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Office of the Press Secretary

For Immediate Release February 23, 1999
                            PRESS BRIEFING BY 
                          FOR HEALTH CARE POLICY 
                            The Briefing Room   

1:12 P.M. EST

MS. WEISS: Ladies and gentlemen, today Chris Jennings will brief you on what the President will be announcing in the next hour. The President will launch a national outreach campaign called "Insure Kids Now," which is aimed to enroll eligible, but uninsured children in Medicaid by promoting awareness and increasing enrollment in the Children's Health Insurance program, also known as CHIP.

Chris Jennings is the Deputy Assistant to the President for Health Care Policy.

MR. JENNINGS: Today we're very excited; on the heals of the NGA meeting over this weekend, we have been working with them very, very closely, as well as a whole bunch of corporate entities, in developing a major new outreach campaign for eligible children who are eligible for either -- millions of eligible children, over 5 million children in this country are eligible and not enrolled in either the Medicaid program or the new CHIP program the President signed into law in 1997.

It builds on a whole host of other initiatives that the President and the First Lady and the Vice President have been involved in the last year. I'm going to just briefly talk about that, and then I'm going to talk about what we're doing today.

After the enactment of the historic $24 billion CHIP program, the President and the First Lady and the Vice President held a series of events, working with the governors and over 11 agencies in the federal government, to develop ways to use our resources to target these children and make them aware of this information about the new children's programs, as well as to help enroll them more effectively.

One of the big challenges in targeting and enrolling children is not just making sure they're aware of the program, but also simplifying applications procedures, actually going to where those children are, whether it be in the school, whether it be in public housing, whether it be in churches and other places, and what we've done last year was to work with all our federal agencies -- not just HHS, which has done a remarkably good job this year for us, but also agencies you wouldn't necessarily think automatically -- Agriculture, Labor, HUD, Justice -- all of the 11 agencies have been participating very, very actively.

And what we've done is laid the groundwork for being able to enroll the children very, very effectively. But really, what we need to do now is to not just make sure we have the on-the-ground support and the infrastructure and the enrollment forms, but we have to make sure kids are actually aware of the programs and have a place to go to get information about these programs.

So what we've been doing with NGA, working very closely and working with Bell Atlantic, is developing an 800 toll-free number. And the toll-free number is now up and running, as of today. I just called it about two minutes ago and they answered, and they have information. The number is: 1-877-KIDS-NOW. And that number translates into 1-877-543-7669.

Now, what we're doing today is announcing the availability of that toll-free number, and what's most interesting about this, this is the first time we've ever done this nationally. Anyone who calls that number, wherever they are in the country will be automatically forwarded to an operator and an information worker within the state they're calling. So if I call from the State of Washington or Utah or whatever, I'll go the national number, but I'll be routed back to the state, where someone will know information about this program, which is really very, very important.

But now that we have this national campaign, and national toll-free number up and running today, we can actually utilize our resources, working with the networks, working with a whole bunch of corporate entities, to advertise this number.

And I want to give you a couple of examples about this, because we're really thrilled about this. First, NBC is going to be -- they have made a commitment to air a public service announcement beginning February 24th, using NBC stars from well-known shows. ABC has made a similar commitment as well -- we're quite pleased about that, Sam -- as well as a whole host of other people, including Turner Broadcasting, Univision, the National Association of Broadcasters, Univision and others.

Getting the information out is critically important for -- and particularly about how to access it, through the toll-free number -- is something very, very important. But also, we need to do this, not just in terms of national networks, but we have to do targeted -- both networks and targeted radio. And we have gotten commitments for radio ads in 45 states -- Bonneville Communications and others are going to be doing a whole host of radio announcements as well -- as has a whole host of print media establishments, too.

But, not just getting the information there, because -- well, everyone watches TV, everyone hears the radio, but we also know where parents go. They go to grocery stores, they go to ---K-Mart, they go to McDonald's. And what we're really thrilled about today is to announce that a whole host of these corporate entities are making commitments to educate even their own shoppers and their consumers with access to information about the program, and even about the toll-free number.

K-Mart, McDonald's, General Motors -- General Motors is going to affix a label to all their child safety seats that they sell, so when you're putting in your children you're going to see your toll-free number, how you can access -- Safeway, Rouse Grocery Store, others are going to be putting this in all their paperbags and everything. So people are going to know this number, if we can find any way at all to do it.

But we've also found that, obviously, the other places where people and their parents try to seek health care is with their providers, whether it be their doctors, their nurses, their dentist -- the American Dentist Hygienist Association is going to put the toll-free number on all their toothbrushes that they send out. We're going to have AMA, the Nurses Association, the American College Emergency Physicians are all going to be providing information directly to their patients who come in.

And we're also thrilled about a whole host of community-based organizations -- United Way, Volunteers of America, Points of Light, America's Promise, others are really making a significant commitment in this area to get the word out as well.

