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The Clinton Presidency: Improving the Nation's Health Care

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The Clinton Presidency:
Improving the Nation's Health Care

From the first days of his Administration, President Clinton has worked to expand access to affordable, quality health care for all Americans. The President has strengthened the Medicare program, increased access and improved the quality of our nation's health care system. President Clinton's balanced approach to increasing access to quality health care has paid off for America, with the number of uninsured Americans declining for the first time in 12 years in 1999.

Strengthening and Modernizing Medicare

THEN: Medicare expected to run out of money in 1999.
Eight years ago, the Medicare Trust Fund was expected to run out of money in 1999. Health care fraud was contributing to rising costs and a shaky financial future for the Medicare program. The President and Vice President succeeded in passing measures to strengthen and modernize Medicare, crack down on fraud, and protect the benefits of today's beneficiaries.
NOW: Medicare trust fund extended until 2025 with more options for patient choice and preventive care.
President Clinton and Vice President Gore enacted the most comprehensive Medicare reforms in history. They insisted on provisions in the Balanced Budget Act of 1997 to protect, modernize and extend the life of the Medicare Trust Fund, while offering new options for patient choice and preventive care. The Balanced Budget Act also provided an array of new weapons in our fight to keep scam artists and fly-by-night health care out of Medicare and Medicaid. President Clinton has assigned more federal prosecutors and FBI agents to fight health care fraud than ever before. The Clinton-Gore Administration's work has extended the life of the Medicare Trust Fund until 2025.

Reforming the Insurance Market

THEN: Families lose coverage because of preexisting conditions and lack of portability
In 1992, there were no Federal protections to ensure the portability of health benefits for workers in between jobs or to prevent discrimination based on health status. Every year, an estimated 25 million Americans had breaks in their health care coverage because they changed jobs, or were self employed, or had preexisting conditions that could lead an insurance company to deny coverage. A technological revolution presented new challenges in safeguarding the privacy of Americans' medical records.
NOW: Insurance market reforms help working families keep their insurance coverage
President Clinton and Vice President Gore took on these new challenges and enacted critical reforms to the insurance market that have helped millions of Americans keep their health insurance.
  • In 1996 President Clinton and Vice President Gore enacted the Health Insurance Portability and Accountability Act, which helps people keep health insurance when they change jobs, guarantees renewability of coverage, and ensures access to health insurance for small businesses.
  • The President enacted mental health parity provisions to help eliminate discrimination against Americans with mental illnesses, and instituted new protections for mothers and their newborns and women recovering from mastectomies.
  • President Clinton also issued landmark Federal regulations protecting the privacy of electronic medical records and issued an executive memorandum preventing genetic discrimination in Federal hiring and promotion actions.
  • President Clinton directed the federal government to ensure that the important new benefits and rights that health care consumers receive under the Administration's proposed Patients Bill of Rights are guaranteed to federal employees, veterans, Medicare and Medicaid beneficiaries, and individuals covered by the Indian Health Service and the Military Health System, including choice of providers and plans, access to emergency services, participation in treatment decisions, confidentiality of health information and a fair complaint and appeals process.

Executive Action Guarantees Medical Privacy

"The Administration has made significant headway where Congress could not [on medical privacy] to restore public trust and confidence in our nation's health care system."
Janlori Goldman, October 29, 1999. Janlori Goldman, considered to be one of the leading medical privacy experts nationwide, directs the Health Privacy Project at Georgetown University's Institute for Health Care Research and Policy. The Project is dedicated to ensuring that people's privacy is safeguarded in the health care environment.

