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PHOTOCOPY
PRESERVATION
��November 11, 1994
MEMORANDUM TO CAROL RASCO
FROM:
Marilyn Yager
MEETING:
Families, USA
DATE/TIME:
Monday, November 14
3 : 3 Opm - 4: 3 Opm
LOCATION:
Room 476, OEOB
AGENDA/TALKING POINTS:
Int:roductions
Thank thein for coming and for their
unbelievable work and sUpport for the Health
Security Act.
OVE~rview
Comments
1. Comment briefly on the broader
Administration priorities for next year,
i.e., welfare reform, etc.
2. Comment on" the new health care team headed
by you and Bob RUbin.
3. Describe how we plan to proceed on health
care, i.e. meetings with allies and key
health players before any decisions are made.
4. Indicate that we are using the next three
to four weeks to listen and learn from our
allies, hence the purpose of this meeting.
Open it up for discuSsion.
No~rE:
When inviting groups to these meetings
I have asked them to come, prepared to give us
thl~ir assessment of the new political
environment and what it means for health care
reform. To tell us what increinental reform
would they support (if any) and what
incremental reform do they think ~ould hurt
thl~ system.' And finally, to be prepared to
tell us what they learned about their own
membership during the past two years on what
could be sold at the grassroots level and
what could not.
�You are likely to be asked whether we are
planning to propose health care reform as a
part of our FY96 budget and whether we are
planning to propose Medicare cuts.
ThE~ most important message we can send, is
that we consider these folks friends and
allies and we are demonstrating that by being
as frank as possible regarding what we are
thinking.
Families, USA, founded in 1982, has served as
a convener of consumer groups and allied
organizations on health and long term care
(formerly the Villiers Foundation). They
issue numerous reports on health and long
term care issues, and are often asked by
Congress to testify and by the media to offer
a (~onsum:er perspective. '
BACKGROUND:
For their size and revenue, their support for
the Health Security Act was unmatched. They
established 30 state health care coalitions,
and in many states hired field staff to build
grassroots support for health reform. They
also published key reports that.we often used
to describe the problem and what the Health
Security Act do to address the need.
Ron Pollack has been executive director of
Families USA since its inception and has been
a committed Clinton supporter since the early
days of the campaign.
Their issue priorities were long term care
and universal coverage. I have attached an
example of their early correspondence with us
on Long term care to give you a flavor of
their detailed knowledge and pragmatic
approach to health care reform. I have also
attache an example of one of their press
releases regarding building support.
ATTENDEES:
Ron Pollack, Executive Director, Families, USA
Judith lNaxman, Director, Government Affairs
Phyllls Torda, Public Education
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Carol Rasco
Chr is Jtennings
.lili~
Fede!
(ctmCac:t"Ve)
Mike Lux
Marilyn Yager
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eONFleEN"FIAl:
TO
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Mike Lux
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DETERMINEDTO BE AN
ADMINISTRATIVE MARKING
INITIALS: ®< DATE: b'6/05/IO
FROM:
Ron Pollack
RE
Seeking a Bottom Line on Long Term Care
:
DATE:
April 29, 1993
You asked me to give you a re~ding about an approximate bottom
line for various senior organizations that you specified concerning
long term care in the President's health proposal. In response to
your request, I held sE:!veral off-the-record conversations and -
while none of them were precise 'about their bottom line -- several
key points can be gleaned:
1.
Due to the President's and First Lady's comments on the
subject, there':'::cis
unanimous expectation t~at~:prescriptionZl'idr,ugs!':_~.~J
will be in the benefit package and in Medicare. While prescription
drug coverage is not their top priority -- long. term care is -
there would be major disappointment if drugs are not in the
package. I am unable t:o glean a bottom line, however, concerning
drug deductiblesand co-payments -- but, given previous experience
on this issue in the Cat:astropl1ic Health Care legislation, it is an
,aspect of drug coveragE! that will be looked at -,carefully.
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2. There is unanimous agreement that the fIrst long term care'
priority is home and'community-based care, not institutional care.
The senior groups, more than the disability organizations, however,
are looking for' some recognition about the need for protection
against expensive nursing home care. Whether phased-in coverage
.. (over a more prot-racted, period of time ) for .P.llx:§i:t:lg.homecaJ;'~~ust
be in the bill, or whet;her it suffices to recognize the need 'with
a promise to deal with it sometime in the future, is unclear. For
the senior groups, however, it seems clear that they need at least
a big enough rhetoriccll fig leaf on nursing 'home protection to
assuage their memberships.