The real point of all this activity -- and I could go on and on and on -- we have a real major commitment from the religious organizations as well. From Amy we can give you a host of -- a nine-page list of commitments from around the country, and I think the most important thing is that we get out the message -- is that children who are uninsured now have access to a free or low-cost option, that there is no excuse that we don't all work together to get this information out, and we must do a better job of target enrolling it. We're very happy that we have the governors on board. We think they've done some creative things and we're going to be committing today to do some more over the next several months and weeks and months to come, and I'd be happy to answer any questions specifically about this initiative.

Q CHIPS was created two years ago. Why has it taken so long to deal with the enrollment problem? Because, presumably, is millions of kids is still out there.

MR. JENNINGS: Actually, it's true. CHIP was enacted into law -- it was the end of 1997. What we're actually quite thrilled about is less than a year after enacting it, we have over 45 states who are now up and running, and they're projecting, I think it's about 2.5 million kids that they will eventually get to. But again, the programs are just up and running.

The most important thing is, you start the programs; now that they're up and running, now that we're doing these easier administrative application and enrollment forms, we're getting the information out about how to access them, really, I've got to tell you, when you're trying to enroll children into these programs, it's a lot of hard work. You've got to go to where they are, you have to go to places that you otherwise might have not immediately thought. You can't just say I have a program, you have to go out and find them and find their parents.

This program that we're doing today actually we think will go a long way to ensure CHIP is successful, but so is the promise of the Medicaid program as well.

Q I don't know what you're talking about. What is CHIP?

MR. JENNINGS: CHIP is the Children's Health Insurance Program. CHIP --

Q State by state?

MR. JENNINGS: Yes, in 1997 in the balanced budget program, the President advocated for and the Congress passed an historic $24-billion Children's Health Insurance Program, short for CHIP. And it is a state-administered program. We provide for flexibility, but --

Q Where does the money come from?

MR. JENNINGS: The money comes specifically from the Balanced Budget Agreement. We had savings from the balanced budget that we achieved that we redirected towards providing subsidies to states so they could provide for children to make health care affordable, and in many cases free.

Q So this is for poorer families? In other words, there is an eligibility requirement?

MR. JENNINGS: There is an eligibility requirement. Actually, there is a lot of flexibility. Many states are -- all the way up to over 200 percent of poverty, some go up to 200 percent of poverty. All these kids, almost probably 95 percent-plus are children of working families -- families who are workers, but who cannot afford or do not have access to health care. And this program was designed to target that population.

As you know, we have the Medicaid program that we've had some success in covering children. We have not done as good a job as we should in terms of enrolling all of the eligible kids even for the Medicaid program. The advantage of this activity that we're announcing today is, it will benefit both the Medicaid program and the CHIP program together.

Q Chris, what are some of the leading reasons after all this publicity that kids are not enrolled? Is it just ignorance in the existence of these programs?

MR. JENNINGS: Historically, lower income programs, you don't have as significant enrollment as you want to have, but what we've learned over the years past is you can significantly improve your enrollment if you can go to the places where the children are, where the populations are, and you can do it in a way that is a non-threatening way. That is in other words, you don't have a 100-page application form you have to fill out, you have a five-page form. You automatically are eligible.

They almost immediately enroll you if you come in and you come close to fulfilling eligibility. In many states, they have what they call "presumptive eligibility," so they can say, okay, you look like you're enrolled, so I'm going to enroll you automatically. And what we've found in many, many states who are using these type of programs, and others, they are having much greater success. But, you have to do the hard work of educating and informing, and publicize this over and over and over again. And you have to use the foundations, the churches, the providers, the schools. You can't just do this about a big public campaign. You have to use the private entities.

And what we're most pleased about is, we're really being joined today by a lot of the corporate community, to educate people about this program, where children go every day.

Q Can you point to any pattern of health problems among children who are not enrolled in this? Is there any --

MR. JENNINGS: Absolutely. I mean, what we have learned, of course, is if you don't have access to health care, you frequently don't have access to the preventive-type coverage that you really need to avoid the illnesses and diseases over a period of time. And we have some really good data on that, we'd be happy to supply to you.

But the lack of uninsured means, also, lack of even performance in schools, a lack of ability to go day in and day out to increase your education capability, increase your economic standing, which again, of course, is a huge correlation between economic standing and health care as well.

Q How old, and how many children are we talking about in this particular --

MR. JENNINGS: Well, in a CHIP program, we believe that there's about -- well, first of all there's probably, or almost 4 million children who are eligible but still not enrolled in the Medicaid program. In CHIP, we think it's, you know, it's over 2 million probably. We're talking about a number of -- certainly in aggregate, over 5 million kids who are eligible and not enrolled in either Medicaid or CHIP. And those are the numbers that we're using right now.

And if we can just -- if we can be very effective at targeting and enrolling these kids, we can, with programs currently available, get millions of kids coverage that they really desperately need.

Q And that is compared to how many that are in? Enrolled?

MR. JENNINGS: And that's -- well, in the Medicaid program for children I think we have about 20 million children today. In CHIP, we have just started the program; we're probably around a million or so, and hoping to increase that number over a period of time.

