
Thank you letter from the President to supportive
groups and individuals (OPL).
B.
Health Care additions to White House Holiday Card List
(OPL).
C.
Thank you Reception with the President and First Lady.
A reception has been scheduled for November 10 at
4:00pm in the State Dining Room. OPL health staff will
submit a list to the Social Secretary's office by
October 28 for invitations.
II. 104TH CONGRESS PLANNING
A.
OPL health care staff liaisons are informally calling
contacts on health care to learn what they are hearing
from both their membership and around town.
B.
Tentative consultative list has been compiled
(attached). This list of 22 meetings includes 'must
see' health care supporters, as well as key players in
the health care debate. The breakdown for Carol and Bob
is seven meetings and six meetings respectively. The
rest are to be handled by the OPL health staff lead.
C.
Schedule consultative meetings (tentative schedule
attached).
1. We suggest beginning these meetings late next week
and spreading them over five weeks (A potential
schedule has been attached).
2. Either Chris Jennings or Jennifer Klein will staff
the consultative meetings from a policy perspective
and, where they deem it appropriate, they will include
other policy staff.
3. We have tried to schedule key allies earlier in the
process than others. Although some meetings will need
to be individual group meetings, where possible
meetings will comprise several like-minded
associations.
D.
Consultative Meetings Agenda
1.
To listen to their thoughts and recommendations
prior to the beginning of Administration policy
and strategy development.
2.
More specifically to learn what forms of
incremental reform they would support, and what
incremental provisions would they oppose.
3.
Since most of these groups are allies it would
probably be helpful if the meetings were begun by
outlining the new health care structure at the
White House, and touching briefly on the other key
Presidential initiatives for the next Congress,
i.e., welfare reform, deficit reduction, etc.
E.
Followup to Consultative Meetings
1.
OPL health staff will draft summary of
recommendations made at each meeting to circulate
among appropriate staff.
2.
OPL health staff will send thank you letters
(depending on who led the meeting) to each group,
thanking them for their input.
3.
OPL health staff will also follow-up with phone
call to each group indicating how helpful the
meeting was for the White House team.
F.
Requests for meetings with Bob or Carol from groups not
listed on the attached 'schedule.' We suggest
forwarding these to OPL Health staff for quick
recommendations: to either immediately schedule with
Bob or Carol, or schedule with Chris, Jennifer, Gene,
or Bill, or hold for later scheduling, or refer to OPL
staff to handle, or finally regret.
CONSULTATIVE MEETINGS
Summary of Suggested Leads - For the 22 meetings outlined below
the breakdown of meetings for Bob and Carol over the next five
weeks is: Bob - 7 mtgs; Carol - 7 mtgs.
Business:
Individual Business Allies (Lobbyists) Bob Rubin
BRT
Bob Rubin or Alexis
HIAA
Bob Rubin
Grp. Health Assn. of AM. Bob Rubin
Other Bus. (1 mtg)
Bob Rubin
ECFC, APPWP, ERISA Industry Comm.
Pharmaceutical Man.
Bob Rubin
Small Business Coalition Alexis Herman
Simmons Business Group
Alexis Herman
NAM
Alexis Herman
Chamber of Commerce/NFIB Alexis Herman
Atkins Group
Caren Wilcox
Gen. Sm. Bus. (1 mtg)
Phil Lader
Sm. Bus. United, Sm. Bus.
Legislative Council, etc.
