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Meetings [Folder 4]
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Meetings [Folder 4]
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Records of the Office of Legislative Affairs (Clinton Administration)
Steve Ricchetti's Files
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FOIA Number: 2018-0141-F
FOIA
MARKER
This is not a textual record. This is used as an
administrative marker by the William J. Clinton
Presidential Library Staff.
Collection/Record Group:
Clinton Presidential Records
Subgroup/Office of Origin:
Legislative Affairs
Series/Staff Member:
Steve Ricchetti
Subseries:
OA/ID Number:
5357
FolderID:
Folder Title:
Meetings [Folder 4]
Stack:
Row:
Section:
Shelf:
Position:
S
26
5
1
1
FOR DISCUSSION PURPOSES ONLY:
Week of 2/13: SENIORS
Sunday 2/13:
Monday 2/14:
Tuesday 2/15:
HRC addresses American Legion
(POTUS- Ohio (crim))
Wednesday 2/16:
POTUS/HRC Seniors Speech, Edison, New Jersey
[Possible drop by of long-term hospital] 2500-3000
[Also, letter writers at airport]
1:00p.m.
(15)
Thursday 2/17:
POTUS lunch with Senior Validators, White House
POTUS Roundtable interview with Senior press (9-10 pubs)
[Also, release announcement of White House Conference (dosh silvation)
on Aging]
HRC visits NIH - Alzeimers
Friday 2/18:
HRC at South Dakota Health Care Forum: IOWA $ Nebraska
invited
Saturday 2/19:
Radio Address--Theme??
(Wassan iri)
HRC health care event in Wisconsin--Seniors (also Obey F.R)
(Klexck) (Fingold kohl)
Week of 2/20: SENIORS
Sunday 2/20:
Monday 2/21:
Tuesday 2/22: [Day]
POTUS Prescription Drug Event, either VA or CT 444
Endorsements by National Association of Retail
Druggists and National Association of Chain Drug Stores
Wednesday 2/23:
POTUS visit to adult day care, local D.C.
Thursday 2/24:
[POTUS in Chicago--Jobs]
[Community Retail Pharmacy Health Care Coalition to
release report showing huge Medicare savings due to
prescription drug coverage]
Friday 2/25:
Saturday 2/26:
Radio Address--Theme?
Week of 2/27: INSURANCE CONTROL
Sunday 2/27:
Monday 2/28:
Tuesday 3/1:
Wednesday 3/2:
POTUS and HRC health care event, Kansas
[PTL to film on this date?]
POTUS and HRC RON, Oklahoma
Thursday 3/3:
POTUS and HRC health care event, Oklahoma
Friday 3/4:
Saturday 3/5:
Week of 3/6: PREVENTIVE CARE
Sunday 3/6:
Monday 3/7:
American Academy of Pediatrics Legislative Conference
Tuesday 3/8:
POTUS Travel: NY, PA, or CT (HRC can also travel)
PENNSYLVANIA OPTIONS:
*Bethlehem Steel
*Mezvinsky's district-cost-shifting, preventive
care, or women's health event
NEW YORK OPTIONS:
*IBM plant, East Fish Kill, NY (Fish's district)
10,500 employees or Poughkeepsie, NY (Fish's
district) 8,800 employees
*Corning, Corning, NY (Houghton's district)
6,000 employees
*Long-term care event, Bronx
(See model discussed in NYT, 2/14, page A1)
*Preventive care event, Manhattan
CONNECTICUT OPTIONS:
*Good seniors outside New Haven
*Preventive care, Bridgeport
*Big companies, Fairfield County
*Well-organized labor
*Insurance--counterscheduling Hartford
Wednesday 3/9:
"
"
Thursday 3/10:
"
"
Friday 3/11:
Saturday 3/12:
WEEK of 3/13:
Sunday 3/13:
Monday 3/14:
POTUS at Jobs Summit, Detroit
HRC Western Health Care Forum, Denver
National Association of Children's Hospitals in D.C.
(ask them to stay over to the 15th)
Tuesday 3/15:
POTUS in New Hampshire, economic event
Wednesday 3/16:
POTUS satellite time into targeted districts as mark-up
really gets under way
Thursday 3/17:
Friday 3/18:
Saturday 3/19:
Week of 3/20:
Sunday 3/20:
POTUS in FL for p.m. FR
Monday 3/21:
POTUS health care event, Florida
OPTIONS INCLUDE:
*University of Florida, Gainesville, 10,000 seats
*Pepper Institute on Aging, Tallahassee
*AARP sponsored senior event(Eckard Drugs also)
*Joe Dimaggio Children's Hospital, Hollywood
*Fraud event with Reno--discuss recent catching of
Delgado in Miami, charged with leading a $14
million Medicare fraud ring
Tuesday 3/22:
Wednesday 3/23:
Thursday 3/24:
Friday 3/25:
Saturday 3/26:
Week of 3/27: MORALITY OF HEALTH CARE/CRISIS (lead-in to Easter)
Sunday 3/27:
Monday 3/28:
POTUS Morality of Health Care speech to medical
students; Georgetown's Dahlgren Chapel
Coordinate CHA endorsement
Week of 4/3:
Sunday 4/3:
Easter Sunday
Non-date specific options in states not listed above:
*
CALIFORNIA:
Seniors:
Leisure World in Walnut Creek, CA
Miller's district
*
NIH event:
Varmus not yet sworn-in?
*
Independence, Missouri: The AARP is incredibly eager to do an event in the
home town of Harry Truman. Their best field operation in the country is in
this area. (Wheat's district)
*
Another women's health event?
*
NEBRASKA:
University seats 10,000
W
Senators and Congressman
Who have met with HRC
Members of Congress
Richard Gephardt (D-MO) 2/3, 2/16
Thomas Foley (D-WA) 2/16
Bob Michel (R-IL) 2/16
J. Dennis Hastert (R-IL) -2/16
Newt Gingrich (R-GA) 2/16
Fortney "Pete" Stark (D-CA) 2/23
Henry Waxman (D-CA) 2/23
Pat Williams (D-MT) 2/23
James McDermott (D-WA) 3/9
John Conyers (D-MI) 3/9
John Dingell (D-MI) 3/9
Ron Wyden (D-OR) 3/11
G.V. Montgomery (D-MS) 3/11
J. Roy Rowland (D-GA) 3/11
House Democratic Leadership 2/16
Womens Congressional Caucus 2/23
House Republican Leadership 2/16
Republican Leaders Task Force of Health 2/16
Congressional Black Caucus 3/2
Congressional Hispanic Caucus 3/2
Senators
George Mitchell (D-ME) 2/4
Jay Rockefeller (D-WV) 2/10, 3/11
David Durenberger (D-MN) 2/23
James Sasser (D-TN) 2/25
Don Riegle (D-MI) 2/25
Paul Paul Wellstone (D-MN) 3/2
Daniel Patrick Moynihan (D-NY) 3/11
Republican Senate Health Care Task Force 3/10
Women Senators 3/11
Health
Carl
F.4
06/17/93 13:57
202 456 7739
WHITE HOUSE
1
002/002
MEMORANDUM
TO: Hillary Rodham Clinton/Patti
June 16, 1993
FR: Chris J./Melanne
RE: Congressional Meetings we've discussed
CO: Steve, Jeff Eller, Distribution
Meeting
Purpose
Timeframe/Contact
Political Vetting
To reassess current
Sunday June 20th
with Steve R.,
political environment,
or Monday, 6/21
Chris J., Jerry K.,
timing advisability,
CHRIS J./ext 2645
Karen P., Stan G.,
legislative strategy,
Mandy G., Melanne,
consultation schedule, and
Jeff E., Steve E.
political implications of policy.
Senate/House Message
To respond to Daschle's
Tuesday afternoon
Meeting with
request for HRC to
or Wednesday
Mitchell, Gephardt,
meet with these Members
lunch. Contact:
and 10 other
to discuss "selling"
Debra Silimeo
Members
health care.
224-3232
Senate/House Policy
To get a policy/political
Thursday
June
24
discussion with
reads from our closest
Mitchell, Gephardt,
Congressional friends
Contact: Chris J
Bonier, Daschle,
from the leadership.
Pryor
(We need to invite Rockefeller
for his own briefing b/c HRC
promised an individual, substantive
meeting and because his presence --
and his staff agrees -- might
alienate Chairmen and others.
We should schedule the Rockefeller
meeting soon.)
Charlie Rose
To discuss the tobacco
As soon as
Meeting
tax and health reform
possible. Contact
Robin S. 225-2731
Senate Small Business
To respond to Sen.
Late in week of
Committee Meeting.
Bumpers request for
June 21st or
a bipartisan meeting
sometime the week
Lo discuss small
of June 28th.
business issues and
Contact: Rosi
health reform
Smith/224-4843
Bill Clay Meeting
To discuss impact of
Anytime within
health reform on Fed.
next 2-3 weeks.
Empl. health benefits
Contact: Gail
Weiss/225-4054
Managed Competition
Follow-up to Cooper
Week of June 28th
meeting
request
Caroline Chambers
PAGE. 001
NOV 10 '00 10:20 FROM our 202 450 2400
Office of the Vice President
TIPPER GORE'S OFFICE
Old Executive Office Building
Washington, DC 20501
FROM: Shile Harris
TO: Howard (202) 456-6640 Pader / Stere Ricchette
DATE: 11/16/93
number of pages:
COMMENTS: Here is a list of Congressional
tomorrows Health Care Percefing
Habinet Sporises attending
by Mrs Clinton / Mrs gore
-
NOV 10 '00 10:20 FROM our 202 450 2400
PAGE. 002
OFFICE OF THE VICE PRESIDENT
WASHINGTON, DC
DELORES
BEILENSON
CA.
- EVELYN BILIRAKIS
FLA.
CAROLYN HOBSON
OHIO
ROSEMARY KING
NY
SHIRLEY JOHNSON
TX
/
DORIS MATSUI
CA.