Q This is on a different subject. Tomorrow the Medicare Commission is meeting, and there's been some concern about what kind of guidance the President or the White House has been giving their four appointees, and also some concern that they're kind of moving on bloc and haven't been given the latitude to split up in their different ways over -- plan. What can you tell us about what kind of guidance the President has given his appointees in the Medicare Commission and where is that commission going?

MR. JENNINGS: First, our hope, of course, is that the Medicare Commission integrates the President's proposal that he announced in the State of the Union, dedicating 15 percent of the surplus to the Medicare program. Every one of our commission members and appointees believes strongly, as does every independent analyst out there, that you can't significantly extend the life of the trust fund without an infusion of dollars. And it almost doesn't make sense to proceed and say that you're going to have really significant reforms without those infusion of dollars.

Having said that, I'll tell you -- I don't know if you've been watching our commission members -- I don't think people would say that Bruce Vladeck and Stuart and Laura Tyson are always in the same exact place. They're not acting or behaving like they are in a bloc vote here at all.

The President did lay out some principles, one of which was dedicating the surplus. The other was a defined benefit; the other was a viable prescription drug benefit; and for low-income protections for beneficiaries. Those are just very basic principles that I think he and his members believe in, but I think most Democrats do believe in. And I think we've been encouraged that some Republicans are.

I guess I would just say that, in general, we're not going to comment on individual iterations of the commission until they complete their work. They have not completed the work, they don't have the details done. We have worked with Senator Breaux for months; we're trying to provide technical assistance and we will continue to do so. And as you know, we respect him greatly and we hope that we can get something very, very positive out of this commission.

Q Senat or Breaux was actually trying to get some time with the President this week to talk about the commission. Has he gotten any and is there any time on the schedule for that?

MR. JENNINGS: I'll tell you what, I don't know if he's talked to the President yet. I don't believe he has, but Senator Breaux has never had a difficulty in contacting the President and they have a very close working relationship and I assume they'll be talking soon -- not just this week, but into the future as we talk about the developments around the Medicare Commission.

Q But if the appeal is for -- if Senator Breaux makes an appeal to the President, have one of your members vote for this so that we can get the 11 votes, the super majority that we need, what's the answer?

MR. JENNINGS: Our members -- first of all, our members, our commission members feel very strongly about some core principles. They feel very, very strongly about defined benefit, they feel very strongly about the issue of a viable prescription drug benefit that's available for all Medicare beneficiaries, and they also all agree very strongly that you should dedicate the surplus to the Medicare program.

Those are things that they, independently, they've been saying this for two months. Now, if the commission moves to address all of those things, I think that they'll see much more openness by our members of working on this issue. But we're just not there just yet. We're hopeful that we will get there. But we're not going to say to one commission member against their desires to vote for something that they don't believe in, but we also think that Senator Breaux really values the input that our people have given to this commission, and our hope is, over a period of time that that will strengthen the work of the commission.

So I'm not going to get into this political "I'll give you this and that." I really believe that this whole policy, this whole issue of the Medicare program is too important to say it's all about political positioning. It really is about having a strong product emerging from the Medicare Commission that we can all be happy with on a bipartisan basis and that does significantly move to extending the trust fund, but also strengthening and improving the program as we know it today.

Q Senator Lott said today that he does not believe -- he believes that if you can't get the 11 votes, you will not get Medicare reform in this Congress. Do you agree with that, or no?

MR. JENNINGS: I think you definitely want to have a strong vote out of the commission and have a bipartisan one. I think that there was not a uniform agreement out of the Social Security recommendation of the commission, and our hope has been and continues to be, as we've seen in recent weeks, that there is growing momentum to have an agreement on Social Security. So despite the fact that the Social Security Commission had a uniform agreement, some of the base ideas that were formed and given to us provide a solid foundation for us to move forward.

The Medicare Commission, we think, with the majority or without a majority, at least has the potential to do so. Obviously, our preference would be if everyone voted for -- if it was all 17 members, it would mean that you would have a very, very -- have a much greater chance. But I wouldn't say that having 11 or 10 or whatever is necessarily dispositive to whether or not it has a significant influence on whether or not we have strong Medicare reform emerging from this Congress.

Q Will the President embrace this thing and will he put as much attention into Medicare as he has into Social Security so far? What kind of priority is this?

MR. JENNINGS: Sure. One thing that people didn't recognize about the President, even during the whole year of Social Security, it was the President who continually said over and over again, he said Social Security and Medicare. It was never Social Security independent of Medicare. He feels they're really joined at the hip, and he feels quite strongly that with his foundation of dedicating the surplus to the Medicare program and some of the reforms he would like to see of the program, modernizing the program, making it more competitive, making it more oriented towards being able to use the same purchasing tools for the fee-for-service program that private sector now has, we can significantly strengthen and improve the Medicare program, and he hopes that as part of an overall agreement on Social Security, we can get an overall agreement on Medicare.

THE PRESS: Thank you.

END 1:32 P.M. EST