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Files of Neera Tanden, Associate Director of Domestic Policy and Sr. Policy Advisor to the First Lady Box 1: Files Archived from 2nd Floor West Wing by Eric Woodard on January 1, 2001 Correspondence Violence/Drugs - Youth Development/Afterschool/Violence Health - Groups - Health Reform Health Care - DNC - Health Reform Health Care - Task Force - Health Reform Health Care - Meetings - Health Reform Health Care - Correspondence - Health Reform Health Care - Correspondence Unit - Health Reform Health Care - Interoffice Memorandum - Health Reform Enclosures filed in # 20357 Oversize Attachments Health Care - Personnel - Health Reform NARA # 17590 Health Care - Talking Points/Task Force - Health Reform Health Care - Scheduling - Health Reform Health Care - Media - Health Reform Health Care - Legislature - Health Reform Health Care - Legal - Health Reform Dick Celeste Media SMALL DEPARTMENT HC-business U.S. SMALL BUSINESS ADMINISTRATION ADMINISTRA 1953 WASHINGTON, D.C. 20416 OFFICE OF THE ADMINISTRATOR MEMORANDUM TO: Christine Varney Deputy Assistant to the President and Cabinet Secretary FROM: Erskine B. Bowles, Administrator Amler RE: Health Security Act DATE: October 15, 1993 As Administrator, I have talked to thousands of small businesses over the last three months. Whether it was talking to an employer or an employee, health care was by far their greatest concern. The rate of increase in the cost of health care for small businesses is 50% higher than the rate of increase for big businesses. Educating the small business community will be critical to the success of the Administration's effort to communicate the need for national health care reform. Since the President's introduction of the Health Security Act, the Small Business Administration has been committed to educating and informing the small business community on what the plan will mean to their business. We identified programs and communication vehicles to determine how we could incorporate the importance of universal health care as a theme. In doing so, we have already committed significant funds ($100,000) from the Agency's budget to begin educating small businesses on the specifics of the Health Security Act, and its probable impact on their businesses. We have a plan for reaching out further to our constituency, but we are unable to commit any additional funds at this time. The SBA is enthusiastic about what health care reform will mean to small business. In order to communicate the benefits of health care reform properly, however, we will need additional resources from other government Departments. Together we can reach the greatest number of constituencies with little or no duplication in our combined effort. 2 It is fitting that other Departments allocate proportionate resources to communicating about the health care reform effort. Since Departments have much larger budgets and staff than SBA their "proportionate" contributions should be substantial (Commerce alone is 25 times our size). Shifting some of these resources to our "small business" effort would make a great deal of sense and have a very positive impact. Here are some of the steps we have taken thus far: Brochure: Health Security Act - Benefits for Business This 10-page brochure was designed to be used in a number of different ways: as an informational document; as a format for a speech; or, as talking points. Our first printing, on September 27, consisted of 150,000 copies. On September 28, we sent out 10,000 copies (1,000 per) to our ten Regional Offices; 53,000 copies to our District Offices; and 6,300 to our Branch Offices. We also sent shipments to the sites of our four upcoming SBA Town Hall Meetings, in Portland, Cleveland, Houston, and Denver. Along with the Commerce Department, we hand-delivered a copy to each member of the House and Senate. In addition, we provided the White House Communications Office with 1,000 copies, and the Office of Public Liaison with 4,000 copies. (See attachment entitled "Distribution of Brochure".) By October 6, we had completed a shipment to each of our 536 SCORE (Service Corps of Retired Executives) chapters around the country, and also had sent 100 to each of our 56 lead Small Business Development Centers, and to several hundred women's business organizations. The brochure has also been sent to Department Chiefs of Staff. It was sent in disk format with the hope that all federal employees will take the time to read it on their own computer. Health Security Act Worksheet/Computer Program: We have developed a computer software program which allows us to input data on an individual small business -- its number of employees, payroll costs, average annual salary, and annual insurance cost - and then calculate their estimated projected cost under the Health Security Act. We successfully used this program during our briefing for 50 small businesspeople which we held at the SBA the day after the President's speech. In addition, this same program will be used when people call our 800 number. We have also sent this worksheet out to all of our District Directors and 70 district offices so they can begin compiling health insurance information on small businesses for our database. 