ELIZABETH PERKINS
NOV 10 '00 10:24 FROM our 202 450 2400
PAGE. 000
ACCEPTANCES - HEALTH CARE BRIEFING - 11-17-93
CABINET SPOUSES
1. Brown, Alma
Hattie Babbitt
2. Cieneros, Tunky Mary Alice
3. McLarty, Donna
Ellen Hart Pena
4. Riley, Anne - plus guest, Anne Riley Smith
BABenson
5. Tarloff, Erik
6. Schulman, Heidi
SENATE SPOUSES
Bennett, Joyce (Robert) UT-R
Bond, Carolyn (Christopher) MD-R
Breaux, Lois (John) LA-D
Brown, Nan (Hank) CO-R
Bryan, Bonnie (Richard) NV-D
Burns, Phyllis (Conrad) MT-R
Calautti (Conrad), Lucy (Kent) ND-D
Daschle, Linda (Thomas) SD-D
Domenici, Nancy (Pete) NM-R
Dorgan, Kimberly (Bryon) ND-D
Glenn, Annie (John) OH-D
Gregg, Kathy (Judd) NH-R
Hollings, Peatsy (Ernest) SC-D (Coming late)
Kempthorne, Patricia (Dirk) ID-R
Kennedy, Vicki (Edward) MA-D
Leahy, Marcelle (Patrick) VT-D
Levin, Barbara (Carl) MI-D
Leiberman, Hadassah (Joe) CT-D +quest
Lott, Tricia (Trent) MS-R
McConnell, Elaine Chao (Mitch) KY-R
Murkowski, Nancy AK-R
Pell, Nuala (Claiborne) RI-D
Pryor, Barbara (David) AR-D
Reid, Landra (Harry) NV-D
Reigle, Lori (Donald) MI-D
Rockefeller, Sharon (John) WV-D
Sasser, Mary (Jim) TN-D
Simon, Jeanne (Paul) IL-D
Simpson, Ann (Alan) WY-R
Smith, Mary Jo (Robert) NH-R
Wellstone, Sheila (Paul) MN-D
Wofford, Clare (Harris) PA-D
NOV 10 '00 10:24 FROM ovr 202 450 2400
PAGE. 004
HOUSE SPOUSES
Andrews, Debra (Thomas) ME-D
Applegate, Betty (Doug) OH-D
Barlow, Shirley (Thomas) KY-D
Bevill, Lou (Tom) AL-D
Bilbray, Michaelene (James) NV-D
Blackwell, Jannie L. (Lucien) PA-D
Brewster, Suzie (Bill) OK-D
Brooks, Charlotte (Jack) TX-D
Browder, Sarah (Glen) AL-D
Bryant, Jan (John) TX-D
Bryne, Larry (Leslie) VA-D
Chapman, Betty (Jim) TX-D
Coleman, Amy (Ronald) TX-D
Costello, Georgia (Jerry) IL-D
deLugo, Sheila (Ron) VI
Deutsch, Lori (Peter) FL-D
Dicks, Suzanne (Norman) WA-D
Dingell, Debby (John) MI-D
Dooley, Linda (Calvin) CA-D
Edwards, LeaAnn (Chet) TX-D
Filner, Jean Merrill (Bob) CA-D
Foley, Heather (Thomas) WA-D
Ford, Dorothy (Harold) TN-D
Hamilton, Nancy (Lee) IN-D
Hayes, Leslie (James) LA-D
Inslee, Trudi Ann (Jay) WA-D
Johnson, Suzanne (Don) GA-D
Kildee, Gayle (Dale) MI-D
Lantos, Annette (Tom) CA-D
Lipinski, Rose Marie (William) IL-D
Taliafero, Betsy (David Mann) OH-D
Blumenthal, Susan (Edward Markey) MA-D
McHale, Kathy (Paul) PA-D
Mineta, Danealia (Norman) CA-D
Neal, Landis (Stephen) NC-D
Obey, Joan (David) WI-D
Kirby, Laurie (Earl Pomeroy) ND-D
Rose, Joan (Charles) NC-D
Rowland, Luella (Roy) GA-D
Sangmeister, Doris (George) IL-D
Smith, Beatrix (Neal) IA-D
Spratt, Jane (John) SC-D
Waxman, Janet (Henry) CA-D
Williams, Carol (Pat) MT-D
Allard, Joan (Wayne) CO-R
Bateman, Laura (Herbert) VA-R
NOV 16 '93 19:25 FROM OVP 202 456 2490
PAGE. 005
Barrett, Elsie (William) NE-R
Castle, Mrs. Michael (Michael) DE-R
Charas-Gekas, Vangie (George Gekas) PA-R
Gilchrest. Barbara (Wayne) MD-R
Goss, Mariel (Porter) FL-R
Houghton, Priscilla (Amory) NY-R
Lewis, Marian (Tom) FL-R
Michel, Corinne (Robert) IL-R
Sanders, Jane (Bernard) VT-I
Thomas, Sharon (William) CA-R
Thomas, Susan (Craig) WY-R
Upton, Amey (Frederick) MI-R
Strickland, Frances (Ted) OH-D
Wyden, Laurie (Ron) OR-D
Levy, Tracy (David) NY-R plus guest, Pat
Tanner, Betty Ann (John) TN-D
Valentine, Barbara (Tim) NC-D
Pallone, Sarah (Frank) NJ-D
Hamburg, Carrie (Don) CA-D
Hughes, Nancy (William) NJ-D
Wise, Sandy (Robert) WV-D
Mollohan, Barbara (Alan) WV-D
Hefner, Nancy (Bill) NC-D
Thompson, London (Bennie) MS-D
McCurdy, Pamela (Dave) OK-D
Tucker, Robin (Walter) CA-D
Hall, Janet (Tony) OH-D
Santorum, Karen (Rick) PA-R
Glickman, Rhoda (Dan) KS-D
Roemer, Sally (Tim) IN-D
Horn, Nini (Stephen) CA-R
Knollenbery, Sandie (Joe) MI-R
Unerwood, Lorraine (Robert) GU-D
7-00 AUTRITOR
Extended Page
Huffington, Arianna (Michael) CA-R
Collins, Julie (Michael "Mac") GA-R
Walker, Desmar (Craig Washington) TX-D
Clement, Mary (Bob) TN-D
English, Jan (Glenn) OK-D
Rush, Carolyn (Bobby) IL-D
Shaw, Emilie (Clay) FL-R
Baker, Joanne (William) CA-R
Klein, Jacquline (Herb) NJ-D
Edwards, Edie (Don) CA-D
Fazio, Judy (Vic) CA-D
Johnson, Barbara (Tim) SD-D
Johnston, Mary (Harry) FL-D
Levin, Vicki (Sander) MI-D
Sabo, Sylvia (Martin) MN-D
Richardson, Barbara (William) NM-D
Minge, Karen (David) NM-D
MCMillan, Caroline (Alex) NC-R
Miller, Glenda (Don) FI-R
HOBSON, CAROLYN ( ) (OH-R)
NOU 16 '93 19:25 FROM OUP 202 156 2190
PAGE. 006
Watt, Eulada (Melvin) NC-D
Romero-Barcelo, Kate PR-D
Panetta, Sylvia OMB
Associates
Coughlin, Susan
DeWine, Frances
(R)
Murphy, Kathleen
** TOTAL PAGE. 006 **
MEMORANDUM
CHC -comphy was
TO: Hillary Rodham Clinton
March 10, 1993
FR: Chris Jennings
RE: Rockefeller, Montgomery, Rowland Veterans Meeting
CC: Melanne, Steve R., Lorraine M., Kim Tilley
After your meeting with the Women Senators, you are
scheduled to meet with the Senate and House Chairmen of the
Veterans' Affairs Committees, Senator Jay Rockefeller and
Congressman Sonny Montgomery. Also in attendance at the request
of Congressman Montgomery will be Congressman J. Roy Rowland, who
is on the House VA Committee and is a physician.
Attending this meeting with you will be Vick Raymond,
Secretary Brown's right-hand policy guy. Vick is Secretary's
staff designate to the Health Task Force and is participating in
the Work Groups.
BACKGROUND
One extraordinarily important political goal of any health
reform proposal is to design it in such a way that a vote against
the Clinton health reform initiative is a vote against veterans.
The veterans represent one of the strongest lobbying forces in
Washington and we need them on our side.
In the past, having the veterans on your side in health
reform meant that they had to be treated separate and apart from
the rest of the system. Now, there is growing recognition within
the VA advocates community that the very survival of special
services for veterans depends on the ability of the VA system to
play an important role within the context of entire system.
Having said the above, there is great nervousness that this
means that the VA and its providers will have to be totally
"integrated" into the system and that veterans may not receive
the type of special care to which they have become accustomed.
Moreover, there are still many interest groups within the
veterans community who are viscerally opposed to any significant
changes from the days of old.
Senator Rockefeller shares your belief that we must the
veterans' groups forward on this issue. However, since he just
became Chairman this year, he wants to make certain he has the
time to build enough credibility with the groups BEFORE he pushes
too hard publicly. He is working on building those relationships
now. One that he apparently has been very successful with is the
friendship he now has with Chairman Montgomery. They are very
close.
Senator Rockefeller's staff has expressed some frustration
that he has not been informed of the policy pronouncements that
Secretary Brown has been making before he has made them.
Although this is not a major problem and can likely be solved
with a meeting between the new Chairman and the new Secretary
(which is now being scheduled), it is somthing the Secretary may
be well advised to be more sensitive to.
Vick Raymond reports that he thinks that the Secretary is
open to even more innovative approaches to health reform than he
has been discussing with the press. Like Senator Rockefeller in
many ways, Vick believes that upside of the Secretary's
statements is that they serve the useful purpose of building up
credibility with these sometimes difficult groups. As Vick said,
Richard Nixon could go to China; perhaps Secretary Brown will be
able to later raise some difficult issues.
Vick prepared a short one page background on the Secretary's
position on reform, as well as a three page summary of the
Department. This information is attached for your review.
Chairman Montgomery, I believe, will be somewhat deferential
to Senator Rockefeller. He will want to hear how important you
feel that the VA and their advocates are part of the process.
Since Vick used to work for the Chairman, he is very comfortable
with who is at the table. As one of the few physicians in the
Congress, Congressman Rowland probably can be counted on to raise
the importance of having doctors in the process. Although you
addressed this at your meeting with him at Energy and Commerce,
he may well raise it again.
This meeting is very important, but I would guess that it
will not be difficult at all. Senator Rockefeller will make sure
it goes very smoothly.
MEMORANDUM
TO: Hillary Rodham Clinton
March 16, 1993
FR: Chris Jennings
RE: Meeting with Chairman Brooks
CC: Melanne, Lorraine, Steve, Kim Tilley
Tomorrow you are scheduled to meet with Congressman Jack
Brooks, Chairman of the Judiciary Committee. As you know, this
legislative body may be one of the "sleeper" Committees during
the health care reform debate. In attendance at this meeting
will be the Chairman's General Counsel, Jon Yarowsky.
BACKGROUND
The importance of doing something on malpractice and anti-
trust reform as a part of the reform initiative becomes more and
more self-evident as we continue our meetings on Capitol Hill.
Physicians and other health care providers will trade a great
deal for malpractice reform. Even more importantly, as you have
seen in your own meetings, this issue is of great importance to
almost every Republican and many conservative to moderate
Democrats. More recently, anti-trust roadblocks to health care
facilities' efforts to coordinate purchasing and utilization of
expensive medical equipment has been raised.
Of the two big issues that have Judiciary Committee
jurisdiction, the anti-trust reform issue appears to be, far and
away, the one of greatest interest and concern to the Chairman.
For years now, Congressman Brooks has been attempting to limit
the one industry (other than baseball) that has an exemption from
anti-trust laws the insurance industry. (As you know, the
McCarren Fergeson law provides this exemption; it has been cited
by the Chairman and others as an example of the unanticipated
problems that can emerge from poorly thought out anti-trust
exemption laws).
At this point, the Chairman believes he is very close to
passing his McCarren Fergeson limiting legislation. He is,
therefore, very sensitive to talk about any legislation that goes
in the exact opposite direction and could, in his opinion,
undermine his efforts to limit abuses by the insurance industry.
What he wants to hear is that you are aware of his legislation
and that you and the President would like nothing less than to
undercut his efforts in any way. In addition, he does not want
you to broadly say that it is important to exempt hospitals and
other purchasers from anti-trust laws.
The Chairman would accept, and be very open to, however,
hearing that narrowly drafted anti-trust exemptions are necessary
and important, as long as it is clear what any reform allows and,
more importantly, what it does not allow. Legislation that
follows that formula in another area and has been endorsed by the
President (the Production Joint Venture initiative) was
introduced last week by Congressman Brooks. He would love to
hear you make an analogy between that bill and any anti-trust
provisions that we would consider that would provide some room
for legitimate coordination agreements with facilities.
On the medical malpractice front, he and his staff believes
that there is very little empirical data to confirm that this
issue is the problem that the health care industry and its
advocates say it is. Having said this, they appear willing to
work with you on this legislation (understanding that perception
is reality and that so many Members are supportive of tort
reform) as long as it is not overly broad. He will want you
acknowledge that empirical limitations on this issue, but you
should be honest about the political problem and about the need
to have something that is perceived as "real." He will
appreciate such candor.
Lastly, Chairman Brooks may raise the issue of the
pharmaceutical industry's request to have a Justice Department
ruling that grants them a private letter of approval to negotiate
with the Administration on their voluntary price constraint
proposal. On this issue, my advice is to just listen and ask him
what he thinks about the need for such intervention by the
Department. In addition, you may want to discuss what, if any
other, anti-trust issues are relevant to cost containment
initiatives.
CONCLUSION
The above mentioned issues are complex and controversial.
To assist us in the front end (as well as hopefully after the
bill is introduced), we have invited Congressman Brooks' staff to
participate in the working groups. They have participated a
great deal already on the medical malpractice reform working
group and, starting later this week, they will be sending someone
else to our discussions about anti-trust issues. You may wish to
thank him for the use of his staff.
Lastly, attached for your information is some background
information on the anti-trust and medical malpractice issues that
were prepared by working group staff. The information is
summarized, but we hope you will find it useful.
MEMORANDUM
TO: Hillary Rodham Clinton
March 10, 1993
FR: Chris Jennings
RE: Thursday Meeting with Ron Wyden
CC: Melanne, Lorraine, Kim Tilley
In response to his invitation, you are scheduled to meet
with Ron Wyden (D-Oregon). Staffing him for this meeting will be
David Schulke, a well respected and former David Pryor Senate
Aging Committee staffer.
BACKGROUND
Congressman Wyden is well known in health reform circles.
He is very adept at picking hot topic health issues, moving
quickly to address them -- particularly through the press, and
introducing relevant legislation. In recent years, he has been
at the forefront of such issues as prescription drug cost
containment, long-term care private insurance standards, and
state flexibility. (All three of these issues have also been
strongly advocated by Senator Pryor).
During last year's effort by the House to achieve a
Democratic consensus on health reform, Congressman Wyden and
Congressman Synar attempted to play the mediator role between the
Gephardt/Stark government regulation approach and the
Cooper/Andrews/Stenholm managed competition approach. He
believes there is some middle ground and he wants to be one of
the Members who helps you find it. Although he will work closely
with Chairmen Dingell and Waxman, he views himself as a major
player as well and hopes you will treat him as one. Apparently,
FYI, he was very happy that you mentioned his name in yesterday's
meeting with the Energy and Commerce Committee.
LIKELY DISCUSSION
A number of issues may come during your discussion with
Congressman Wyden, including: (1) How best to talk about
revenues and recapture provisions, (2) How best to target
wavering Members and what Wyden's role can be in this regard; and
(3) the provision of state flexibility and, somewhat related, the
status of the Oregon waiver request. This visit is very
important to Congressman Wyden. If it turns out like I believe
it will, you will have another strong and helpful ally in the
House.