Labor (One Meeting) :
Bob Rubin
AFL-CIO, AFSCME, SEIU, CWA,
UAW, Building Trades Council
Seniors (One Meeting) :
Carol Rasco
AARP, NCSC, NCOA, Alzheimers
Providers:
Hospital Groups (1 mtg) Carol Rasco
CHA, NAPH, NACHRI, AAMC,
Protestant
Physician Groups (1 mtg) Carol Rasco
ACP, AAP, AAFP, ACOG,
NMA, AMWA, NHPC, Redlener
Nat. Assn. of Homecare Carol Rasco
AHA
Marilyn Yager
AMA
Marilyn Yager
]
Carol to do
ANA & Black Nurses Assn. Marilyn Yager
Allied Health (1 mtg)
Skila Harris
NASW, Mental Health,
Substance Abuse
Base/Consumer Groups:
Families, USA
Carol Rasco
Consortium of Citizens
Carol Rasco
with Disabilities
Gen. Base (1 mtg)
Carol Rasco
Children's Defense Fund, AIDS
Action Council, Citizen Action
NFU, Nat. Council of Churches,
Religious Action
Women's Groups (1 mtg)
Melanne Verveer
AAUW, NARAL, League of Women
Voters, Women's Legal Defense
Fund
Suggested Five Week Timeframe
GROUP
BOB RUBIN,
POLICY STAFF
OPL STAFF
CAROL
Usually Chris
Although not
RASCO, OR
Jennings or
always noted
OTHER
Jennifer Klein
Marilyn Yager
will staff -
will staff as
they will
well, with
invite other
some
appropriate
exceptions.
staff
November 3 -
November 4
Families, USA
Carol
Mike Lux
Rasco
Small Business
Alexis Ersune,
Caren Wilcox
Coalition (resail pharm.)
Herman Carol
Individual
Bob Rubin
Alexis Herman/
Business Allies
Caren Wilcox
BRT
Bob Rubin
Alexis Herman/
or Alexis
Caren Wilcox
Herman
November 10 & 11
Labor - AFL-CIO,
Bob Rubin
Mike Lux
AFSCME, SEIU,
CWA, UAW,
Building Trades
Council
Nat. Assn. of
Carol
Debbie Fine
Homecare
Rasco
November 14 -
November 18
Senior Groups -
Carol
Mike Lux
AARP, NCOA, NCSC,
Rasco
Alzheimers
Simmons Business
Alexis
Caren Wilcox
Group
Herman
Atkins Group
Caren
Caren Wilcox
Wilcox
Hospital Groups -
Carol
Marilyn Yager
CHA, NAPH,
Rasco
NACHRI, AAMC,
Protestant
Physician Groups
Carol
Marilyn Yager
- ACP, AAFP, AAP,
Rasco
ACOG, NMA, AMWA,
NHPC, Redlener
AHA
Marilyn
Marilyn Yager
Yager
AMA
Marilyn
Marilyn Yager
Yager
ANA, Black Nurses
Marilyn
Debbie Fine
Yager
Allied Health -
Skila
Debbie Fine
NASW, Mental
Harris
Health, Sustance
Cavol
Abuse
Consortium of
Carol
Debbie Fine
Citizens with
Rasco
Disabilities
Women's Groups -
Melanne
Marilyn Yager
AAUW, NARAL,
Verveer
League of Women
Voters, Women's
Legal Defense
Fund
November 21 & 22
General Base
Carol
Marilyn Yager
Groups -
Rasco
Children's
Defense Fund,
AIDS Action
Council, Citizen
Action, NFU, Nat.
Council of
Churches,
Religious Action
Other Business -
Bob Rubin
Caren Wilcox
ECFC, ERISA
Industry
Committee, APPWP
November 28 -
December 2
NAM
Alexis
Caren Wilcox
Herman
Chamber of
Alexis
Caren Wilcox
Commerce/NFIB
Herman
African-American
Alexis
Ben Johnson
Groups - Black
Herman
Leadership Forum
HIAA
Bob Rubin
Caren Wilcox
Group Health
Bob Rubin
Caren Wilcox
Assn. of America
General Small
Phil Lader
Caren Wilcox
Business - Small
Business United,
Sm. Bus.