3 1-800 Number: We are expanding the capabilities of our existing SBA Answer Desk (1-800-U-ASK- SBA) so that small businesses will be able to call in and get information about the Health Security Act. A caller dialing this number will be asked to choose from a number of options, which automatically routes it to the Health Care Hotline. We have set up a local area network with 10 workstations to handle the software used for the computations in the program described above. The information will be obtained from the callers and entered into the database, which can be used for analysis or for follow-up activities. The people staffing the hotline also will have the capability from their workstations to FAX the caller a copy of their worksheet, and an electronic version of the brochure (as is available via SBA ON-LINE, described below). We are preparing to have 10 to 25 workstations operational and staff trained as soon as possible. We anticipate 300-500 calls daily. However, having already expended $100,000 on this project, we do not have adequate funding to operate this 800 number and need other Departments to share in its cost. When the Health Security Act Information Service is operational, we will develop a "hypertext" type feature as an aid for our information providers. This is an on-line help window that the user can invoke after each entry filed. Each help window would provide clarification or Q&As related to the information in that field. Creating this help feature is essentially a software-writing task which we can perform internally over a two to three week period. SBA "On-Line": This is the SBA's electronic bulletin board that is accessible by anyone with a microcomputer and a modem. The service is provided free via an 800 number. SBA ON- LINE is being modified to allow callers the option of going to a section of the bulletin board where they can view or download to their individual computers a copy of the Health Security Act brochure. We also are establishing a mailbox on the bulletin board, where callers can leave comments regarding health care. This information will be analyzed by our trained staff and an immediate response will be sent via modem. We also can provide the capability for SBA staff to interactively communicate via computer with people calling the bulletin board. This might be something we would do periodically with updates on Health Security Act legislation. In addition, we plan to set up a mechanism to collect basic information from the callers that can go into a database to be used for analysis or for follow-up activities. Associations Database: To date, we have contacted over 100 small business-related associations to obtain information on their annual meetings and their publications, and plan to send them copies of the brochure, along with articles on small business and health care. After reviewing all association/trade speaking dates we will work closely with the "War Room" to identify the appropriate keynote speakers for specific events. 4 Part II: 1-800 Number Cost Estimates These are the cost estimates for two options to provide Health Security Act information services to small business callers. We cannot reliably estimate the number of calls we will receive or the average length of each call. Assumptions have been made for discussion purposes and to create a budget estimate. ASSUMPTIONS: (for both options) -Full service operation 9 a.m. - 9 p.m. Mon-Fri. using two shifts (9-3; 3-9) -All phone lines in continuous use -Salaries based on SBA Agency-wide average -10 minute average call length during full service hours . Option #1: Call Processing System This system will answer calls on 25 incoming lines, provide menu-based information, transfer a caller to an operator for estimated cost calculations, or ask caller to hold if all operators are busy. System will feed 12 "on hold" callers to the next of the available 25 operators. EQUIPMENT COSTS (One time only) Microlog Call Processing Hardware $24,900 Phones & Headsets 7,500 25 Microcomputers 67,500 Fax server, cabling, misc. hardware 31,000 Fax machines & lines 7,400 Phone line installation 2.500 TOTAL $140,800* *(SBA expenditure to date: $42,500) RECURRING COSTS PHONE LINES: 1-800 lines (during full service hours Mon-Fri 9 a.m.