MEMORANDUM
TO: Hillary Rodham Clinton
March 16, 1993
FR: Chris Jennings
RE: Meetings with Conservative/Moderate Democrats
cc: Melanne, Lorraine, Steve
Last year, the House did not have anywhere close to a
sufficient amount of Democratic support to even consider a vote
on last year's Gephardt health care reform plan. One of the
major problems was that the moderate/conservative Democrats did
not feel it necessary or in their interest to sign on.
With the election of a new Democratic President, the
dynamics most definitely have changed. Having said this, as
evidenced by the conservative Democrats position on the
President's economic package, it cannot be assumed that these
Members will jump on board the President's health care reform
plan. If these Members can use the excuse that they have not
been consulted with or taken seriously, many may well not
hesitate to oppose the health reform proposal and offer an
alternative that a number of Republicans might find attractive.
With the above in mind, and even though I know how hectic
your schedule is, I believe it is in your and the President's
best interest for you to meet with the three conservative
Democratic membership organizations that have formed in the
House. Because of his experience with these Members, Dick
Gephardt strongly endorses this idea. The three groups are:
(1) the Budget Study Group -- (fiscal but generally not
social conservatives), Chaired by Congressman David Price
from North Carolina;
(2) the Mainstream Forum -- (perceive themselves to be
generally moderate, but frequently vote conservative),
Chaired by Congressman Dave McCurdy from Oklahoma; and
(3) the Conservative Democratic Forum -- (the most
conservative organized group in the House), Chaired by
Congressman Charles Stenholm from Texas.
Although there is some membership overlap on these groups,
particularly from the larger Budget Study Group, Melanne, Andie
King (from Gephardt's staff) and I believe that (unfortunately)
separate meetings are advisable. May we proceed and ask Patti to
start the process of scheduling these meetings?
MEMORANDUM
TO: Hillary Rodham Clinton
March 10, 1993
FR: Chris Jennings
RE: Thursday Meeting with Ron Wyden
CC: Melanne, Lorraine, Kim Tilley
In response to his invitation, you are scheduled to meet
with Ron Wyden (D-Oregon). Staffing him for this meeting will be
David Schulke, a well respected and former David Pryor Senate
Aging Committee staffer.
BACKGROUND
Congressman Wyden is well known in health reform circles.
He is very adept at picking hot topic health issues, moving
quickly to address them -- particularly through the press, and
introducing relevant legislation. In recent years, he has been
at the forefront of such issues as prescription drug cost
containment, long-term care private insurance standards, and
state flexibility. (All three of these issues have also been
strongly advocated by Senator Pryor).
During last year's effort by the House to achieve a
Democratic consensus on health reform, Congressman Wyden and
Congressman Synar attempted to play the mediator role between the
Gephardt/Stark government regulation approach and the
Cooper/Andrews/Stenholm managed competition approach. He
believes there is some middle ground and he wants to be one of
the Members who helps you find it. Although he will work closely
with Chairmen Dingell and Waxman, he views himself as a major
player as well and hopes you will treat him as one. Apparently,
FYI, he was very happy that you mentioned his name in yesterday's
meeting with the Energy and Commerce Committee.
LIKELY DISCUSSION
A number of issues may come during your discussion with
Congressman Wyden, including: (1) How best to talk about
revenues and recapture provisions, (2) How best to target
wavering Members and what Wyden's role can be in this regard; and
(3) the provision of state flexibility and, somewhat related, the
status of the Oregon waiver request. This visit is very
important to Congressman Wyden. If it turns out like I believe
it will, you will have another strong and helpful ally in the
House.
MEMORANDUM
TO: Hillary Rodham Clinton
March 10, 1993
FR: Chris Jennings
RE: Visit With Senator Moynihan
CC: Melanne, Steve R., Kim
Tomorrow at 4:45, you are scheduled to meet with Finance
Chairman Daniel Patrick Moynihan. Likely attendees at the
meeting will be Lawrence O'Donnell (Staff Director), Faye
Drummond (long-time health policy assistant), and Paul Offner
(Faye's staff counterpart and former Ohio Medicaid Director).
BACKGROUND
The Chairman has been one of our best friends on Capitol
Hill on a wide range of issues. He has basically stated that he
will support virtually any health care proposal the President
proposes. At the same time, he has expressed some reservations
that the issue is so complicated that it may take more time than
the President may think for the Administration to develop and the
Congress to digest a comprehensive health reform proposal.
Despite his reservations, the Finance Committee Chairman has
supported the Majority Leader's contention that health care
reform has its best chance for passage if it can be incorporated
into the reconciliation bill. Irregardless of what happens in
the budget process, Senator Moynihan -- if treated with the
respect that he deserves -- can be counted on to be helpful to
"set the stage" in terms of desirable hearings and statements.
On health care, Senator Moynihan is not a detail person. He
generally asks broad questions with broad implications, rather
than focusing on the many complexities of the health care issue.
The primary health oriented issues that he has previously
indicated some interest in include: (1) the inadequacy of mental
health and substance abuse coverage benefits, and its impact on
the homeless population, (2) state-based reform and need for
flexibility (he was the lead sponsor of a state-based managed
care initiative that was adamantly opposed by Henry Waxman), and
(3) the impact of any reform effort on New York's powerful,
influential and vulnerable hospital providers.
LIKELY DISCUSSION
The Chairman had to miss the last scheduled meeting with you
because he was sick. You may want to acknowledge this and ask
him how he is feeling. With Senator Moynihan, even more than
most Members, one cannot predict the topic of conversation. He
probably will want to make sure you are still on track with your
bill and to get a sense as to what direction you are headed.
More than anything, I believe, he will be more process oriented
and "big picture" oriented than most of your recent meetings.
MEMORANDUM CHC was
TO: Hillary Rodham Clinton
March 10, 1993
FR: Chris Jennings
RE: Rockefeller, Montgomery, Rowland Veterans Meeting
CC: Melanne, Steve R., Lorraine M., Kim Tilley
After your meeting with the Women Senators, you are
scheduled to meet with the Senate and House Chairmen of the
Veterans' Affairs Committees, Senator Jay Rockefeller and
Congressman Sonny Montgomery. Also in attendance at the request
of Congressman Montgomery will be Congressman J. Roy Rowland, who
is on the House VA Committee and is a physician.
Attending this meeting with you will be Vick Raymond,
Secretary Brown's right-hand policy guy. Vick is Secretary's
staff designate to the Health Task Force and is participating in
the Work Groups.
BACKGROUND
One extraordinarily important political goal of any health
reform proposal is to design it in such a way that a vote against
the Clinton health reform initiative is a vote against veterans.
The veterans represent one of the strongest lobbying forces in
Washington and we need them on our side.
In the past, having the veterans on your side in health
reform meant that they had to be treated separate and apart from
the rest of the system. Now, there is growing recognition within
the VA advocates community that the very survival of special
services for veterans depends on the ability of the VA system to
play an important role within the context of entire system.
Having said the above, there is great nervousness that this
means that the VA and its providers will have to be totally
"integrated" into the system and that veterans may not receive
the type of special care to which they have become accustomed.
Moreover, there are still many interest groups within the
veterans community who are viscerally opposed to any significant
changes from the days of old.
Senator Rockefeller shares your belief that we must the
veterans' groups forward on this issue. However, since he just
became Chairman this year, he wants to make certain he has the
time to build enough credibility with the groups BEFORE he pushes
too hard publicly. He is working on building those relationships
now. One that he apparently has been very successful with is the
friendship he now has with Chairman Montgomery. They are very
close.
Senator Rockefeller's staff has expressed some frustration
that he has not been informed of the policy pronouncements that
Secretary Brown has been making before he has made them.
Although this is not a major problem and can likely be solved
with a meeting between the new Chairman and the new Secretary
(which is now being scheduled), it is somthing the Secretary may
be well advised to be more sensitive to.
Vick Raymond reports that he thinks that the Secretary is
open to even more innovative approaches to health reform than he
has been discussing with the press. Like Senator Rockefeller in
many ways, Vick believes that upside of the Secretary's
statements is that they serve the useful purpose of building up
credibility with these sometimes difficult groups. As Vick said,
Richard Nixon could go to China; perhaps Secretary Brown will be
able to later raise some difficult issues.
Vick prepared a short one page background on the Secretary's
position on reform, as well as a three page summary of the
Department. This information is attached for your review.
Chairman Montgomery, I believe, will be somewhat deferential
to Senator Rockefeller. He will want to hear how important you
feel that the VA and their advocates are part of the process.
Since Vick used to work for the Chairman, he is very comfortable
with who is at the table. As one of the few physicians in the
Congress, Congressman Rowland probably can be counted on to raise
the importance of having doctors in the process. Although you
addressed this at your meeting with him at Energy and Commerce,
he may well raise it again.
This meeting is very important, but I would guess that it
will not be difficult at all. Senator Rockefeller will make sure
it goes very smoothly.
MEMORANDUM
TO: Hillary Rodham Clinton
March 16, 1993
FR: Chris Jennings
RE: Meeting with Chairman Brooks
CC: Melanne, Lorraine, Steve, Kim Tilley
Tomorrow you are scheduled to meet with Congressman Jack
Brooks, Chairman of the Judiciary Committee. As you know, this
legislative body may be one of the "sleeper" Committees during
the health care reform debate. In attendance at this meeting
will be the Chairman's General Counsel, Jon Yarowsky.
BACKGROUND
The importance of doing something on malpractice and anti-
trust reform as a part of the reform initiative becomes more and
more self-evident as we continue our meetings on Capitol Hill.
Physicians and other health care providers will trade a great
deal for malpractice reform. Even more importantly, as you have
seen in your own meetings, this issue is of great importance to
almost every Republican and many conservative to moderate
Democrats. More recently, anti-trust roadblocks to health care
facilities' efforts to coordinate purchasing and utilization of
expensive medical equipment has been raised.
Of the two big issues that have Judiciary Committee
jurisdiction, the anti-trust reform issue appears to be, far and
away, the one of greatest interest and concern to the Chairman.
For years now, Congressman Brooks has been attempting to limit
the one industry (other than baseball) that has an exemption from
anti-trust laws . the insurance industry. (As you know, the
McCarren Fergeson law provides this exemption; it has been cited
by the Chairman and others as an example of the unanticipated
problems that can emerge from poorly thought out anti-trust
exemption laws).
At this point, the Chairman believes he is very close to
passing his McCarren Fergeson limiting legislation. He is,
therefore, very sensitive to talk about any legislation that goes
in the exact opposite direction and could, in his opinion,
undermine his efforts to limit abuses by the insurance industry.
What he wants to hear is that you are aware of his legislation
and that you and the President would like nothing less than to
undercut his efforts in any way. In addition, he does not want
you to broadly say that it is important to exempt hospitals and
other purchasers from anti-trust laws.
The Chairman would accept, and be very open to, however,
hearing that narrowly drafted anti-trust exemptions are necessary
and important, as long as it is clear what any reform allows and,
more importantly, what it does not allow. Legislation that
follows that formula in another area and has been endorsed by the
President (the Production Joint Venture initiative) was
introduced last week by Congressman Brooks. He would love to
hear you make an analogy between that bill and any anti-trust
provisions that we would consider that would provide some room
for legitimate coordination agreements with facilities.
On the medical malpractice front, he and his staff believes
that there is very little empirical data to confirm that this
issue is the problem that the health care industry and its
advocates say it is. Having said this, they appear willing to
work with you on this legislation (understanding that perception
is reality and that so many Members are supportive of tort
reform) as long as it is not overly broad. He will want you
acknowledge that empirical limitations on this issue, but you
should be honest about the political problem and about the need
to have something that is perceived as "real." He will
appreciate such candor.
Lastly, Chairman Brooks may raise the issue of the
pharmaceutical industry's request to have a Justice Department
ruling that grants them a private letter of approval to negotiate
with the Administration on their voluntary price constraint
proposal. On this issue, my advice is to just listen and ask him
what he thinks about the need for such intervention by the
Department. In addition, you may want to discuss what, if any
other, anti-trust issues are relevant to cost containment
initiatives.
CONCLUSION
The above mentioned issues are complex and controversial.
To assist us in the front end (as well as hopefully after the
bill is introduced), we have invited Congressman Brooks' staff to
participate in the working groups. They have participated a
great deal already on the medical malpractice reform working
group and, starting later this week, they will be sending someone
else to our discussions about anti-trust issues. You may wish to
thank him for the use of his staff.
Lastly, attached for your information is some background
information on the anti-trust and medical malpractice issues that
were prepared by working group staff. The information is
summarized, but we hope you will find it useful.