Legislative
Council, Assn.
for Self-Employed
Pharmaceutical
Bob Rubin
Marilyn Yager
Research and Man.
of Am. (formerly
PMA)
Jennifer
OCT 20 1994
OFFICE OF PUBLIC LIAISON
MEMORANDUM FOR ALEXIS HERMAN
From: Caren Wilcox
Subject: Options for Business Outreach for Health Care Reform
Date: October 18, 1994
BACKGROUND
You have requested a suggested process for business outreach for
health care over the next several months. In light of the fact
that the Business Roundtable is meeting on December 6 we should
be clear on our activities before then. (See their letter
attached.)
As we knew in the campaign and over this past year, many
businesses have been in this battle for reform for many years.
Mobilizing them to support reform, and getting their buy-in to
100 of the
Fortune 500
the process is the challenge.
Businesses, both formerly supportive and opposed, would like to
be consulted before a package is fully developed. As with most
other issues involving public policy and the private sector, they
want to feel that they have had real input to policy development,
before being presented with hard drafts of legislation which
cannot be changed significantly. Sophisticated business players
in this legislative game realize that they will not have all
their ideas accepted in the drafting game, but they expect a
certain number of them to be acknowledged, massaged and
developed.
There is certainly an opportunity for more of a buy-in from
certain companies and perhaps a few trade associations, if we
take into account this desire for participation and consultation.
Generally the business community, whether friendly or hostile,
appears to be expecting a fairly major initiative from the White
House on health care in the coming year. Several have called for
advice, or to seek input into what is being done here.
CURRENT POSITIONING OF PAST ALLIES
We have spoken to several organizations and individuals about
this interim period and next year.
Small Business Coalition for Health Care Reform - This group has
remained relatively intact, and is hoping for continued effort to
gain health care coverage for small businesses. They are seeking
opportunities to help us on other issues, such as urging members
to go to the White House Conference on Small Business in their
states etc. We must remember that the staffing for this group
comes from the drug stores, and that they were very interested in
our proposals on this subject.
National Leadership Coalition for Health Care Reform - This
group, most commonly identified with Dr. Henry Simmons, contains
many of our most hard core manufacturing supporters. They have
opinions of what they believe went wrong in the process, learned
a few lessons themselves, and have received a grant to conduct
grassroots meetings across the country with business people to
describe the need for universal coverage. Their focus is cost
containment and universal coverage.
Atkins Group - This group is in the process of determining
whether it should continue as a coalition. They are planning a
retreat in January to discuss strategy for next year. Their
issues are multi-state operations problems and ERISA pre-emption.
IBM which is a member of this group, is worried about its
reputation with the administration, and how much damage they
sustained in the end of the battle.
Various Companies - Several companies, such as American Airlines
are very anxious to continue the battle for universal coverage.
Others such as TRW want some dialogue, having opted out of an
effective process during the debate. Some large companies are
clearly warning of their need to drop coverage or are fearful
that others, including competitors will do so, placing them at a
competitive disadvantage.
PAST ADVERSARIES
Business Roundtable - The attached letter signed by Bob Winters
12/6 Meeting
of Prudential is indicative of where some of the insurers and
some of the large businesses remain - hostile and fearful.
in wash-
However, in the opinion of some representing BRT companies, there
Policy
Health
is room for movement among the more progressive companies.
Group
Prudential's representative in Washington, actually suggested a
meeting to discuss the future, but I did not express strong
interest in that. I understand that Mr. Winters may not continue
as chair of the BRT Health, Welfare and Retirement Income Task
Force, and may not continue as CEO of Prudential, given their
problems.
We have been urged to hold a meeting with some companies from the
BRT, so that the December meeting cannot take place with the
statement being made that the White House did not meet and seek
opinions.
ERIC AND APPWP - The Erisa Industry Committee and the Association
of Private Pension and Welfare Plans each had problems with the
Clinton bill, but were initially supportive of concepts. Their
current status is unclear, but will be explored.
ECFC - This group was opposed to the Clinton plan due to its
taxation of cafeteria plans, and was fearful of other aspects of
the organizational part of the bill. It is primarily made up of
benefits managers of large manufacturers, with a few other
companies such as Pepsico which clearly lead the way toward
opposition.