-9 p.m.) $186,480 1-800 lines (info messages during off-hours, after 9 p.m. and Sat-Sun 24 hours) 108,864 LABOR: 50 FTE 633,000 Recurring total 928,344 + equipment total 140,800 Total Estimated Cost over 3 months $1,069,144 5 CAPACITY: -25 simultaneous operator assisted calls -12 calls holding for next available operator -Up to 9,000 operator-assisted calls per week during 9 a.m. - 9 p.m. period; 4,500 on hold for next available operator . Option #2: Direct Call System ASSUMPTIONS: (as in 1. above) -Full service operation 9 a.m. - 9 p.m. Mon-Fri. using two shifts (9-3; 3-9) -All phone lines in continuous use -Salaries based on SBA Agency-wide average -10 minute average call length during full service hours This is direct person-to-operator calling with no pre-recorded intermediate answering system. This system has no "on hold for next operator" capability and no off-hours message capability. All callers after #26 will get a busy signal; after hours callers will get no pickup or response. EQUIPMENT COSTS (One time only) Phones & Headsets 7,500 25 Microcomputers 67,500 Fax server, cabling, misc. hardware 31,000 Fax machines & lines 7,400 Phone line installation 2.500 TOTAL $115,900 RECURRING COSTS PHONE LINES: 1-800 lines (during full service hours. M-F, 9 a.m. - 9 p.m.; No off-hour message or $126,000 information service) LABOR: 50 FTE 633,000 Recurring total 759,000 + equipment total 115,900 Total Estimated Cost over 3 months $874,900 6 CAPACITY: -25 simultaneous operator assisted calls -Up to 9,000 operator-assisted calls per week during 9 a.m. - 9 p.m. period [A third option considered was an interactive voice response system which would collect information by prerecorded questions which the customer would respond to via touch-tone phone input. Operator Assistance would be available as an option. We have decided to exclude this system from consideration because it would require 45-60 days to develop, and we believe the complexity of these issues merits more immediate operator assistance.] Distribution of "The Health Security Act: Benefits for Business" Department of Commerce 23,800 SBA Regional Offices 10,000 SBA District Offices 53,000 SBA Branch Offices 6,300 Portland, OR (town hall meeting) 350 Cleveland, OH (town hall meeting) 350 Des Moines, IA District Office 400 New York District Office 400 Houston, TX District Office 500 Houston, TX (town hall meeting) 350 Other Executive Departments/Agencies 300 White House Office of Communications 1,000 White House Office of Public Liaison 4,000 Democratic National Committee 10,000 Mailing to SCORE, SBDCs and WBOs 19,200 appoarent attempt to break has specit I know he is resilient 40 Chester se but mean known such nuston, ma 02161 medial system and self September 14 1993 serving disrespect by members more of a Clintonite thanks of both parties I've become Dear Dick Democrat. I write to express my at LarvardCommssinity Health my husband is an internet relief being, and enthusism about yours selected to lead the Plant (14- how days) Pa fight for the Freudents health have been waiting for a care plan The good to know national program of uneversal the that you continue to fight you Hodspied and lookforward and when- courage for years with for the greater good in a public arend to felsing however One of my most distinct we can. memorres of high school was sincerely of your medically inforced sep weeks of silence you Signame Berwind Better) always seemed to feel a her sponsibility to others. as I remember, we both worked one would go on to Decome a crs- the Kennedy campaign you fessional while remained a volunteer It has been very difficult to watch the attempt to delute the Presidents program and a tic BC/ARC ROUTON 101> Rosemarie Marshall Johnson. M. D. Board of Fost Office Box 82807 San Diego. California 92135-2809 Telephone 10101 505-9660 September 28, 1993 Governor Richard F. Celeste Chair, National Health Care Campaign 430 S. Capitol Street, S.E. 3rd Floor Washington, D.C. 20003 Dear Governor Celeste: I entered the meeting at the UCSD University Hospital with a healthy skepticism for the President's healthcare agenda. I was moved by your insight, cogent reading of health matters, and person anecdotes that to me confirmed your strength as a leader. Your revelation of family medical matters and the brief but poignant and insightful mention of the lessons of failure won my admiration and attention. 1 thought we'd merely be fed the party line, the acceptable speech on doing good for our brethren (and sistren?) but I was happy to be wrong. I still believe in the ideals of my profession after almost thirty years of practice and half that in medical advocacy (read politics). And I believe you want to do good things for our wonderful country. You are a superb emissary for our President and his program and bridge a gap I previously felt. As incoming President of the San Diego County Medical Society, I pledge honest effort to make the reform of healthcare delivery viable here. I had planned to form a committee called "Medicine in Transition" at our medical society and have asked Jeff Morris to help. I also had just written an opinion editorial for The San Diego Union-Tribune on neighborhood meetings of health experts and citizens aimed towards getting smart together. Your words were the final push I needed to move on these projects. We have particular problems in San Diego, as every region does. I am very interested in border health issues and have represented the California