MEMORANDUM
TO: Hillary Rodham Clinton
March 16, 1993
FR: Chris Jennings
RE: Meetings with Conservative/Moderate Democrats
CC: Melanne, Lorraine, Steve
Last year, the House did not have anywhere close to a
sufficient amount of Democratic support to even consider a vote
on last year's Gephardt health care reform plan. One of the
major problems was that the moderate/conservative Democrats did
not feel it necessary or in their interest to sign on.
With the election of a new Democratic President, the
dynamics most definitely have changed. Having said this, as
evidenced by the conservative Democrats position on the
President's economic package, it cannot be assumed that these
Members will jump on board the President's health care reform
plan. If these Members can use the excuse that they have not
been consulted with or taken seriously, many may well not
hesitate to oppose the health reform proposal and offer an
alternative that a number of Republicans might find attractive.
With the above in mind, and even though I know how hectic
your schedule is, I believe it is in your and the President's
best interest for you to meet with the three conservative
Democratic membership organizations that have formed in the
House. Because of his experience with these Members, Dick
Gephardt strongly endorses this idea. The three groups are:
(1) the Budget Study Group -- (fiscal but generally not
social conservatives), Chaired by Congressman David Price
from North Carolina;
(2) the Mainstream Forum -- (perceive themselves to be
generally moderate, but frequently vote conservative),
Chaired by Congressman Dave McCurdy from Oklahoma; and
(3) the Conservative Democratic Forum -- (the most
conservative organized group in the House), Chaired by
Congressman Charles Stenholm from Texas.
Although there is some membership overlap on these groups,
particularly from the larger Budget Study Group, Melanne, Andie
King (from Gephardt's staff) and I believe that (unfortunately)
separate meetings are advisable. May we proceed and ask Patti to
start the process of scheduling these meetings?
MEMORANDUM
TO: Hillary Rodham Clinton
March 24, 1993
FR: Chris Jennings
RE: Possible Meetings for Week of March 28th
CC: Melanne, Patti, Marge, Howard, Susan, Steve, Lorraine
Although this is probably one of the last things you should
have to think about, there is a great demand and need for
meetings with some key Members of Congress BEFORE the recess
begins at the end of next week. Although I could come up with a
much longer "wish list," I have tried to prioritize and narrow
the following meeting request list as much as possible:
Meeting and Purpose
Likely Time
1. House Leadership Meeting w/
Friday, April 2
Foley, Gephardt, Bonier,
9:00 am or some
Rostenkowski, Dingell, Ford
other early start
(To give final Leadership briefing
Contact: Andrea King
BEFORE recess and set up a process
225-0100, Chief of
for continuing consultation in April).
Staff.
2. Senate Leadership Meeting w/
Wednesday, March 31
Mitchell, Ford, Pryor, Daschle,
or Thursday, April 1
Kennedy, Moynihan, Rockefeller &
at HRC convenience.
Riegle. (Same purpose as House
Contact: John Hilley
meeting).
224-5556, Chief of
Staff.
3. Senate Finance Committee w/
The morning of
Members and Staff. This
Wednesday, March
meeting will have both Democrats
31st. (Should be
and Republicans). The purpose
BEFORE the Senate
of this meeting is to have direct
leadership meeting)
interaction with the primary Senate
Committee of jurisdiction BEFORE
Contact: Lawrence
recess -- much like we have already
O'Donnell, 224-4515,
done for the House Ways and Means and
Staff Director.
Energy and Commerce Committee.
4. House Education and Labor Committee
Tuesday, Wednesday,
with Democratic Members. (This is
or Thursday
the only one of the three primary
House Committees that did not get
Contact: Pat Rissler
an individual meeting with you).
225-4527, Staff
Having said this, Pat Rissler just
Director
told me it does not have to be next
week, but it needs to be scheduled right away.
Meeting and Purpose
Time
5. Ways and Means Subcommittee on
Tuesday morning?
Health. (Ira, Judy and Chris
went to the Thursday meeting, but
Contact: David
House votes precluded holding
Abernathy, Staff
the meeting). They urged us to
Director, 225-7787.
reschedule. IF you have no time,
perhaps we could send the Ira/Judy team?
6. Veterans Event. This has been on hold
Sometime in very
pending a meeting between Sec Brown
near future.
and you and/or Ira. Since Ira just
held meeting, we advise going ahead
Contact: Vic Raymond
and doing the event; Rockefeller's
523-1802
staff advises as soon as possible,
so that it is held early enough to make
groups feel invested. This could wait until
recess, however, unless you want Congressional Members there.
7. The House Mainstream Forum. Although
TUESDAY AFTERNOON:
you met with Cooper and his gang, the
5:30 pm.
Mainstream forum represents 50 plus
moderate to conservative Democrats
Contact: Jenny Estes,
who will be critical to passing
225-6165 (Cong.
the President's proposal this year.
Dave McCurdy, Chair).
(It would be good to meet BEFORE
these guys return home for recess to
say they have NOT been consulted).
This meeting may be able to be
combined with the Budget Study Group,
another moderate/conservative House group
with membership overlap with the Forum.
8. Congressional Republicans. They
Whenever, but before
are still complaining about how
the recess.
they are not being treated fairly.
Not that this proposed meeting will
Contact: Shiela Burke
change this much, but it will give
at 224-2105 and David
us an answer to their criticism.
Kehl at 225-0600.
Suggested attendees: Dole, Michel
and anyone else we can get them to
invite.
9. Kassebaum, Danforth, Burns, McCurdy
Would be nice to hold
and Glickman on their BIPARTISAN
this meeting before
health reform bill with premium
recess OR at least
caps. These three Senate
schedule it so they
Republicans are on our target list
know it is coming.
and we are finding it hard to meet
outside the cover of Dole. A
Contact: Jenny Estes,
meeting hosted by McCurdy gives us
225-6165.
this cover.
Meeting and Purpose
Time
10. House Leadership Invitational
To be determined and
to Democratic Members on Key
and arranged by
Committees in the House.
Majority Leader
This is to attempt to keep the
Gephardt.
Rank and File of the Committees
Informed. (Ira and Judy did one
Contact: Andie King
of these today). You don't have
225-0100
to do this unless you wish, but I
wanted you to know it is occurring.
11. Weekly Senate Democratic Policy
Thursday, at 1:00?
Meeting with Members. Ira and Judy
have been going for weeks now and
Contact: Greg
the meetings have been very
Billings, 224-3232
successful. You need not attend
this one.
12. Entire Congressional Caucus.
Wednesday, from
Dick Gephardt's office just called
8:00 to 9:00 am
to request a meeting with the
Contact: Andie
entire Democratic Caucus BECAUSE
King, 225-0100
he felt today's meeting with the
Members of the 3 primary Committees
went so well.
13. Meeting with Congressional Staff
Wednesday evening
in prepartation for House and Senate
as late as
Leadership meeting late in week.
necessary. Perhaps
from 8:00 to 10:00.
03/29/93 10:47 202 456 7739
WHITE HOUSE
$
001/007
Date: 3/29/93
Time: 10:45
THE WHITE HOUSE
FAX COVER SHEET
TO:
LORRAINE MILLER
X 2604
HOWARD PASTER
X 6220
STEVE RICCHETTI
X 2604
Phone:
(
)
FAX:
)
FROM: CHRIS JENNINES
Phone:
(202) 456-2645
Pages following cover sheet = 6
03/29/93
10:48
202 456 7739
WHITE HOUSE
1
002/007
The astensks (*) mark meetings that don't have
to take place. MEMORANDUM
If HRC cannot do meetings,
I think we should go cheed anyway.
TO: Hillary Rodham Clinton
March 24, 1993
FR: Chris Jennings
RE: Possible Meetings for Week of March 28th
CC: Melanne, Patti, Marge, Howard, Susan, Steve, Lorraine
Although this is probably one of the last things you should
have to think about, there is a great demand and need for
meetings with some key Members of Congress BEFORE the recess
begins at the end of next week. Although I could come up with a
much longer "wish list," I have tried to prioritize and narrow
the following meeting request list as much as possible:
Meeting and Purpose
Likely Time
Iral
1.
House Leadership Meeting w/
Howard
Foley, Gephardt, Bonigr,
on
Friday, April 2
9:00 am or some
Rostenkowski, Dingell, Ford
other early start
steve
(To give final Leadership briefing
Contact: Andrea King
BEFORE recess and set up a process
225-0100, Chief of
for continuing consultation in April).
Staff.
2. Senate Leadership Meeting w/
Wednesday, March 31
Mitchell, Ford, Pryor, Daschle,
or Thursday, April 1
Kennedy, Moynihan, Rockefeller &
at HRC convenience.
stare
Riegle. (Same purpose as House
Contact: John Hilley
meeting).
224-5556, Chief of
Staff.
3. Senate Finance Committee w/
The morning of
Members and Staff. This
Wednesday, March
Fra/Harand/
meeting will have both Democrats
31st. (Should be
steve
and Republicans). The purpose
BEFORE the Senate
of this meeting is to have direct
leadership meeting)
interaction with the primary Senate
Committee of jurisdiction BEFORE
Contact: Lawrence
recess -- much like we have already
O'Donnell, 224-4515,
done for the House Ways and Means and
Staff Director.
Energy and Commerce Committee.
4. House Education and Labor Committee
Tuesday, Wednesday,
with Democratic Members. (This is
or Thursday
*
the only one of the three primary
House Committees that did not get
Contact: Pat Rissler
an individual meeting with you).
225-4527, Staff
Having said this, Pat Rissler just
Director
told me it does not have to be next
week, but it needs to be scheduled right away.
03/29/93
10:48
202 456 7739
WHITE HOUSE
1
003/007
Meeting and Purpose
Time
5. Ways and Means Subcommittee on
Tuesday morning?
JealHared
Health. (Ira, Judy and Chris
went to the Thursday meeting, but
Contact: David
House votes precluded holding
Abernathy, Staff
the meeting). They urged us to
Director, 225-7787.
reschedule. IF you have no time,
perhaps we could send the Ira/Judy team?
6. Veterans Event. This has been on hold
Sometime in very
pending a meeting between Sec Brown
near future.
and you and/or Ira. Since Ira just
held meeting, we advise going ahead
Contact: Vic Raymond
*
and doing the event; Rockefeller's
523-1802
staff advises as soon as possible,
so that it is held early enough to make
groups feel invested. This could wait until
recess, however, unless you want Congressional Members there.
7. The House Mainstream Forum. Although
TUESDAY AFTERNOON:
you met with Cooper and his gang, the
5:30 pm.
Ira Judy
Mainstream forum represents 50 plus
moderate to conservative Democrats
Contact: Jenny Estes,
who will be critical to passing
225-6165 (Cong.
the President's proposal this year.
Dave McCurdy, Chair).
(It would be good to meet BEFORE
these guys return home for recess to
say they have NOT been consulted).
This meeting may be able to be
combined with the Budget Study Group,
another moderate/conservative House group
with membership overlap with the Forum.
8. Congressional Republicans. They
Whenever, but before
are still complaining about how
the recess.
Iral Hand
they are not being treated fairly.
Not that this proposed meeting will
Contact: Shiela Burke
steve
change this much, but it will give
at 224-2105 and David
us an answer to their criticism.
Kehl at 225-0600.
Suggested attendees: Dole, Michel
and anyone else we can get them to
invite.
9. Kassebaum, Danforth, Burns, McCurdy
Would be nice to hold
and Glickman on their BIPARTISAN
this meeting before
health reform bill with premium
recess OR at least
caps. These three Senate
schedule it so they
*
Republicans are on our target list
know it is coming.
and we are finding it hard to meet
outside the cover of Dole. A
Contact: Jenny Estes,
meeting hosted by McCurdy gives us
225-6165.
this cover.
03/29/93
10:49
202 456 7739
WHITE HOUSE
1
004/007
Meeting and Purpose
Time
10. House Leadership Invitational
to Democratic Members on Key
wed
To be determined and
and arranged by
Iralstine
Committees in the House.
Majority Leader
This is to attempt to keep the
Gephardt.
Rank and File of the Committees
Informed. (Ira and Judy did one
Contact: Andie King
of these today). You don't have
225-0100
to do this unless you wish, but I
wanted you to know it is occurring.
11. Weekly Senate Democratic Policy
Thursday, at 1:00?
Meeting with Members. Ira and Judy
Isalstane Isa
have been going for weeks now and
Contact: Greg
the meetings have been very
Billings, 224-3232
successful. You need not attend
this one.
12. Entire Congressional Caucus.
Wednesday, from
Dick Gephardt's office just called
8:00 to 9:00 am
Isa (Howsell
to request a meeting with the
Contact: Andie
stem
entire Democratic Caucus BECAUSE
King, 225-0100
he felt today's meeting with the
Members of the 3 primary Committees
went so well.
13. Meeting with Congressional Staff
Wednesday evening
Isc(stered
in prepartation for House and Senate
as late as
Leadership meeting late in week.
necessary. Perhaps
from 8:00 to 10:00.