They have called, and asked what we would think of a meeting of
various business groups to determine what they can live with in
the future. I indicated that they should not look to us for
permission to meet, but had a long hard talk with them regarding
financing solutions, because that is the nub of business problems
of insuring the uninsured now.
U.S. Chamber/NFIB - These two groups are so closely allied with
the Republican Party, that they will probably follow whatever
path the Republicans choose to pursue.
National Association of Manufacturers - They have expressed an
interest in incremental reform including something for children,
insurance portability, "a start toward universal coverage" and
scaled back insurance reform.
However, their track record with the administration is such that
we need to remain cautious about their continuous use of many of
our legislative initiatives to develop new membership based on
critiques followed by promises to members to "save them from the
Clinton administration."
We understand that a few manufacturers did resign from NAM during
the health care debate, and I have been forthright with other
manufacturers about their being the losers to the retailers,
insurers and some of their other suppliers of services, instead
of more effectively influencing the debate in their favor.
Specialized Trade Associations - Dependent on the financing
formulas, and any adverse impact on certain industries of any
reform package, we may be able to attract quite a number of these
associations to a modified package.
HIAA - The Principal Financial Group and two or three other
companies in HIAA realize how counter productive their efforts
were. It may be possible to have a dialogue with some of them.
National Restaurant and Retailers - There are members in these
organizations with whom there could be dialogue, but the
associations themselves should not be expected to support much.
OPTIONAL RECOMMENDATIONS FOR IMMEDIATE OUTREACH
The structure for the outreach would include continuing business
constituency political outreach from OPL and, cooperatively with
appropriate business liaisons in various departments. OPL would
facilitate meetings and policy exploration discussions with
outside groups in coordination with individuals from the NEC and
DPC.
There are options as to the level and timing of outreach to the
business community, and the identity of those included in the
outreach. Possibilities include:
4. Convene a meeting of Washington representatives from
previous hardcore supportive companies. Ask their advice,
Bob
what they are hearing from staff on the Hill and from other
businesses. What kind of a new package would they like to
Figure out what
see?
wash reps wi
J2. Meet with helpful contract lobbyists on the past bill.
need to meil with
Ask their advice, what they are hearing from clients, Hill
and colleagues. What kind of a package do they think is
realistic? Wexles, Berman
Alexis
Lunuk Ask a few CEOs who were most visibly and continuously
supportive of the administration to meet with senior White
1. Luncheen use
House staff, and possibly the First Lady, after temperature
12/10 Gen't
taking meetings with their Washington Representatives.
Individuals such as Bob Crandall, Hank Barnette, David Hoag,
Bus. Supporters
Chuck Corry, Chuck Johnson, and Bob Eaton, and Paul Allaire
Luncheon in
come to mind.
N.Y. include
health
care
Kearly Meet with leaders of the Small Business Coalition for
2. Listening
Health Care Reform to determine their aspirations for a new
effort.
sessions
- suggestions
5. Next Meet with National Leadership Coalition for Health Care
we.ck- Cavin mtg
For groupings
Reform and discuss what they are hearing in the field at
their meetings and what they would like to see in a package.
3. 11/2 Policy Health
Wait
Group appid
6. Consider a meeting with the so-called Atkins Group, a
But if OK
key swing group in the business community, with very
by BRT -
influential members in the BRT. What elements of reform
w/ Harvld,
follow up.
would they like to see in a package? A number of their CEOs
got in
should be consulted after we determine where this group is
before
4. Marilyn will
going.
election
have generic
11/2 Policy Mty
Guidance from
schedule by
7. Following these meetings with many BRT companies,
identify next tier of BRT companies for meetings.
Monday start
week after
8.
8!Hoid
Consider small meetings with some friendly companies in
election.
unfriendly associations or industries.
