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Office of the Press Secretary

For Immediate Release June 23, 1998

The Briefing Room

1:51 P.M. EDT

MR. LOCKHART: Hello everybody. Before Mike comes out we've got a couple of experts to help us through what the President did today. From OMB we have T.J. Glauthier, and Barbara Chow who are both associate directors of OMB who can talk to you about the Ag Research Bill that the President signed and the food stamp provisions which he stressed during his presentation. And Chris Jennings, who you all know is the President's health care advisor can talk to you about the changes that are going on in Medicare and the comments the President made today about what's going on on the Hill concerning the Healthcare Bill of Rights.

So why don't I just let them come up. Chris, T.J. and Barbara. Ask away.

MR. JENNINGS: Rather than make a presentation or summary of this we understand that you've all been given the summary statements earlier that summarize the major elements of this; you've heard the President's speech. We'd like to respond to any questions that you have.

Q When do the food stamps actually start? When are they available?

MS. CHOW: It's November 1, 1998.

Q Pardon?

MS. CHOW: It's November 1, 1998.

Q What does it entail?

MS. CHOW: The food stamp benefits? There are five major categories of beneficiaries: immigrants who are or become disabled who are in the US as of August 22, 1996, which was the date of welfare reform, immigrant children who are under the age of 18 and in the US as of the same date, immigrants who are 65 years of age and older. It also extended the food stamps eligibility period from refugees and assylumees from five to seven years and it restores food stamp benefits for the Hmong and Highland Laotian immigrants who aided the US personnel during the Vietnam war. And there is also another small category for native Americans and those living along the Canadian and Mexican boarders.

Q Were they all on food stamp benefit rolls before the Welfare Reform Bill and then they were dropped?

MS. CHOW: They were all eligible. I mean, the individuals obviously could be a different set of individuals but they were all in eligible categories.

Q Are any being left out in terms of the immigrants who would have ordinarily gotten them?

MS. CHOW: This is not a full restoration of benefits. The President's budget had a larger restoration but it's a very, very important step towards achieving what the President had wanted to do.

Q How many are left out?

MS. CHOW: There's, let's see we had I think about --

Q Roughly?

MS. CHOW: 700,000 additional immigrants would have been aided by the President's budget that were not helped as part of this bill.

Q What's going to happen to them?

MS. CHOW: We'll continue to work toward restoration of benefits for the other folks that we were not able to achieve the restorations for in this bill.

Q And those 700,000 people were eligible before the Reform Bill in 1996?

MS. CHOW: Yes, they were generally -- is that right? Yes.

Q What's your estimate on the number --

MS. CHOW: The largest category that was not included here are families with children who may have entered before or after August 22nd, which was the date of welfare reform.

Q But, what's the --

MS. CHOW: The additional -- I guess it's not 700,000 total it's 450 additional. So we did 250 in this bill and there were 450 additional in the President's budget.

Q Are the grants for land grant colleges and so forth, do they remail basically the same in the amounts and funding?

MR. GLAUTHIER: The same as they were before, you mean? Well, there is an increase there. Mark Weatherly is my branch chief at the Agriculture Branch. Mark, can you answer the specific?

MR. WEATHERLY: The bill provides another $120 million for research. Most of those are competitive grants so the land grants can compete for it. It is not like the formula funds that now go straight to the land grants but they can be in on it.

MR. GLAUTHIER: Any questions for Chris on Medicare?

Q Tell us what it amounts to.

MR. JENNINGS: Okay, the President, as you saw, highlighted in his remarks today when he signed the Bill into law both the regulation that will become -- will be actually printed in the Federal Register this Friday implementing the new balanced budget act choices options. And within those choice options every managed care plan who will be participating in the Medicare program will have to come within compliance with the Patient Bill of Rights. You will recall in December, and then subsequently in the Spring he issued an executive memorandum applying all the Patient Bill of Rights protections to federal health programs.

Today's announcement that the President is discussing was -- and the publishing of it this Friday, will integrate a number of these important protections for Medicare beneficiaries and they include the access to specialist provisions, the access to OB-GYNs for women and a number of privacy protections, privacy and confidentiality protections. That is combined today with his announcement of his strong support for the actions that Dr. Ganske, Congressman Ganske a Republican from Iowa, as well as Mr. Dingle is taking today by filing a discharge petition this very morning to bring the bill, the Patient Bill of Rights, up for an up or down vote.