03/29/93
10:49
202 456 7739
WHITE HOUSE
0
005/007
MEMORANDUM
TO: Howard Paster, Steve R., Lorraine M.
March 29, 1993
FR: Chris Jennings
RE: Health Care Meetings with Hill During Recess
CC: Melanne
On Friday and again today, Andie King made a strong push for
inviting House Committee Chairmen for meetings on the health care
reform proposal during recess. Howard, a heads up: She feels so
strongly about this that I believe that she may have Majority
Leader Gephardt call you up.
Andie has grave reservations about having the recess period
go by with no Member-level face-to-face discussions and then
having them confronted with a very brief two to three week
substantive consultation period BEFORE the health care proposal
is sent to Congress. She fears that if we do not have such
discussions, the Chairmen, Subcommittee Chairmen, and significant
others (e.g., McDermott) may come back with an impossible to
privately contain belief (more than they do already) that this
complex and controversial initiative has no chance of getting
done in the timeframe we have been discussing. Added to their
disbelief may well be a perception that we were never really that
serious about consulting with them and that all we are going to
do is attempt to force down our legislation on them.
I believe that we have two options to address Andie's
concerns:
1.
Advise Leadership and Chairmen that we are going to
significantly narrow options that are being prepared for the
President and invite them to participate during the recess.
Pros
*
Gives Members a sense of importance and priority of the
legislation and gets them invested.
*
Gets work done outside the confines of voting and in session
scheduling conflicts.
*
Gets a sense of influential Members' concerns and desires
early enough in process to be more easily responsive.
*
Keeps a few key Members busy, addresses their perception
that they are not being adequately consulted, and
(hopefully) keeps them from talking about their reservations
about this reform ever getting done to the press.
03/29/93
10:50
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006/007
Cons
*
Most Members have already completely scheduled their recess
and, if they are to come back, there is a risk that their
time spent with us may not be viewed as substantive enough
to have justified a late change in their plans.
If all the Chairmen do not come, there is a risk that those
not participating feel either left out or insulted that such
meetings are taking place without them.
*
Rank and file Democrats and Republicans who hear or read
about any such meetings may well make us conclude that
meetings for a few, albeit important, Members was not worth
the alienation of so many others.
2.
Arrange for multiple meetings with appropriate staff of
Leadership and Committees, give a set schedule for meetings
with Members as soon as they return from recess, and hold
recess meetings with Members only in response to their
request.
Pros
*
By providing a pre-arranged plan for significant
consultation immediately after recess, this option addresses
most of the Members' concerns that they will be adequately
consulted.
*
Significant staff consultation will better prep us and the
Members for more constructive Committee Member-level
discussions post recess.
This approach does not require last minute rescheduling of
Members that has potential to alienate Members.
We can respond to those Members who desperately want to be
briefed on a REQUEST BY THEM basis, without risk of
alienating others who are not briefed.
Cons
*
If the Majority Leader does make the request for Member-
level meetings, it is not fully responsive.
*
A long recess without direct meetings with Members may well
not appease some influential Members of Congress.
*
Staff meetings have the potential to force issues to be
addressed that may be more staff-driven than Member-driven.
As a result, more time may be required (and we don't have
extra time) to address issues that are not even important to
those who will be voting on the President's proposal.
03/29/93
10:50
202 456 7739
WHITE HOUSE
5
007/007
RECOMMENDATION
Consistent with your conversation with Jerry Klepner, and
keeping in mind all the risks of changing Members' schedules so
late in the game, it seems advisable to give serious
consideration to option 2. Steve R. agrees with this approach as
well. If you approve, we will proceed with locking in timetables
for Committee/Members' meetings to occur as soon as they return
from recess. We will also set up meetings with staff during
recess, (although some will be traveling with Members).
Lastly, attached for your review, is a tentative schedule of
meetings we are trying to schedule for this week. None are yet
completely finalized because we thought Mrs. Clinton might be
able to attend many of them. Obviously, as time goes by, this
looks more and more dubious. The meetings are important,
however, and we are going to try to schedule Ira and you (and
Steve) to most of them.
Hope this heads up list is somewhat useful. I know this
week is a terrible time for both you and Steve, but everyone on
the Hill and here (including me) think most of these are
essential to take place before recess. Thanks.
DETERMINED TO BE AN ADMINISTRATIVE
MARKING Per E.O. 13526
Sec. 2018-0141-F 3.2(C) Initials: JGP Date: 1/29/18
PRIVILEGED AND CONT IDENTIAL
MEMORANDUM
TO: Steve R.
April 9, 1993
FR: Chris J.
RE: Republican Members and Staff Meetings/Contacts
Steve, as you will be able to tell by the attached list, I
have been busy scheduling and holding meetings with Republican
Members and staff from both Houses during the last two months. I
believe the list will give Howard and you more than ample room to
say that any future meetings with Republicans are simply a
continuation of our past practice of consultation -- (even though
the Republicans, particularly the Senate Members, have been
complaining about their adequacy).
A couple last notes. I have been trying for weeks to find a
way to extract Chafee and his moderates from the rest of the
Republicans. The First Lady has desired to have a meeting with
Senator Chafee, but has hesitated from calling to initiate one.
(She does not want to appear to be going around the Minority
Leader). Ira has tried too, but Chafee has repeatedly indicated
he does not wish to meet with him at this time.
Tn addition, Senator Chafee's office (Christy Fergeson on a
very confidential basis) has called to indicate that she believes
their could be a constructive working relationship with at least
a group of Members from the Republican Health Care Task Force.
Most recently, though, she and her boss -- probably because they
too fear alienating Senator Dole -- have taken the position that
we should wait to have active Member-level discussions on the
Senate side AFTER we have a better sense about what direction we
want to go. (The reason why they are taking this position, no
doubt, is that they do not have any desire to appear to be
"bought off" so early in the process). Also, they still feel
that having a larger number of Republicans to negotiate, at this
point, places them in a much more powerful negotlating position.
Dased on my numerous "off-the-record" conversations with
senior staff of Chafee's office (Christy Fergeson), Danforth's
office (Peter Leibold), Kassebaum's office (Andrew Patzman), and
Senator Jefford's office, their is a great desire to work with
us, but their is also a great fear about how it will be perceived
by the rest of the Republicans. At a recent Members meeting, a
comment about how "Republicans would get more than a good night's
sleep if we go to bed with the Administration on health care" was
made and well received by most of the Members present.
002/005
P
HOUSE ELIHA
7739 456 2022
00:91
06/60/10
Obviously, if we have any chance of passing health care
reform this year, we will have to have Republicans on board.
Based on our record of meetings to date, I think we should have
no problem defending a closer working relationship.
Lastly, I want to point out that, although Senate Ropublican
Members have not been coming to meetings recently, it is not
because we did not want them there. I have consistently pointed
out to Shiela that our Democratic Senators are being briefed by
Ira and are being done SO in large numbers. Shiela always says,
though, that if it is just Ira or other work group members, it
will be just staff.
Hope this information is helpful. Call me up with any
questions.
003/005
D
WHITE HOUSE
6339 159 1202
16:01
DATE
MEMBER(S)
MET WITH
SUBJECT
2/4
DOLE/CHAFEE
HRC/ICM/JF
process, general
discussion
2/23
DURENBERGER
HRC/ICM
3/10
Senate Republican
IIRC
general
Members
discussions about
process and about
Bond
directions
Burns
for/components of
Chafee
reform
Cohen
Craig
Danforth
Dole
Durenberger
Gregg
Kassebaum
Mack
Murkowski
Nichols
Packwood
Roth
Simpson
Stevens
Thurmond
(others were present as
well)
3/10
JEFFORDS
ICM
3/11
House Republican
ICM
Members/Staff
3/12
Senate Republican Staff
ICM
3/18
House Republican
ICM
MALPRACTICE
Members
Hastert
Goss
Johnson
Thomas
Blily
McMillin
004/00
WHITE HOUSE
7739 159 202
TO:9T
DATE
MEMBER(S)
MET WITH
SUBJECT
3/23
Senate Republican Staff
Walter Zellman
New System
Rick Kronick
Development
Lois Quam
Governance
3/25
House Republicans
ICM
GLOBAL
Members
BUDGETS
Hastert
Goss
Johnson
Thomas
Grandy
Blily
McMillin
4/1
House Republicans
Lois Quam
RURAL HEALTH
Members
CARE
Hastert
Goss
Johnson
Thomas
Grandy
Blily
McMillin
Roberts
Gunderson
4/1
Senate Republican Staff
ICM
short-term
controls
Sheila Burke
Christy Ferguson
Ed Mihulski
005/005
V
WHITE HOUSE
6339 459 2022
16:02
DETERMINED TO BE AN ADMINISTRAT
MARKING Per E.O. 13526
Sec. 3.2(C) Initials.JGP
Date:
2018-0141-F
1/27/18
PRIVILEGED AND DENT
MEMORANDUM
TO: Steve R.
April 9, 1993
FR: Chris J.
RE: Republican Members and Staff Meetings/Contacts
Steve, as you will be able to tell by the attached list, I
have been busy scheduling and holding meetings with Republican
Members and staff from both Houses during the last two months. I
believe the list will give Howard and you more than ample room to
say that any future meetings with Republicans are simply a
continuation of our past practice of consultation -- (even though
the Republicans, particularly the Senate Members, have been
complaining about their adequacy).
A couple last notes. I have been trying for weeks to find a
way to extract Chafee and his moderates from the rest of the
Republicans. The First Lady has desired to have a meeting with
Senator Chafee, but has hesitated from calling to initiate one.
(She does not want to appear to be going around the Minority
Leader). Ira has tried too, but Chafee has repeatedly indicated
he does not wish to meet with him at this time.
In addition, Senator Chafee's office (Christy Fergeson on a
very confidential basis) has called to indicate that she believes
their could be a constructive working relationship with at least
a group of Members from the Republican Health Care Task Force.
Most recently, though, she and her boss -- probably because they
too fear alienating Senator Dole -- have taken the position that
we should wait to have active Member-level discussions on the
Senate side AFTER we have a better sense about what direction we
want to go. (The reason why they are taking this position, no
doubt, is that they do not have any desire to appear to be
"bought off" so early in the process). Also, they still feel
that having a larger number of Republicans to negotiate, at this
point, places them in a much more powerful negotiating position.
Based on my numerous "off-the-record" conversations with
senior staff of Chafee's office (Christy Fergeson), Danforth's
office (Peter Leibold), Kassebaum's office (Andrew Patzman), and
Senator Jefford's office, their is a great desire to work with
us, but their is also a great fear about how it will be perceived
by the rest of the Republicans. At a recent Members meeting, a
comment about how "Republicans would get more than a good night's
sleep if we go to bed with the Administration on health care" was
made and well received by most of the Members present.
Obviously, if we have any chance of passing health care
reform this year, we will have to have Republicans on board.
Based on our record of meetings to date, I think we should have
no problem defending a closer working relationship.
Lastly, I want to point out that, although Senate Republican
Members have not been coming to meetings recently, it is not
because we did not want them there. I have consistently pointed
out to Shiela that our Democratic Senators are being briefed by
Ira and are being done so in large numbers. Shiela always says,
though, that if it is just Ira or other work group members, it
will be just staff.
Hope this information is helpful. Call me up with any
questions.
04/13/93 19:15
202 456 7739
WHITE HOUSE
1
002/003
10:00
Wednesday
Roosevelt Room
MEMORANDUM
TO: Hillary Rodham Clinton
April 13, 1993
FR: Chris Jennings
RE: Ways and Means Subcommittee Meeting
CC: Melanne, Ira, Judy, Steve Lorraine
Because of its jurisdiction, Members, staff resources and
expertise, the House Ways and Means Committee and its
Subcommittee will probably be the most influential body in the
Congress as it relates to health care. As challenging as it may
be, we must have and continue to build a close and productive
working relationship with the Committee.
With this in mind, you, Ira and Judy are scheduled to meet
with the Ways and Means Subcommittee on Health in the Roosevelt
Room tomorrow morning. This meeting was originally requested by
the Subcommittee following the last Subcommittee Members' meeting
with Ira and Judy on March 31st.
To focus discussion, the Subcommittee Members requested that
the meeting review two major issues: (1) System Organization:
Federal and State Roles and (2) Cost Containment: Short-Term and
Long-Term (but will focus primarily on short-term). In terms of
meeting format, the Subcommittee has suggested that you or Ira,
for each issue, give a brief 15 minute presentation, followed by
a 45 minute Q&A session. Attached for your use is a summary of
the direction and options Ira and his work groups have been
discussing for all of these issues.
In preparation for this meeting, Pete Stark suggested that
all the Subcommittee Members submit questions that they may pose
during your meeting. The questions will be focused on the two
issues outlined above. As of 6:30 tonight the questions had yet
to arrive, but we will send them over as soon as they arrive.