Medical Association (as a Trustee) on this issue for the past five years. This is an extremely important aspect of health care for us, as you know. I am making this another focus of our agenda at the Medical Society. I believe all of us have to invest significant effort in making decisions about the development of this reform. Neither the President nor American physicians want unhappy, unhealthy citizens. Please keep us informed and let me know how we can help here in San Diego. Sincerely, Rosemarie Marshall Johnson, M.D. President-Elect, San Diego County Medical Society RMJ:p White Bulletin Bill Frenzel, agreed to "most" of the demands. One exception, apparently, is the one which called for the agreements to be "in writing." While the negotiations clearly underscore the gener distrust Republicans have for the Administration, Republicans apparantly view any commitment from the White House's political arm, the DNC, with even more suspicion. Organized MOOT, 84 ardera appoinent of NAF TA. is 5 major contributor to the DNC, Moreover, some Democi audisided a net the ONC set so admptetely geared up for health care reform, it lacks the respures R effectively engago n another brittle. Meanwhile, on the GOP side, sources 589 Rep. Creditor ON Rep (PGEX) with play the roles of Republican whips in the NAFTA President Clinian to distuss NAF IA at the White House the morning whois this? The Officers companies are presenting a luke Lux 000 perside 8 trugs dray 218 winding on organization designed 8 combat me The Aydminication official. "it appears issued Companies positive w us & ave making nice statements, and they are and Seadersh Council, which is what [former Senator 00 If the amexic "They want to appear statements on a gobd which 0003 not say insurance Speed aight, soumious material on us. So, the below the radar screen Alliance for 01 ad had coalition of ManagedCompetitin havaged Competition Tsongas has been out doing anded the official. "thefive..." The White Nouro No. no M simple the the teaching email business lobby over health accounting the kild the Bulletin Ready to come and the more they areun the info the tent. to wage.an even pigger for the White House to get Put money behind wine cirectly to small businesse cas dosta, and get them politically the Pres proposals... Helpfor public / political White House Save Fire, tvgpt lhs visida Yesterday. while compaign. used & couple of things that Good legislative engenex some 3139 is "doing more work and team. biging nozen years The President also and Please the everk 00 or 70 or 80 hours a WERE and and According to a number Issues: of non-political was neither statement is fair, as and this of time on the job (as those Administration We recognize it in of a new Premium caps Administration past willi people living to Sgdra works tim, by and large, the level of Closerto Cooper/breamx confusion and disorganizations viewed as a sorry speciacial stid one non-political White House worker Added another: There $ no need for the President to bag mouth the workers who have been here to Regulatory scope of a number of years. We keep this place operating, despite the best efforts of his politicos to turn it into Alliances. a circus." According to a third: "Since the very beginning, many of US who were accustomed to politice appointees who had 8 degree of reverence for this institution have been disgusted by the behavior many of the Clintonites. Quite a few come to work in casual closes and act like this is party central, PHOTOCOPY 3 PRESERVATION HIAA D&H TOTAL TO Dick Health Celeste Insurance Association of America DATE 9/29/93 FROM Bun Prodesing SUBJECT "Blaclemail"? B. - 10/1 rec'd POLITICAL DISPATCHES Lobbyists ready for health care hardball By Amy Bayer lines of his reform plan. According stitute. COPLEY NEWS SERVICE to observers close to the process, it The industry is targeting law. was hardball lobbying that filled in makers from blue-collar districts, Dr. Benjamin Stohlman has a new most of the details. arguing that a beer tax could cost a bumper sticker on his Acura: "If you Mr. Clinton added expensive lot of votes in the vast middle class like the Postal Service, you'll love benefits for prescription drugs and The anti-beer-tax campaign re- Hillary's health care plan." long-term care after a pointed warn- sembles hundreds being played out "I've never marched on Washing- ing from the American Association by interests as diverse as medical ton for anything," said Dr. Stohlman, of Retired Persons that its 33 million equipment manufacturers, plastic who is by his own account so members would not back a plan surgeons, ambulance drivers and apolitical he has never joined the without them. epileptics. American Medical Association To mollify organized labor, he "But I'm so angry I'd walk the Nearly every interest group has postponed plans to tax some work- halls of Congress," said the 47-year- lined up lobbyists to pressure mem- ers' health benefits, a proposal cen- old Baltimore cardiologist. "It's bers