Asse Havold 1 Joan
if it's a problem to
do this before the election
Work w/ Marilyn on 11st of people to meet w/ groups.
Charlevribean West mtg
9. Evaluate, dependent on package being developed, whether
meetings can be held with pharmaceutical companies, some
in
large insurers etc.
Roy Vagelos
10. Continue private dialogue with ECFC to determine the
results of their consultations, with other associations.
I believe the immediate next steps should include a meeting to
review these options, timing, calendar and structure for
coordination.
This meeting has been arranged for Friday, October 21 at 5 p.m.
in your office, following Mr. Panetta's meeting, and attendees at
this time include: Robert Rubin, Carol Rasco, Erskine Bowles,
Marilyn Yager, Sylvia Matthews and myself.
cc: Robert Rubin
Carol Rasco
Erskine Bowles
Marilyn Yager
Sylvia Matthews
attachment
The Business Roundtable
John D. One
1615 the N.W.
Chairman
Bule 1100
Washington, D.C. 20035-5810
Charles A. Cerry
(202) 878-1280 FAX (202) 488-3509
Coshairms
Samuel L. Maury
Richard J. Mahoney
Executive Director
Cachairmas
Robert C. Winters
October 6. 1994
Edgar &. Woolard. Jr.
Cochernes
TO: Members of the Business Roundrable Health
Walfare and Retirement Income Task Force
RE: Strategy
As the 103rd Congress winds down, we can claim a victory of sorts. We weren't
bit with the kind of bureaucratic restructuring of health care most of US oppose.
of course, WE also didn't achieve the kind of health care reform most of us
support.
The BRT is still committed to responsible health care reform - reform that
provides access to high quality, affordable health care to all Americans. The
administration's proposal went far beyond that, however. To the extent that the
Roundtable contributed to the defeat of the administration's proposal - and it is
casy to overstate how much impact we had - there were two reasons. First, WB
had prepared ourselves. The task force, and particularly our staffi, put in 1 lot of
time and effort. We thought through the alternatives and conditioned the Policy
Committee. Second, when the time came we acted decisively. Ido not believe the
second would have been possible without the first.
Now is the time to start preparing for the future which Eas beyond the failure of
this Congress to enact health care legislation This future has two Important
dimensions: federal and state.
At the state level, we face a lot of activity.
One influence will be the California
ballot initiative for a single payer plan. If that passes, or even falls narrowly, it will
energize the forces supporting 1 Canadian-style plan. Current Indications are that
we will come out better than that, but the election is still five weeks away.
2
Historically, the BRT has had difficulty marshalling efforts at the state level, with
some notable exceptions. We need to consider how much offort we should put
into state initiatives ourselves, versus looking to the staff-based organizations like
the Chamber and NAM.
At the federal level, special interests will receive a lot of blame for the gridlock,
with the Clintons leading the charge. I believe that the reality is somewhat
different. My version is that the mood of the country turned against big
government solutions and the politicians in Congress sensed it. I have enclosed
two items supporting that version: i Wall Street Journal column and notes from a
recent talk by CNN political analyst Bill Schneider.
Now is the time for us to start preparing for next year's battle in Congress. We
have about four months before things heat up again, and we should use that time
well. In 1994 we fought a defensive campaign against the administration's
proposal. We need to consider whether 1995 calls for offense, for working with
some kind of coalition to develop 1 position we can support.
We face important decisions at both the federal and state levels. I have asked the
staff to develop the information we need to make these decisions. However, until
THE know the outcome in California and the makeup of the House and Senate, sve
are not in a position to make definitive decisions. Thus, I sm cancelling the
November 2 Task Force meeting. and have asked the staff committee to schedule a
meeting soon after the elections. In the meantime, I would be interested in any
thoughts you may have on how we should move forward.
Our next BRT Task Force meeting is scheduled for Tuesday, December
Sob
Chairman, Health, Welfare and
RCW/jt
Retirement Income Task Force
Copies to:
Planning Committee