Lastly, as you will recall, the last time you met with the
Committee, we had a press leak problem. At some point during the
meeting, without being overly confrontational, you may want to
discuss the importance of keeping these meetings quiet, so that
we can have as constructive and productive a working relationship
as possible. This, in my mind, is entirely appropriate and
should be well received by most.
MEMORANDUM
TO:
Distribution
FROM:
Steve Ricchetti
Chris Jennings
DATE:
April 13, 1993
There has been a great deal of discussion and reporting about the need for bi-
partisan consultation on health care, springing in part from our current difficulty in
moving the stimulus package in the Senate. I want to emphasize to everyone that the
Administration's Health Care Task Force began an on-going dialogue with House and
Senate Republicans many weeks ago.
It would be both erroneous and potentially damaging for a perception to develop
that our work with Congressional Republicans only began after they employed delaying
tactics in the debate on the stimulus. We have actively solicited their advice and ideas
on health reform since our first week. We fully expect, however, that for partisan
political purposes some Republicans will attempt to promote this notion and I want to
urge everyone involved in our health reform effort to watch for this characterization and
be aware that it is factually incorrect.
You should know that the President asked the bi-partisan leadership for designees
to consult with the Health Care Task Force as early as January 26. Senator Dole
appointed himself and Rep. Michel appointed Rep. Dennis Hastert (R-IL). Mrs. Clinton
met with Senators Dole and Chafee on February 4 and with members of the Senate
Republican Caucus on March 5. We have also been holding weekly meetings with
Republican Members on the House Health Task Force and staff and the staff of the
Senate Health Task Force since February, typically with Ira Magaziner leading the
presentation and dialogue.
The staff of the Senate Republican Health Task Force has suggested that more
active member-level discussions be delayed until we have a better sense internally about
what our proposal will contain. As decisions about our plan are being made, we will
reach out to this group again. It is important to note, however, that we have always
encouraged and been open to meeting with Republican Senators.
It is clear that on each of our major initiatives during the next two years we will
need and will be soliciting bi-partisan support for our proposals. I want everyone to be
aware of the on-going efforts to consult with Republicans on health reform and to try to
win their support for our program.
#####
Attachment.
DATE
MEMBER(S)
MET WITH
SUBJECT
2/4
DOLE/CHAFEE
HRC/ICM/JF
process, general
discussion
2/23
DURENBERGER
HRC/ICM
3/10
Senate Republican
HRC
general
Members
discussions about
process and about
Bond
directions
Burns
for/components of
Chafee
reform
Cohen
Craig
Danforth
Dole
Durenberger
Gregg
Kassebaum
Mack
Murkowski
Nichols
Packwood
Roth
Simpson
Stevens
Thurmond
(others were present as
well)
3/10
JEFFORDS
ICM
3/11
House Republican
ICM
Members/Staff
3/12
Senate Republican Staff
ICM
3/18
House Republican
ICM
MALPRACTICE
Members
Hastert
Goss
Johnson
Thomas
Blily
McMillin
DATE
MEMBER(S)
MET WITH
SUBJECT
3/23
Senate Republican Staff
Walter Zellman
New System
Rick Kronick
Development
Lois Quam
Governance
3/25
House Republicans
ICM
GLOBAL
Members
BUDGETS
Hastert
Goss
Johnson
Thomas
Grandy
Blily
McMillin
4/1
House Republicans
Lois Quam
RURAL HEALTH
Members
CARE
Hastert
Goss
Johnson
Thomas
Grandy
Blily
McMillin
Roberts
Gunderson
4/1
Senate Republican Staff
ICM
short-term
controls
Sheila Burke
Christy Ferguson
Ed Mihulski
DETERMINED TO BE AN ADMINISTRATIVE
13526
2018-0141-F
1/29/18
PRIVILEGED AND BONFIDENTIAL MEMORANDUM
TO: Hillary Rodham Clinton
April 19, 1993
FR: Chris Jennings
RE: Tomorrow's Finance Committee Meeting
CC: Steve, Melanne, Howard, Ira, Judy
All 20 Members of the Senate Finance Committee (11 Dems:
Moynihan, Baucus, Boren, Bradley, Mitchell, Pryor, Riegle,
Rockefeller, Daschle, Breaux and Conrad and 9 Republicans:
Packwood, Dole, Roth, Danforth, Chafee, Durenberger, Grassley,
Hatch and Wallop) have been invited to tomorrow's meeting.
Because this Committee has traditionally worked on a generally
bipartisan basis and because so many of the Committee's
Republicans are on our target list, we and Chairman Moynihan felt
it was critical that this important meeting be bipartisan.
BACKGROUND
No health reform bill has a chance of passing the full
Senate if it does not first gain the approval of the Senate
Finance Committee. Conversely, if a reform bill does get
favorably reported out of the Committee (with some Republican
support), it has a good chance of attracting 60 votes.
The Finance Committee comes as close to representing the
philosophical center of the Congress as any one Committee. As
such, getting a favorable response to the President's health
reform initiative from this body is both a great challenge and a
great opportunity. It is therefore necessary that a constructive
and bipartisan working relationship be formed and cemented during
the next several weeks.
Currently, the Finance Committee is viewed by many insiders
as in disarray. The transition (like most changes of the guard)
from Chairman Bentsen to Chairman Moynihan has not been very
smooth. The staff, with perhaps the exception of the Staff
Director -- Lawrence O'Donnell, does not appear to have much
influence with, or much authority from, the Chairman. As a
result, decisions and actions have been slow to occur and a sense
of what direction the new Chairman wants to take the Committee
has been slow to emerge.
In recent weeks, Chairman Moynihan and his Staff Director
have been relatively pessimistic about the chances of passing
health reform this year. There are a number of reasons for this,
but there is no doubt that one of them is that Moynihan and
O'Donnell are not overly familiar with the issue. What they do
know is that health care reform will be complex, controversial,
and potentially expensive, and they are extremely nervous about
taking on this issue as their first big initiative.
As a result of the current Committee situation, the other
Democratic Members will be even more critical than usual to
assuring that health care is favorably received and acted upon by
the Committee. The most important Members in this regard are
Senators' Mitchell and Rockefeller. These two have the potential
to actually (although not visibly) run the Committee on this
issue.
The other Democratic Members who will play particularly
critical and influential roles are Senators Pryor, Daschle, and
Breaux. If we cannot get all three of these Members to both
support and strongly lobby for the President's bill, we will be
in very deep trouble.
Cultivating a close working relationship with the
Republicans on this Committee is absolutely critical. Four out
of eight of our "best-chance" Republicans -- Senators Packwood,
Danforth, Chafee, and Durenberger -- serve on the Finance
Committee. They have invested years of work on this issue and,
from all indications, have a great interest in being "players."
Although there have been numerous meetings and phone calls with
all of these Members on a staff level, they (with the exception
of Senator Durenberger -- the least influential of the four) have
hesitated to break from Dole's Republican unity tent. The
stimulus package debate only helped Dole in this regard.
If we could attract the Finance Republicans, we would have a
good chance of signing up a core group of Republicans to work
with us. For example, the above mentioned Members' involvement
with us would virtually guarantee the participation of Senators
Cohen, Kassebaum, Hatfield and Jeffords. If we could sign up 8
Republicans, we could very well get our needed 60 votes.
GENERAL ISSUES TO ADDRESS AND TO AVOID IN MEETING
The Finance Committee Republicans may be a bit more feisty
and aggressive than they would be under normal circumstances.
This is because they now feel so unified behind their position on
the stimulus package and because they believe that they have not
been fairly and equitably consulted on health care (e.g., unlike
the Democrats, their staffs have not been invited to be on the
working groups). Senators Mitchell, Pryor, Rockefeller, Riegle,
Daschle, and hopefully Moynihan will be on guard and, no doubt,
quick to defend should any discussion get out of control.
All of the Members are likely to want to discuss process,
timing, and how they will be consulted. (These issues should be
addressed). They will probably then want to jump to how you
envision controlling costs, what will be the program's price tag,
and how will it be paid for. (Although it is advisable to
illustrate your working knowledge about these difficult issues
and options, as well as to acknowledge their understandable
interest in them, you should probably tell them up-front that no
decisions have been made on these difficult fronts).
In addition, you should know that many of the Members
believe that numerous decisions about the health care package
have already been made. (The newspaper articles give them the
sense that many major issues have been dealt with). It might be
advisable to acknowledge the perception problem. Then, you
should consider following this up with a statement along the
lines that the President has been very clear that he does not
want to make such critical and final decisions before having a
clear and direct sense of what the Members' priorities are.
As in the House, the many of the Finance Committee Members
remain cynical about the prospects for passage of health care in
the near term. A reiteration of the President's desire to have
this introduced, passed and signed into law by the end of the
first session of the Congress is, therefore, highly advisable.
STATUS OF RECONCILIATION
As you know, many people inside and outside the White House
believe that it is imperative that the President wait to
introduce the health care legislation AFTER the Senate has passed
the Reconciliation bill, or at least until after it has been
marked-up by the Finance Committee. Unfortunately, the Budget
Resolution provided for a mid-June mark-up of the Reconciliation
bill. As a result, the full Senate might not get to the
Reconciliation bill until well into July or perhaps even later.
As Howard, Secretary Bentsen, and others have pointed out,
it would be optimal for the Finance Committee work timeframe to
be moved up. This action would better keep alive the chances for
a health bill to be introduced without the constraints of
reconciliation baggage. Some key health staff on the Finance
Committee seem open to this, but it remains unclear whether
Chairman Moynihan or his Staff Director is. We may want to
consider having the President, you, or Howard talk with the
Chairman to see if he would be open to pushing up his timeframe.
CONCLUSION
One last point: Secretary Bentsen still holds a great deal
of influence over the Members of the Finance Committee,
particularly moderate/conservative Democrats and moderate
Republicans. At some appropriate point, and done in careful
consultation with Senator Moynihan, it might be useful to
consider using him to help lobby this Committee. If he appears
to be on board, it will heighten the seriousness with which
Members treat health care reform.
SPECIFIC POINTS TO HIT IN DISCUSSIONS WITH THE FINANCE MEMBERS
State Importance of Finance Committee. The Finance
Committee feels that it is the most important Committee in
the Senate, particularly as it relates to health care
reform. It is, therefore, advisable to acknowledge the
Committee's role and history, as well as the many Members
who have been active in health reform. (See attached
summaries).
*
Discuss Importance of Bipartisan Effort. It is important to
stress how determined the President and you are to making
the work on this legislation a bipartisan effort.
Acknowledge the longstanding tradition of bipartisanship on
the Finance Committee. (If the Republicans complain about
how they have been treated inequitably, you may want to
acknowledge that they have been treated on a somewhat
separate basis, but also on an equal basis. You could cite
the numerous meetings -- see attached list of meetings --
that we have held with Members and/or staff).
*
Provide Update on Timing of President's Decisions.
Acknowledge the two week delay in forwarding the final
working document to the President, but ONLY two weeks.
Stress that you anticipate that the bill will be unveiled
and introduced soon thereafter.
*
Illustrate Commitment to Pass Health Care This Year.
Because of the doubts surrounding health care, it is
advisable to emphasize that the President is strongly
committed to passing health reform this year.
*
Illustrate Understanding of Timing and Process Constraints.
Acknowledge that the Finance Committee will kept very busy
if it is to mark-up both the Reconciliation bill and then
the health reform initiative. Reiterate that it is the
President's desire to do just that, though, and how
confident the President and you are that this will be
achieved with the bipartisan cooperation and guidance of
this Committee. (If any question is raised about the
Committee jurisdiction issue, you should probably state that
the President and you will be working closely with the
Congressional Leadership on the matter, but that you could
not imagine that the Finance Committee would not have
primary jurisdiction over the bill).
Give Commitment to Consultation. Indicate how determined
the President and you are to building on the consultation
that has already taken place. Discuss how committed the
President and you are to consulting with Senator Mitchell,
Senator Dole, Chairman Moynihan, Senator Packwood (the
Ranking Republican of the Finance Committee) and the rest of
the Committee over the next few weeks.
Acknowledge Perception Problem that Decisions are Made.
Acknowledge how anyone reading the papers might conclude
that decisions about cost control and financing have been
made. Explain how this is not the case, and that the
President does not desire to make final decisions in this
regard until after he has had direct conversations with the
Senate and House Leadership (including committees) from both
sides of the aisle.
*
Provide General Outline of Direction the President May Be
Headed. Although some Members have heard Ira give a general
outline of the likely direction health reform is going, many
(and all Republicans) have not. This should not be a long
or detailed discussion, but it would be good to illustrate
your command of the complexities of health reform. Although
they (will then) know no decisions have been made on cost
containment and financing, they will want to hear you at
least acknowledge the issues. Since virtually every one of
these Members are from predominantly rural states, some
likely to be well received issues you or Ira may want to
touch on are rural and state flexibility issues.