on Capitol Hill. The law firm of tral to Mr. Clinton's "managed com- enough to make me a lobbyist." Patton, Boggs and Blow, for exam- petition" method to reduce costs. Dr. Stohlman has plenty of com- ple. is lobbying on health care for no Mr Clinton abandoned plans to pany As President Clinton puts the fewer than three dozen clients. cap doctor and hospital fees rather finishing touches on his controver. than risk alienating those extremely But on this bill, more than any sial health care plan. a legion of lob- powerful lobbies. other, the target is outside Washing byists, professional and otherwise, The president promised subsidies ton. is gearing up for perhaps the biggest in small-business owners, who "The best lobby efforts begin at lobbying blitz in history would be forced to buy health insur- home," said Michael Bromberg. di- Millions of dollars already have ance for their employees. And he of- been spent to defend. fight or re- "There are so many rector of the American Federation fered an unexpected bonus to larger of Health Care Systems. "When push write the president's plan before it businesses by proposing that the lobbyists up here I comes to shove, members usually even lands on Capitol Hill. government assume 80 percent of vote how the folks at home want And with a $900 billion industry at the health care costs for early re- think the line forms them to." stake, the battle has just begun. tirees. somewhere in Beer makers plan to put signs in "There are so many lobbyists up "The administration is playing liquor stores and use their delivery here 1 think the line forms some- good politics," said AARP lobbyist Virginia." trucks as rolling billboards, advis- where in Virginia," joked Sen. John John Rother "You want to have - Sen. John D. Rockefeller IV ing drinkers that new taxes will hit D. Rockefeller IV. a leading reform something to offer everyone." them in the wallet. advocate The lobby campaign now moves to Perhaps the most heated cam- Among the players in the health Congress. which offers a far warmer paign is being waged by the health care lobbying game are health pro- reception for lobbyists than a White Even the winners under Mr. Clin- insurance industry "If they choose, fessionals, universities, disease sup- House that has threatened to "take ton's plan are gearing up for a fight. we lose," it warns in a $2 million tele. port groups. scientists, veterans, on" special interests. The beer industry, for example, vision ad intended to make Amer- unions, religious groups, ethnic "They shut us out completely." was greatly relieved that the pres. icans think twice about changing groups, and nearly every business said Sean Sullivan of the National ident did not include a six-pack tax plans. and industry Business Coalition on Health. refer- to help pay for new health benefits. The White House predicted the "Everybody is getting into the ring to the presidential health care "I've been around this town long onslaught but views it with some in- game," said Common Cause Presi- reform task force. "Once the plan enough to know that Congress could dignation. dent Fred Wertheimer hits Capitol Hill, it's an open book. come a-knocking when they're look. "Essentially, they're trying to When Mr. Clinton took office. he We believe we can change it. and ing for more money." said Raymond blackmail us." said Ira Magaziner. had already decided the broad out. we're not alone." McGrath. president of the Beer In- Mr. Clinton's top health care adviser. Fileste 1 redd 9129 HIAA Health Insurance Association of America TO Didk Celeste DATE 9/28/93 FROM Bur G. SUBJECT Dr this the response to our "good faith efforts" ?? Bur \ White House Seeks Insurance Firm Curbs During Transition HEALTH, From A1 transition period or are unable to buy insurance because they have a pre-existing health condition would be able to purchase coverage through the Department of Health and Human Services. The HHS-sponsored plan would be funded by the premiums it charged consumers. But if the premiums were insufficient, the government would force all insurance companies and large companies that operate their own health plans to contribute as well, according to the draft. The HHS-sponsored plan would use the Medicare payment rates to reimburse hospitals and doctors treating its members. Several states, including Missouri, currently have state-run plans to in- sure people who have been turned away or charged high rates by pri- vate insurance companies because they have medical conditions that required expensive treatment. In general, these "state risk pools," as they are called, have not kept up with the demand for coverage. Under Clinton's plan, insurance companies would not be prohibited from raising premiums. But the in- creases could not be applied to a small class of customers, such as prohibit employers "from reducing the elderly. The premium increases existing coverage for any medical would have to apply uniformly to all condition or course of treatment" if customers