It would -be' very helpful to enact
·nursing home coverage, even if the implementation schedule is far
in the future .. '
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3. -There is every expectation that the new' home care coverage
will be phased -in over a period of time.
I . have not heard a_
specific bottom line about the length of the 'phase-in period,"
but the typical response assumes a five-year range.
(These,
assumptions, however, .~re not based on an adequate sophistication
about
the
fiscal, difficult.iesthe Administration has ,in
constructing the overall package, or the,Administration's possible
decision to complete clcute care universal coverage in more than
five years.)
No one expects completion of home care phase-ins
prior to acute care coverage.
"
1334 G STREET, NW • WASHINGTON, DC 2000S • 202-737-6340 • FAX 202-347-2417
�Memo to Mike Lux
April 29, 1993
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4.
There isa willingness to see coverage phased-in on an
income needs basis. There is a very strong antipathy, however,
to an ultimate des ign that results in a poor people's program.
This should be clear in the legislative proposal.
I believe,
however, that a progies:sively graduated set of co-payments and/or
deductibles -- perhaps (although I'm not sure) even a fairly steep
graduation based on economic circumstances -- might be acceptable.
5.
It would be very helpful if there was·a modest start on ,',
long term care at the earliest stages. I believe that respite care
could work as the likely candidate for sucha.first step.
I have not seen the long term care option paper currently
before the TaskForce, nor have I seen the cost estimates of the
options. From the accounts I have read, however, I believe that
.- -the option ..tp.~~.·9raduallyp~~se.s..-,,~ .. home care~£~~~f:it_for all j,,_~L~.J:l_e...:~._.._..,_
right direction to go for securiri~f-the organ1.zatrdiial-support':':froiii;:'Sl'~~ .,'
the groups you identifiE~d. (And, if I may editorialize rather :than:'
just report: I would add mandatory spend down protection ~tQr
nursing home care undeir Medicaid for the 19 states that don'i't
currently provide it together with modestly. upgraded spousal
prote.ction --' joined wi th an oral conunitment .to .future nursing
home reform.) .
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�Families
FOR IMMEDIATE RELEASE
WEDNESDAY, SEPTEMBER :~2, 1993
LEA1)ING HEALTH CONSUMER' GROUP
VOICES ENTHUSIASTIC SUPPORT
FOR CLINTON HEALTH REFORM
"It's great for American familie$! The President's Reform
will absolutely guara:ntee that you'll never lose your health
insurance, no matter what," according to consUmer ,advocate Ron
Pollack, '·executivedirector,:~f.:=Families USA.=-,,,_=_,-,",,. _ _ , _., __ ~__ '''-'~'' ,,"
The health consumer group" came out strongfy"-'in suppcift~6f:~~~~""
the President's Health Reform.
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"This plan will restore peace of mind to ,American families
who worry they'll be among the two million Americans who 'lose" ,
coverage every month," Pollack said.
,
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"President Clinton's Health Reform will barithe fine print -~ ,
that insurance compan.ies, use to dump you or deny you benefits' "
you've paid for. ~.Ij:,.wj.ll_,cJ;:'~qk .. gQwn on ins\lranc~_ a,.ud',qI"U,g',:-::,:;;o,: ",;,::~~
company overcharcjes~"-"Weire'-very"eiithusra:s-'Fic"In' 'our"support,"'for'-
the reform, It--Pollack 'said." ~,:~.,~,: ...:,-.. ,
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FOR IMMEDIATE RELEASI~
WEDNESDAY I' SEPTEMBER 22, 1993
HEALTH CONSUMER GROUP RELEASES ANALYSIS
SHOWING ,FAMILIES HELPEDay CLINTON HEALTH REFORM '
Families USA today released ananalysissbowing how'
Americans would:be helped by Clinton's Health Reforin.
[NOTE TO EDITORS: THE FULL TEN PAGE REPORT TEXT (WITH STORIES OF
REAL PEOPLE IN EACH CATEGORY) IS AVAILABLE BY FAX OR MAIL.]