Request Suggestions, Guidance, and Questions. As is the
case with all Members, they will want to give their own
views. So you do not have to do a monologue, and go into
all the difficult issues on your own. Throw back some of
the questions to them. They will be appreciative of the
opportunity to speak and be heard.
Consider Concluding with a Suggestion for Another Finance
Committee Meeting. Because this Committee is so critical,
just as you are doing with the Ways and Means Subcommittee,
you or Ira and Judy should seriously consider suggesting
holding substantive meetings with this Committee during the
next few weeks.
SENATE FINANCE COMMITTEE
DEMOCRATS
DANIEL PATRICK MOYNIHAN (D-New York) (Finance Committee Chairman)
As you know, the new Chairman has yet to take a position on
national health reform. His interests lie primarily in the areas
of Social Security and welfare reform. He is not a detail person
when it comes to the health care debate. Although a number of
people have discussed health care with him, it is notable that
the one who seemed to catch his fancy the most was Alan Enthoven.
The only health care-specific issues that the Senator is
particularly known for are: (1) his advocacy and support of New
York hospitals, (2) his concern about the mentally ill and the
homeless, (3) his support for chemical and substance abuse in a
benefit package, and, most recently, (4) his support of
innovation at the state level. On the latter point, he
introduced a liberalized Medicaid managed care measure that the
NGA strongly supported. (This legislation was opposed by the
Children's Defense Fund because they felt that savings through
this cost containment approach would be at the expense of the
Medicaid population).
Most recently, the Chairman and his staff have been rather
pessimistic about the chances for health reform this year. The
compexity, controversy, and potential expense of it frighten
them. The Chairman, in comments that have been somewhat
retracted by staff, has indicated his concern about any large new
taxes to fund the program and any use of price controls to
contain costs. Although he has stated to you his willingness to
raise whatever tax is necessary for the elimination and
integration of Medicaid into the new system, as well as a one
card for all system, his nervous statements should not be totally
written off.
Senator Moynihan's most recent communication was in a letter
to the President, in which he reiterated his strong support for a
health security card and in which he proposes the idea of merging
the health card and Social Security card into one. In the
letter, he also expressed his strong concerns that the Social
Security Commissioner has not yet been appointed.
MAX BAUCUS (D-Montana)
In health circles, Senator Baucus is best known for his
early 1980s work to reform the private Medicare supplemental
"Medigap" insurance market. The provisions came to be known as
the "Baucus" Amendments, for which he is very proud. In
addition, Senator Baucus was a member of the Pepper Commission.
Most notably, however, he voted against the final access
recommendations (they won by just an 8-7 vote), primarily because
of his concern about the proposal's impact on small business.
Baucus is concerned about any proposal that utilizes any employer
requirement to help finance health care. As a result of this
concern, and because the Canadian system is quite popular in
Montana, he is a single-payer advocate.
He is a member of a 5-Member working group (Daschle, Kerrey,
Bingaman, and Wofford) that is looking at alternatives to
employer-based models. This group wrote to you on February 3rd
on principles which should be incorporated into a managed
competition framework including universal participation (no opt-
outs), state or regional administration, and phase-in of coverage
for long-term care. More recently, on March 30th, he sent a
letter with 8 Democratic Senators from rural states expressing
their belief that the allocation of health budgets among states
should not be based on historical costs but on the true cost of
providing appropriate level of care to a state's residents.
Senator Baucus believes health reform must include real cost
containment, sensitivity to legitimate small business concerns,
and the advisability of a special consideration for rural
concerns. We have been advised by staff that he is very
committed to the concept of every citizen being in the health
allisance (or HPIC). In addition, he apparently would be
supportive of a VAT tax for health care.
DAVID BOREN (D-Oklahoma)
Although not generally associated as a health care reform
leader, Senator David Boren is the lead sponsor of the Senate
companion (S. 3299) to the House Conservative Democratic Forum's
managed competition bill. In recent months, however, he has
become more sensitive to the inability of the Conservative
Democratic Forum's approach to adequately address the access or
cost containment challenge. Like virtually every member of the
Committee, he considers himself to be a strong supporter of rural
health and small business issues. Like Senator Bradley, though,
he has been traditionally more focused on tax policy than health
care.
2
There have been some exceptions to the rule of Senator
Boren's non-interest/association with heath care. In addition to
the CDF bill, he is now supporting the concept of significant
state flexibility within the context of any health reform
proposal (OK Governor Walters is pushing a major initiative now
and wants some significant assistance/relief from the Federal
Government). In addition, he sponsored legislation last year to
provide for an extension on higher payments to rural hospitals
that disproportionately serve Medicare patients. (This
legislation passed the Congress, but was vetoed when then
President Bush vetoed the tax bill).
BILL BRADLEY (D-New Jersey)
Senator Bradley is known more for his work on tax policy
than for his work on health care financing. He has indicated an
interest in introducing health care reform legislation similar to
managed competition model that he believes the President has been
advocating. The one exception to his general support of the
Clinton health care approach may well be with regard to
prescription drugs. As a Senator representing the state which is
the capital of the pharmaceutical industry, Bradley is a fierce
advocate for the industry and their concerns. With Senator
Hatch, he led the fight against Senator Pryor's effort to
influence the industry to contain price increases to inflation by
linking their pricing behavior to eligibility for tax credits.
(The Pryor proposal was endorsed by President Clinton in the
campaign).
As a member of the Infant Mortality Commission, Senator
Bradley is proud of his work to ensure that the Medicaid program
was expanded to eventually cover pregnant women and kids. He
also is a strong advocate for preventative care services. He has
sponsored several bills on tobacco, including revised warning
labels and tobacco as a drug to be included in the Drug Free
Schools program. Lastly, although he incurred the wrath of some
aging groups with his opposition to prescription drug price
constraint, he has been a long-time supporter of home and
community-based long term care services, particularly with regard
to respite care services.
GEORGE MITCHELL (D-Maine) (Senate Majority Leader)
Few Majority Leaders in the Senate's history have been as
interested and as committed to passing comprehensive health care
reforms. Mitchell is the sponsor of two Senate Democratic
leadership comprehensive reform bills dealing, respectively, with
access (S. 1227, Health America) and long-term care (S. 2571, the
Long Term Care Family Security Act).
3
Senator Mitchell is leading an effort by the Democratic
Policy Committee (within the Senate) to attempt to develop
consensus on the health care issue within the Democratic party.
For weeks now, Ira and Judy have been holding very successfuly
briefings with, on average, 30 plus Senate Democrats a meeting.
Senator Mitchell believes that the single payer approach is
not politically feasible. However, at this point, his primary
concern and commitment is to push through anything, which can be
defined as truly comprehensive, that will pass the Congress. He
has repeatedly indicated his intention to work closely with the
President to help assure that a bill can make it to the White
House before the end of the 103rd Congress.
As you know, however, he was a strong advocate of
incorporating the health care legislation into the budget
reconcilation bill. Having failed that, he and his lead staff
are now relatively pessimistic about attracting enough
Republicans to support a health reform initiative without having
to make major, and perhaps unacceptable, concessions. Just
yesterday, (Sunday, April 18th), he indicated his opposition to
price controls, his uneasiness with but possible openess to a VAT
tax for health, and his desire to wean out all the fraud, abuse
and waste BEFORE contemplating large tax hikes.
DAVID PRYOR (D-Arkansas) (Aging Committee Chairman and Secretary
of the Senate)
Senator David Pryor is part of the Senate leadership
(Secretary of the Democratic Conference). As the Chairman of the
Senate Special Committee on Aging, he is well liked and respected
by the powerful aging advocacy community. In addition, he is one
of the few Democrats that the small business community genuinely
trusts. Further, his status as a former Governor and his
advocacy of state-based approaches to comprehensive reforms has
gained him a great deal of good will with the Governors.
Although an unassuming Member and one who does not get overly
involved in detailed policy discussions, he has also emerged as
one of the most influential and best liked Members of the Senate.
All of these roles ensure that he will be a particularly key
player on the health care front.
In terms of health care priorities, drug cost containment is
the first, second, and third highest priority for Senator Pryor.
The concept of linking drug cost containment to tax credits
(embodied in Pryor's Prescription Drug Cost Containment Act --
S. 2000) was endorsed by President Clinton.
4
In addition to his drug cost containment interests, he also
has a notable legislative achievement record in rural health
(relief for hospitals and incentives for primary care doctors in
medically underserved areas), state-based reform (his NGA and
Clinton candidate-endorsed Leahy/Pryor bill), and long-term care
(his proposal for Federal standards for private long-term care
insurance policies).
DONALD REIGLE (D-Michigan) (Finance Medicaid Subc. Chairman)
Senator Riegle considers himself to be a major player in the
health care debate. He is Chairman of the Finance Subcommittee
on Medicaid and was a lead sponsor of the Mitchell, Rockefeller,
Kennedy "play or pay" health care reform proposal. He has always
felt he did not get adequate credit for his work on the bill.
Although he sponsored this bill, he appears to be extremely
willing to sign on to virtually any approach that achieves
universal coverage and cost containment.
Senator Riegle is very interested in many health issues,
including: child immunization programs, rural health care,
Medicare prescription drug coverage, retiree health liability
concerns, long-term care, and a host of others. Senator Riegle
strongly believes that cost containment savings should be used to
help reform the health care system -- NOT for deficit reduction.
Most recently, Senator Riegle has pushed his outreach
efforts with the Medicare Qualified Medicare Beneficiary (QMB)
program. The QMB program pays for the deductibles, premiums and
copays of low-income Medicare beneficiaries. Unfortunately, only
about 50 percent of the eligible population receive the benefit.
This program, because it is partially underwritten by the states,
is one of the most unpopular benefits that the states support.
(Most of the states believe there are higher priorities). At any
rate, Senator Riegle has introduced legislation to expand
outreach efforts at SSA offices and other areas. (The
Administration has not yet taken a formal position yet).
JAY ROCKEFELLER (D-West Virginia) (Finance Medicare Subcommittee
Chairman)
Senator Rockefeller views himself as being (and is) Bill
Clinton's number one health care advocate. He was a tireless
campaigner and defender of the Clinton health care plan and was a
National Co-Chair of the Clinton campaign. Rockefeller is the
current Chairman of the Finance Subcommittee on Medicare and Long
Term Care. He also has chaired the Pepper Commission and the
National Commission on Children.
5
In addition, Senator Rockefeller is the founder and Chairman
of the Alliance for Health Reform, a nonpartisan organization
dedicated to advance health care reform through education of
public opinion leaders. Lastly, as you well know, his is now
serving as the new Chairman of the Senate Veterans Committee.
Senator Rockefeller's health care priority is very simple:
He desperately wants to see a comprehensive reform package
enacted during the Clinton Presidency. Although he thinks the
long-term outcome of such an achievement is politically
attractive, he is primarily pushing this reform because he is
sincerely committed to the need for reform. In this vein, he is
not overly committed to any one particular approach although he
has advocated an employer-based approach. He, therefore, can be
counted on to support virtually anything the President ends up
proposing, as long as it achieves universal access and cost
containment.
Senator Rockefeller was very pleased with the Veterans'
meeting last Thursday. He was concerned about the the AP story
the day after, but from the beginning did not believe it was
true.
As you know, he has requested a meeting with you to discuss
substance and strategy. He very much wants this to occur this
week. He feels he needs a substantive background briefing to be
at his best in his role as cheerleader in the Congress and with
the press. At that meeting, it is my understanding through Steve
Ricchetti and his staff that he may extend an invitation to you
and the President to go out to his house for dinner. If you wish
to come, he will suggest you using his house and the event for
whatever purpose you want: to have a quiet dinner out or to use
it for a backdrop for a social occasion for appropriate guests
interested in health reform.
TOM DASCHLE (D-South Dakota)
Senator Daschle is the Co-Chair of the Democratic Policy
Committee (with Majority Leader Mitchell) and he is one of the
more well informed Democratic Members on health care issues. In
his brief tenure, he has already become very well known in this
arena, particularly through his work on rural health and Medigap
insurance reform issues.
Senator Daschle and his staff are participating in (and
helping run) Senator Mitchell's DPC working group, but he has
also been a leader of a separate working group (Kerrey, Bingaman,
Wofford, and Baucus) that was developing alternative approaches
to health reform. This group has been relatively quiet lately,
seeming to be comfortable with working with and through the DPC
health policy group.
6
Personally, Daschle is much more comfortable with a single-
payer type approach to health care, primarily because he believes
it is a much easier political sell to his small business folks
and the rest of his constituents. He joined Senator Harris
Wofford in introducing legislation (S.2513) to achieve this end.
Daschle is a team player, however. As part of the Senate
leadership, he can be counted on to push his agenda as far as it
can go, but he will also do everything he can to assure that we
pass comprehensive reform and the President's plan.