within what the insur- the cost of that treatment is likely ance companies refer to as either to exceed $5,000 a year, according the small group market-individ- to the draft. uals or small businesses-or within One way insurance companies the large group market-usually have made money is to select only medium-to-large firms. the best "risks"-younger, healthier The rules would also apply to people that the insurer believes will companies that self-insure and to not need medical care. Conversely, companies that join together to buy some companies have found ways to insurance as a group. avoid insuring "bad risks"-usually To ensure that employers who elderly people or women in their pay much of their employees' cov- child-bearing years. erage do not cut back on coverage "We don't want to make risk se- of sick employees, the plan would lection worse," Magaziner said. 20F2 HIAA WASHINGTON POST Insurance 9/27/93 Curbs Asked For Interim Administration Seeks Stable Coverage During Health Plan Transition The administration's proposal, if enacted by Congress, also would immediately limit the amount insur- ers could charge some individual By Dana Priest new subscribers and existing pol- Washington Post Staff Writer icyholders. It would also prohibit President Clinton, as part of his companies from terminating or fail- health care reform proposal, wants ing to renew health insurance cov- Congress to prohibit insurance erage for any insured person or companies from dropping sick sub- group, according to a draft of the scribers or selectively raising their plan. premiums during the three years The interim measure would mean before his plan would be fully im- that insurance companies would not plemented. be allowed to drop coverage of Clinton also wants Congress to small businesses or individuals, for set up a government-sponsored in- instance, while maintaining cover- surance plan for consumers who age for large-sized firms. cannot buy private coverage during "That appears to me totally con- the transition period. tradictory to their overall goals of Both measures reflect the admin- consolidation," said Linda lenckes, istration's belief that health insur- lobbyist for the Health Insurance ers, faced with declining profits be- Association of America, referring to cause of impending reform, might the president's other goal of weed- price-gouge or drop coverage for ing out inefficient, wasteful health sick people who need medical ser- plans. vices during the transition period By requiring companies to renew between the time Congress passes all policies and restricting their rate Clinton's proposal-if it does-and adjustments, "you really could run full implementation of it. the risk of making a company insol- The administration has said it vent" if health costs go up, Jenckes would like the plan to be up and said. running in all states by the end of If the proposals are enacted, peo- 1997, although Hillary Rodham ple who lose their health insurance, Clinton recently suggested the for whatever reason, during the White House was open to a later See HEALTH, A6, Col. 1 date. "We want to prevent the insur- ance market from becoming unsta- ble during the interim," top White House health adviser Ira Magaziner said in an interview yesterday. "We want to prevent them from raising prices in a profiteering manner or selectively" dropping the more ex- pensive policyholders, who usually are people with existing medical conditions and the elderly. 10F2 HIAA BASHINGTON SEP 2893 : 1029 Health Insurance Association of America 1025 Connecticut Avenue, NW Washington. DC 20036-3998 THE HONORABLE RICHARD CELESTE Democratic National Committee 430 South Capitol Street, S.E. Washington, D.C. 20003 !!!!! TENE ree'd 1014 HIAA Health Insurance Association of America TO Dids Celeste DATE 10/1/93 FROM Bun SUBJECT am 9 beating a dead horse ? Bur FOR IMMEDIATE RELEASE Contact: Barbara Gracey September 30, 1993 HIAA 202/223-7782 Health Insurance Association of America STATEMENT OF BILL GRADISON, PRESIDENT OF THE HEALTH INSURANCE ASSOCIATION OF AMERICA ON HILLARY CLINTON'S TESTIMONY TO SENATE LABOR AND HUMAN RESOURCES COMMITTEE The Clinton Administration continues to try to portray the health insurance industry as the scapegoat in the debate over health care reform (see attached article from the 9/27 White House Bulletin). Yesterday, in hearings, Hillary Clinton was quoted as saying "the heavy administrative percentages that you will find in the private sector insurance market is due to a very clear decision, which is, the more money we can spend making sure we don't insure people who might cost us money, the more money we will make..." The facts are -- the insurance industry wants to broaden coverage so all Americans have universal, cradle-to-grave coverage. Reforms that the health insurance industry advocates now, and advocated before President Clinton came into office, would eliminate the need for any underwriting in bringing people into the system. In addition, since 1976, profits for commercial health insurers have averaged less than 2 cents on the dollar. During that same time, the number of people with private health insurance has increased by more than one million. Clearly, insurers are neither profiteering nor trying to insure fewer people. ### 1025 Connecticut Avenue, NW Washington, DC 20036-3998 202/223-7780 Telecopier 202/223-7896 THE WHITE HOUSE BULLETIN 9/27/93 BULLETIN BROADFAXING NETWORK. 