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CONTACT: ARNOLD BENNETT OR AVIVA SHLENSKY (202) 628·3030
1334 G STREET NW • WASHINGTON DC 20005 • FAX (202) 347·2417
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�'Page 2 of 7
The report looks at the impact of reform on ten groups:
1. Insured Americans at risk of losing their health
insurance.
2. Americans with inadequate insurance.
3. Americans with high prescription drug costs.
4. Americans 'whol retire early and lose health benefits.
5. Americans who are job-locked.
6. Americans who own small businesses--and their families.
7. Americans who need long term care at home.
S.· Americans whoseemp;J.~yers :cut:back, o.l'!:~~~~~~h})er:te!~~~.:;':.::~,t.;. . ,.·"c~":' ":
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9. Businesses with skyrocketing premiums.
10. Americans on Medicaid who can't
geth~a~th care • •. ~::.~f;;~~'
INSURED AMERICANS WHO WOULD LOSE THEIR ·INSURANCE.,._ .....:"-',""-'~~c.
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For the mOr.$;i?than;two Ullil1ion::insured~:America:nS 'Who·.:.losec0"~;~·i::;~·,:, '.:
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their health insurance each month, the Clinton Health
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Reform',~":;:"' .
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A health security card will guarantee all Americans
comprehensive health benefits, even if they lose or change jobs/
move out of state, .get divorced, start a small business, or'
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someo.ne in the family gets sick •. FAMILIES USA RATING:
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reason to support plan.
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�Page 3 of 7
INSURED AMERICANS WITH INADEQUATE INSURANCE
Millions of Americans have inadequate insurance that can
leave them with many th.ousands of dollars in medical bills.
About 18 million insured Americans will have to spend at least
one-tenth. of their incomes on out-of-pocket health costs in 1993;
CI int.on 's
comprehensive
pocket costs.
Health Reform guarantees all Americans
~ealth
benefits, with strict iimits on out-of
It bans all lifetime limits on benefits such as:
hospital care, emergenc:y services, doctor visits, pre-natal care
and . home healtjl-:;:.care·fc)r
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Important new protection for insured Americans; savings
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for. families hit by illness.
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...Oi".,.:AMERlCAHS WITH, HIGH PRESCRIPTION' ·DRUG··COSTS "~~ , .
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About· 72 million ;/\mericans now
lack ~rnsul:'ance, covel:'ageh.:t,QI:'ih·
prescription drugs, and skyrocketing drug prices make it more and .
. more
diffic~lt . .for
Americans to afford their medications •
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The Clinton Health Reform includes an important new drug
benefit for Americans.
No elderly American'will ever again have
to pay more than $1,000 a year for drugs, and most· will pay far
less. . After mCi!eting a $250 annual deductible, Americans· ~f-:'ari~;;:
- .....
.- .
age will have to pay no more than 20 percent of· their
prescription drug costs.
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Americans under 65 w"ill have a$li,50~··; .'
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annual limit on what they can be charged, or $3,000 per famaly.
FAKILIES USA RA'l'ING: l:mportant step forward.
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�Page 4 of 7
AMERICANS WHO RETIRE EARLY AND LOSE HEALTH BENEFITS
Many companies have cut back or eliminated health coverage
for their early retirees,
protection.
le~ving
many Americans without health
Clinton's Health Reform will guarantee health
coverage to early retirees, with the federal government paying 80
percent of premiums for retirees between the ages of 55 and 65.
The former employer or the retiree will pay the remaining. 20
F~ILIES
percent of the health premium.·
USA RATING:. Protects
retirees while taking pressure.off businesses.
AMERICANS WHO ARE "JOB-LOCKED"
One in five worlce:r:'s
rep~rt
can~:{'
they or a familymeInber
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switch jobs because ne'flir workol·fers limited
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insurance.
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The . ,.ClintorlHealth Refprmwill"absdititely:ban:,., .,-....,.'' ','".,;"..~'''
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insui:cimce ,companies' Ero:ra(.,exclud.'ingc;'anyone~n or:any:~ health::::,,:, '.'
condition, from coverage under any circumstances by·1997 •.
. FAKILIES USA RATING: El~cellent.y~o~~tion~o.~~,~i,~~~.,,~~p'ro]):!~::Ii':"~~'_:f:::;;,~"",':
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AMERICANS WHO OWN SMALL BUSINESSES--AND THEIR FAMILIES
Small'business owners pay si911ificantlymo:re for heal:t:h
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. insurance for their ·f~u{\ilies ,and' wor,kers thanlarge'businesses:
pay.