In addition, Senator Daschle is one of the signatories of a
March 30th letter opposing the allocation of the global budget
among states based on historic costs. He is very concerned that
rural states would be discriminated against using such a formula.
Senator Daschle also worries that people don't understand
the real costs of the current health system and how they are
paying too much in direct and indirect spending. He feels that
education regarding these costs are critical so that people don't
feel the new system will cost them too much money. Lastly,
Senator Daschle also supports restructuring graduate medical
education to emphasize primary care.
Most recently, Senator Daschle has requested that you join
him in South Dakota at some health care event at some point in
the future. We are trying to be responsive to a request by him
to get someone from with working groups to go to an early May
event that he is holding. (We may also ask you to do a satelite
feed for this event).
JOHN BREAUX (D-Louisiana)
Senator Breaux is the second most junior Member of the
Finance Committee. He is one of those "up and coming" New
Democrats for whom many see a bright future. His politics are
moderate to conservative but he is known more as a pragmatist
than a idealogue. In the area of health care, Breaux is yet
another of the Committee members who care deeply about small
businesses and rural health care.
Previous to this year, Senator Breaux was not overly active
in health care issues. That changed when he introduced the
Conservative Democratic Forum's managed competition bill with
Senator Boren in 1992. He is very concerned, however, about the
bill's limitations with regard to assuring adequate access to
health care in rural areas. He is also concerned about whether
this approach will actually achieve broad-based costs savings.
Despite this, he remains uncomfortable with alternative
approaches and he will want to make sure that the Conservative
Democratic Forum's model is used as much as possible during the
upcoming debate. He opposes price caps and freezes to control
costs.
7
KENT CONRAD (D-North Dakota)
Kent Conrad is the newest member of the Senate Finance
Committee. Senator Conrad is known as a "budget hawk." Strong
cost controls will be critical for his support. He will look
closely at the financing package and how the reform plan impacts
the federal deficit. He opposes large new taxes to support
reform.
Senator Conrad's foremost health concern is rural health
care. He is concerned both with how rural health care will be
addressed in the context of managed competition as well as
current access and delivery issues. He is aware of successful
models from his state -- one a network of clinics, the other an
HMO -- which have been able to increase access to primary and
preventive care. He signed the March 30th letter opposing the
allocation of the global budget among states based on histoci
costs. He is also an advocate for the need to improve and
increase funding for the Indian Health Services. Insufficient
funding has led to rationing of services. He also feels the IHS
has not been sufficiently responsive to Congress or tribal
leadership.
Most recently, I (Chris J.) and Christine gave him a general
health care background briefing. (He had missed one given by Ira
and wanted a private meeting). He was very appreciative and
appeared to feel much better about the direction the President
andyou are heading by the conclusion of the discussion.
8
REPUBLICANS
BOB PACKWOOD (R-Oregon) (Finance Ranking Republican Member)
Senator Packwood is an advocate of an employer-based
universal coverage plan. He is the only Republican on the
Finance Committee that has publicly supported an employer mandate
and as a result, putting him in a somewhat uncomfortable position
with many in the Senate leadership--who vehemently oppose an
employer mandate.
Packwood attacked his opponent's (AuCoin) single-payer
approach last year as a multi-billion dollar tax increase that
would result in a government run system. The primary criticism
of Packwood's plan was that it didn't go far enough on the cost
containment side. Some of the aging advocacy groups also
criticized it for its lack of comprehensive long-term care
coverage. In Oregon, at least, Packwood won the debate.
Beyond the above-mentioned work, Senator Packwood has had a
notable health care career. He has sponsored quite a bit of
legislation dealing with rural health and long-term care (LTC).
Specifically, he introduced a relatively extensive public/private
LTC bill in the 101st Congress. However, because it costed-out
as a rather expensive initiative and because the aging advocates
were not enthralled with it, he decided to stick to Federal
standards and tax clarifications for private LTC insurance
policies. In addition, working with Pryor, he introduced
legislation that could provide tax credits for primary care
personnel to serve medically underserved rural areas.
ROBERT DOLE (R-Kansas) (Senate Minority Leader)
The Minority Leader is, without question, the most
influential Senator among Republicans. As an ally, he can be
absolutely invaluable. As an enemy, he can be vicious and
effective. Currently, it appears he is trying to decide whether
health care reform should be a partisan or a bipartisan issue.
Dole and his staff will probably opt to appear to be willing to
work with the Democrats, but will eventually choose to turn on
the new Administration on the reform issue.
Senator Dole has a strong interest in rural health and is
currently Co-Chair of the Senate Rural Health Caucus.
Legislatively he has supported initiatives to protect the
viability of small rural hospitals as well as to expand civil
rights protections and services for the handicapped.
9
Yesterday (Sunday, April 18th, on Meet the Press), he
indicated his opposition to price controls, his concern about
large taxes without delivering on cost containment first, and his
hesitancy about a VAT tax unless it is used to replace or offset
other taxes. Although it may well be an impossible task, we must
continue to work to at least try to get him on board with us. If
we do not succeed, we might have some success in attracting other
moderate Republicans for making the effort to obtain Dole's
support.
WILLIAM (BILL) ROTH (R-Delaware)
Until the last couple of Congresses, Senator Roth was not
known for his involvement in health care. As Ranking Member of
the Government Affairs Committee, he has had extensive
involvement and interest in the Committee's Permanent
Subcommittee on Investigation's inquiry into the multi-billion
dollar issue of health care fraud and abuse.
More recently, Roth has actively advocated that the Federal
Employee Health Benefit Program, which the Government Affairs
Committee oversees, be extended to the working uninsured and
small businesses. (This is similar to, and builds on, a proposal
that has been championed by the Heritage Foundation.) Under this
proposal, the self-employed and working uninsured would have
access to the FEHB plans that were utilizing managed competition
as a cost containment/quality assurance mechanism. In so doing,
these individuals would have access to the same rates that the
insurers charge the federal government and their employees for
the benefits.
JOHN DANFORTH (R-Missouri)
Senator Danforth is to cost containment what Bob Packwood is
to mandates. He is the most likely to state that strong
federal/state caps on spending must be imposed to effectively
contain health care costs. He states his strong views on this
issue repeatedly, despite admonitions from his staff and other
Republicans that such statements are not consistent with the
Republican Party line.
Although willing to support the need for strong government
cost regulation, he also believes that to do so would require
explicit rationing. (He is a big fan of the Oregon waiver).
What is more, unlike most Democrats, he desires to publicly
proclaim that rationing is necessary and something we must own up
to.
10
JOHN CHAFEE (R-Rhode Island) (Finance Medicaid Subc. Ranking
Republican)
Senator Chafee is the Chair of the Republican Task Force on
Health Care. He likes to point out that the bill they introduced
in the last Congress had the most cosponsors of any major
comprehensive health reform bill. He was not pleased with last
year's health care debate with the Democrats. He believes that,
if not for Presidential and partisan politics, there was enough
consensus between his and many Democrats' bills to move forward
on many high priority health reform proposals such as: self-
employed tax deduction increase to 100 percent, insurance market
reform, expansion of community health centers and other health
care delivery systems, and state experimentation.
On the Committee, Senator Chafee is primarily known for his
long-standing interest in providing alternative care settings --
through the Medicaid program -- to persons who are disabled. He
and his staff are literally heroes with many in this field,
particularly those who advocate non-institutional care
approaches. He is also well known for his strong advocacy of,
and relationship with, community health care centers. In
addition, he -- like a number of the Finance Committee membership
-- are growing weary of funding programs for the elderly when
there are so many needs in the non-elderly population.
As you know, we have been trying for weeks to invite Senator
Chafee to talk with Ira. We sense that he and his staff want
desperately to come in, but are afraid to alienate Dole. On
Friday (April 16th), though, I (Chris J.) received a call
indicating that he might come for a meeting. We will have to
wait until Monday or Tuesday to get a confirmation. We will keep
you informed.
DAVE DURENBERGER (R-Minnesota) (Finance Medicare Subc. Ranking
Republican)
Senator Durenberger is one of the Committee's most well
versed Members on health care reform. He also is one of the few
Members who has served concurrently on the Labor and Human
Resources Committee (the other major health care committee) and
the Finance Committee. He is a moderate who is viewed by the
Republican leadership as somewhat of a loose cannon. Because of
this and his long-standing interest in health care reform,
Durenberger, too, is a candidate to be a possible and important
ally.
11
In the last Congress, he joined Senator Bentsen as the lead
Republican on the Texas' Senator's incremental (insurance market
reform, etc.) health reform initiative. He has been a key health
care player for years, however. He now is the Ranking Republican
on Jay Rockefeller's Subcommittee on Medicare and Long Term Care,
and he has served as either a Chairman or Ranking Member of this
Committee for years. In addition, he served (as a Vice-Chair) on
the Pepper Commission. While he joined all the other Republicans
in voting against the access recommendations of this Commission,
(he did vote for the long-term care recommendations) it is
important to note that it was unclear that Durenberger was going
to vote against the Pepper Commission recommendations until very
late in the process. An important offshoot of this experience,
though, was that he and Jay Rockefeller forged a close working
relationship.
Most recently, Durenberger has focused on state-based
comprehensive care initiatives. This is because he does not
believe that a consensus yet exists for national reform and
because his own state is tired of waiting. Minnesota has a long
tradition of moving ahead on health care reforms and is THE
nation's capital of managed care/HMO delivery systems. It is one
of the 5 or 6 states that has gone ahead and passed legislation
to implement its own reform proposal. Since Minnesota has
historically been more efficient in terms of the delivery of
health care, Senator Durenberger will be very concerned about the
allocation of the global budget, particularly that it does not
reward the inefficient at the expense of the efficient.
Last week, Senator Durenberger called me (Chris) to talk a
little strategy and health policy substance. He indicated his
nervousness with any price controls. He said he thought we could
get some savings for speeding up implementation of the new
physician payment system. He also urged us to find a way to fold
in Medicare into whatever we do. Lastly, he again asked for a
meeting with Ira. It has been arranged for Wednesday, April
21st, at 11:00.
CHARLES GRASSLEY (R-Iowa)
Senator Grassley is one of those Senators who can give the
impression (because he is far from a detail-oriented person) that
he is less than sharp and is not a significant player. This is
not the case. Although he may not be extremely quick, he has a
very sensitive and accurate gut for politics and policy and, with
a very capable staff, he has managed to become quite an effective
Member of the Committee.
12
Grassley's primary health care interest has been related to
rural health care. He, again like most other Members of the
Committee, has been greatly concerned about perceived inequities
in reimbursement to rural providers.
ORRIN HATCH (R-Utah)
Senator Hatch is relatively new to the Committee having
joined during the last Congress. He is one of the brightest
individuals in the Senate, but has yet to really get a
comfortable grasp of the Finance Committee. Although he is well
known for his very conservative philosophy, he has in recent
years appeared to become more open to more traditionally moderate
approaches. For example, although he is close with the drug
industry, he has been willing to push them to be more responsive
on pricing issues.
Up until 1993, he served as either the Chairman or the
Ranking Republican of the much more conflict-oriented Labor and
Human Resources Committee. In this capacity, he became extremely
well informed about PHS, NIH, and FDA issues. On health reform
issues, he can be expected to be very supportive of market-
oriented reforms to the health care system. In that vein, he
will be extremely uncomfortable with employer mandates and
discussions of global budgeting and enforcement. He has
introduced legislation to reform the medical malpractice system
and sees this as an important means for reducing health care
costs.
MALCOLM WALLOP (R-Wyoming)
Senator Wallop was just renamed to the Finance Committee
this term. In his previous tenure (1979-1988) he demonstrated an
interest in rural health concerns but focused primarily on tax
matters. He is known for his very strong conservative views. In
the last Congress, he cosponsored the Republican reform bill and
Senator Hatch's bill to improve the medical liability system. If
there is one Member of the Committee we can almost certainly
write off as a possible supporter, it is Senator Wallop.
13
DATE
MEMBER(S)
MET WITH
SUBJECT
2/4
DOLE/CHAFEE
HRC/ICM/JF
process, general
discussion
2/23
DURENBERGER
HRC/ICM
3/10
Senate Republican
HRC
general
Members
discussions about
process and about
Bond
directions
Burns
for/components of
Chafee
reform
Cohen
Craig
Danforth
Dole
Durenberger
Gregg
Kassebaum
Mack
Murkowski
Nichols
Packwood
Roth
Simpson
Stevens
Thurmond
(others were present as
well)
3/10
JEFFORDS
ICM
3/12
Senate Republican Staff
ICM
3/23
Senate Republican Staff
Walter Zellman
New System
Rick Kronick
Development
Lois Quam
Governance
4/1
Senate Republican Staff
ICM
short-term
controls
Sheila Burke
Christy Ferguson
Ed Mihulski
4/19
Senate Republican staff
Gary Claxton
Insurance Reform
Individual Meetings.