625 KING STREET. ALEXANDRIA. VA 22314 (703) 684-2020 assessment system hasn't changed in 20 years. The plans of the Clinton Administration to bar insurance companies from dropping coverage for sick people or raising their premiums during the transition to a new health care system may also have 8 political benefit While the Clinton team reportedly believes the insurance companies may take advantage of the period between now and when the larger reforms kick in by trying to Increase profils, if also sees an opportunity to use the industry as a political foil, painting the companies and other opponents of the Clinton plan as greedy special interests wanting to hold on to the status quo. "Go back to the beginning of the campaign," a White House official told the Bulletin this morning. "We attacked two type of companies from the very beginning: the insurance companies and the drug companies. This is not a change in strategy. This is not some new strategy." The official concluded: "Number one, it is the same strategy. And number two, its the truth. If there are any villains out there who the American people can't stand, its the insurance companies and the drug companies." Reportedly, the Clinton plan would: : Bar insurers from cutting off anyone's health insurance for any reason "except for non-payment of premiums or other strictly defined cause." - Require insurers to develop a single rate manual with only three categories; individuals, groups of fewer than 100 and larger groups. Any premium increases would have to apply equally to all three. I Forbid exclusions for pre-existing conditions for new employees and their families who had insurance in the previous 90 days. If they had been uninsured, only medical conditions that occurred in the previous six months would be grounds for exclusion. - Ban employers from imposing waiting periods for coverage on eligible employees. I Prohibit employers and insurers from reducing coverage for AIDS or any other disease expected to cost more than $5,000 a year to treat. - Also, the government may set up a national risk pool for sick people who lose coverage or cannot buy new coverage during the transition. 0 Congressional committee chairmen on Capitol Hill are competing 10 have Hillary Rodham Clinton address them first, and longest, reports a White House official. This official told the Bulletin: "The committees are in a bidding war to see who can get her first and for how long. I wouldn't be surprised if there is going to need to be a little health care provided up on the Hill after these chairmen finish with each other to see who can get her First." The official added: "There are some bruises already, and 1 am not just talking about egos. Think of the publicity she brings to them." As for what the First Lady will say, considering the actual While House legislation won't be sent up to the Hill for another couple of weeks, the official said: "She will have plenty to say. It will definitely be worth watching. There will be some more details, but there will also be statements of rhetorical interest. The tone will be every bit as important, if not more important, than the details. 0 The "entitlement summir" which President Clinton promised Rep. Marjorie Margolies-Mezvinsky will most likely take place In late November, according to informed sources. One Administration source told the Bulletin: "While we do not yet have a political strategy for this high profile meeting, we are starting to prepare the substantive side of the issue of entitlement controls. A lot will depend upon the specifics of the President's recision package in October. Obviously, the President will want to make the most out of the need to first control health care spending. Vice President Gore, who told the Congresswoman he also would try to attend, will want to emphasize reinventing government." But another source close to the planning for this event said that "we think the conference will be very eye opening to most Americans when they realize how generous middle and upper class entitlements are. The unfortunate part of the whole propaganda war about budget cuts, from Republicans and Democrats, is trying to convince people that if only we got rid of fraud, waste and abuse, WG could solve the budget problem. It is just not true, and we have got to decide that if we really want to help our 3 HIAA S OCT 1 93 ÷ 9 Health Insurance Association of America 1025 Connecticut Avenue. NW Washington, DC 20036-3998 THE HONORABLE RICHARD CELESTE Democratic National Committee 430 S. Capitol Street, SE Washington, D.C. 20003 111 un