The President, as you know, has been calling for this legislation to be moving through Congress since December of last year. He called on it again just yesterday. He's been frustrated that the Congress has yet to respond to this call. He hopes that the filing of the discharge petition, as well as hopefully positive action by members on both sides of the aisle will ensure that we get the bill passed this year -- a strong and enforceable bill passed this year.

Q What's the outlook?

MR. JENNINGS: Well, we are finding that there are more and more Republicans who are interested in passing a Patient Bill of Rights this year. Certainly the leadership of Dr. Ganske and others in this regard encourages us in that regard. We hope that it is not a fig leaf bill, we want to make sure it's a strong bill. And as we understand it a number of folks within the Republican leadership are contemplating new legislation to be offered this week or soon after recess. We hope that it's a good strong bill. We hope it's not full of poison pills. We remain hopeful that it won't be.

Q From what you know of that bill, do you feel that you can work with -- do you think it will at least be a starting point to work with Republicans to get a bill in that way?

MR. JENNINGS: Well, the President -- you know, understanding as he's been saying for many, many days that there is not many days left in this Congressional session -- that he would want to focus it specifically on the Patient Bill of Rights -- if we can do more and it's -- there are strong contributions consistent with the President's and in a bipartisan consensus point of view and moving any additional provisions forward we would do so.

But what we don't want to do is have a long debate about issues that we can't agree on. We think that the American public have reached a consensus that they want to have a strong Patient Bill of Rights this year and it is our hope and our determination to work towards that end this year.

Q But what are some of the issues that you think you can agree on? Would one of them be the right to sue HMOs, which apparently the Republicans are considering or would there be this idea of health marks? What are some of the issues where you think you can not agree on?

MR. JENNINGS: Well, I think that there has been a division -- there is a very significant division among the Republicans on the issue of enforcement and the right to sue. I think that it is at best split. Probably the majority of the caucus is not particularly comfortable with that. We do think that there should be a strong enforcement mechanism; one is the enforcement mechanism included in Congressman Dingle's legislation, Congressman Norwood's, Dr. Ganske's -- but there are other approaches. But it's got to be enforceable or -- because we strongly believe a right is not a right without a remedy. And that's what we're going to be pursuing this year.

Q Well you describe Republican's position on the right to sue HMOs, how about the White House's position that --

MR. JENNINGS: As I say, our position -- if the President -- if the Congress passed the Ganske-Dingle legislation the President would be happy to sign that into law but he remains open to alternative approaches to enforcement mechanisms. And there are ways -- we've had this -- the Labor Department has testified on numerous occasions that there are alternative ways to get to the same end but we want to make sure that there is an enforcement mechanism.

Q How about the insurance industry, are they opposing it also AMA types and --

MR. JENNINGS: Well, this is one issue in which the AMA and the President stands united together on this issue. We've had a number of events together. We've worked very, very closely with the AMA. They believe that these type of protections that would liberate doctors, provide the type of care that they want to provide for their patients is something that we need to do and need to have done this year. So we're there together.

As to the insurance industry -- for the most part the insurance industry is strongly opposing any federal legislation in this regard. There are exceptions to that rule. New York HIP, Kaiser and others have exclusively said that they would support federal standards. We're encouraged by that. We hope more come to the forefront.

We are hearing that there are a number of progressive managed care plans who are thinking about doing just that and we're encouraged by those developments.

Q One more. What does the White House think of the idea of medical savings accounts? Do you think they've worked so far or do you think they need to be improved or just chucked?

MR. JENNINGS: Well, the medical savings account -- as you know, we supported and signed into law the demonstration program. There has not been an enormous take up rate of interest by the public; it's unclear as to all the reasons why. The reason why we had a demonstration is to determine whether or not one, there would be an interest; two, whether they would have any type of significant negative impact on the insurance market.

I think the jury is still out and we look forward to having an analysis on that demonstration. But it's -- we're only a few months into it.

Thank you very much.

END 2:20 p.m. EDT