Their
premiums'~an
skyrocket if, an
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Insurance companies bften refuse to '
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cover an individual whc).worksfora smallbusinesslbecause of a
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coverage6f a business bec;:ause of the
nature of the industry.
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Page 5 of 7
The Clinton Health Reform will guarantee that small business
,~wners
can buy insurance at'the same--or lower--price as big
business.
The Reform will also limit insurance company premium
increases, putting an end to health premium increases of 20
percent, 30 percent and more that small businesses have suffered.
Also, insurers will no longer be able to reject businesses or
individuals for any reason.
In addition, small businesses will be eligible for
significant new discounts.
c
:~insurance:companies,
FAMILIES USA RATING: Tough on
helps,most':$mall
bus,i~,~sse~~q.;~_a~!y!~.:p2~~~l'::'-;:-
AMERICANS NEEDING LONG TERM CARE ATBOME
Almost every American family eventually faces a long tem :;;'.;.
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care crisis,i-...and ,"most AIpericans'want "theiI?-elderlyparents_tC!.;. be,
cared forat"·lrome,ratber·:'than in'Cl',;:;nursing home •.' But, many
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American families who need long term care at homez:eceive no
professional home care services, often because they can't .:....
afford
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The Clinton Reform will provide home care help to Americans'
who most need the help..
By 1996, Americans who need long term
,
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will begin to be t!ligible for services that can keep' them at
home; the program is tc::> be. fully phased in by the year 2000 •
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PANXLIES USA RATING: Valuable. first step!, an important new
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benefit for· older Americans.
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AMERICANS WHOSE EMPLOYERS CUT BACK ON THEIR HEALTH BENEFITS
About 40 percent of employees and their families are covered
by employer health plans that are self-insured.
Self-insured
companies do not purchase health insurance from a private
insurance company, opting instead to pay.the cost of their
employees' medical care directly.
Self-insured compa.nies are now allowed to limit or eliminate
health insurance benefi.ts at 'any time.
Some self-insured
employers have,limited employees' health coverage after sickness
str!kes. '. - .':
The Clinton ReforIll will absolutely prohibit all employers
and insurers ·from imposing caps or' exclusions on coverage for
specific medical conditions, 'and will ban lifetime limits 'on
benefits.
.Comprehensive coverage will be required.
,
FAMILIES DSA
RAYING: Excellent new protection.
BUSINESSES WITH SKYROCKETING PREMIUMS
Health costs are eating away at
employee wages.
~usiness
profits and
Today, business spending for health care nearly
equals after-tax profits, up from 40 percent in 1980.
The Cl inton Health· Reform, will strictly 1imit .the amount·.,
insurance companies .can raise premiums.
not be allowed to increase
.By 1999; premiums
w.~ll·
inflation. FAMILIES DSA
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RATING: Tough on insurance companies, good for families and D.S.
fas~erthan
economy.
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�Page 7 of 7
AMERICANS ON MEDICAID WHO CAN'T GET HEALTH CARE
Last year, almost one of five adults on Medicaid were turned
away by a hospital or doctor.
emergency ,room for
carE~
Another 20' percent had to go to an
because they did not have a regular
physician.
Under the Clinton Health Reform, Medicaid recipients will be
enrolled in the same
hE~alth
same high quality care..
plans as other Americans, and get the
FAMILIES USA RATING:
Ends the scandal
of Uedicaid failure.
Families USA is the health consumer group fighting for'
health and long term care reform.
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�
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Carol Rasco - Issues Series
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Carol Rasco
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<a href="http://clinton.presidentiallibraries.us/items/show/36305" target="_blank">Collection Finding Aid</a>
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Carol Rasco's Issues Series collection consists of records relating to affirmative action, health care and reform, Medicare/Medicaid, immigration, disability, children, families and seniors, education, welfare reform, Middle Class Bill of Rights, and state and local economic issues. This collection consists of memos, letters, reports, schedules, itineraries, talking points, copies of legislation, and organizational material such as flyers and pamphlets.
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Health Care Meeting: 14 Nov. 1994 Families USA 3:30-4:30
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Carol Rasco
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Box 124
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2010-0198-Sb-health-care-meeting-14-nov-1994-families-usa-3-30-4-30