Improving and Expanding Health Insurance Coverage

THEN: Barriers to coverage result in uninsured children, people with disabilities and self-employed workers.
The number of uninsured — especially uninsured children — was growing. People with disabilities who wanted to work could not for fear of losing their health insurance, and young people leaving foster care could not retain the critical health insurance they needed to make a healthy start as adults. Unlike many other American workers, self-employed Americans received absolutely no tax assistance in purchasing health care insurance.
NOW: Barriers to health coverage removed for millions of Americans.
President Clinton came into office determined to expand access to health care for all Americans. His work has led to the first decrease in the number of uninsured Americans in at least twelve years.
  • President Clinton and Vice President Gore enacted the largest investment in health care for children since 1965, providing health care for up to five million children in working families with the State Children's Health Insurance Program. They also led aggressive outreach efforts to enroll eligible children.
  • President Clinton enacted landmark legislation providing new health insurance opportunities for working people with disabilities and enacted new legislation to help young people leaving foster care keep their health insurance, as well as legislation to assure that self-employed Americans receive the same tax benefits as workers who have job-based health coverage.
  • The Clinton-Gore Administration has improved quality and access of long term care. The Clinton Administration has made ensuring the health and safety of nursing home residents a top priority and has issued the toughest nursing home regulations in the history of the Medicare and Medicaid programs, requiring states to crack down on nursing homes that repeatedly violate health and safety requirements and changing the inspection process to increase the focus on preventing bedsores, malnutrition and resident abuse. They also enacted legislation simplifying state options to expand eligibility and design community based long term care programs, allowing seniors and people with disabilities to receive care in their homes rather than in institutional settings. And the Administration enacted legislation allowing the Federal government to serve as a model employer by offering quality private long-term care insurance to Federal employees.
  • In October 2000, President Clinton enacted the Breast and Cervical Cancer Prevention and Treatment Act, which provides new treatment options to low-income, uninsured women with breast and cervical cancer who are diagnosed through federally sponsored screening programs.

Children's Health Insurance Program Provides Security for Families

"When we found the Healthy Families program, it was like a miracle. Now my kids have a regular doctor who knows our family. I don't have to worry about taking them in for their school physicals or for their vaccinations. They can run around and climb on things and jump off things and the only thing I really need to worry about is if they get their clothes dirty. Because of the Healthy Families program, my husband and I can make sure that our kids grow up healthy."
Evelyn Alvarado, California, September 7, 1999. Evelyn Alvarado, enrolled her children in California's S-CHIP program (Healthy Families) in June 1999. Before they enrolled in Healthy Families, Evelyn's children — Daniel (aged 13), Mary (aged 11), and Samuel (aged 8) —were uninsured for eight years and only saw the doctor in the case of emergencies.

Ensuring that All Americans Have Access to Cancer Prevention and Treatment

The National Breast Cancer Coalition applauds this Administration for its dedication and commitment to furthering substantive breast cancer policies that move us closer to eradicating this disease. From enhancing access to quality clinical trials, to enacting an optional Medicaid bill that would ensure treatment for low-income women diagnosed with breast and cervical cancer through federal programs the Clinton Administration leaves a legacy of unprecedented progress for women with breast cancer, their families and friends.
Fran Visco, President, National Breast Cancer Coalition

Improving Public Health

THEN: Low child immunization rates, neglected public health and research
In 1992, America's public health delivery system was badly in need of repair: half of two year olds did not receive their immunizations, infant mortality rates were too high, and funding for biomedical research was inadequate.
NOW: Record child immunization rates, increased research funding, improved public health
President Clinton and Vice President Gore have improved our public health system and made investments that have given us a healthier America. They have increased child immunizations, implemented new food safety protections, increased research funding and became the first Administration to take on the tobacco industry to reduce teen smoking.
  • President Clinton and Vice President Gore raised childhood immunization rates to record levels by investing in the Childhood Immunization Initiative in 1993. More than 90 percent of America's toddlers received the most critical doses of each of the routinely recommended vaccines in 1996, 1997, and again in 1998. The infant mortality is at an all-time low, and has declined by 15.2 percent since 1992.
  • The Clinton-Gore Administration improved the safety of food for all Americans by seeking substantial funding for such initiatives as a nationwide early-warning system for foodborne illness, increased inspections, and the expansion of food-safety research, risk assessment and education. The Administration has also put into place improved science-based standards for meat, poultry, and seafood products and enacted strict new standards for pesticide residues in food, including the first pesticide standards aimed specifically at protecting children.
  • President Clinton and Vice President Gore have nearly doubled funding for the National Institutes of Health, increasing our investment in NIH by $10 billion since 1993, and they have strongly supported the efforts of the National Human Genome Research Institute to map the entire human genome, which will revolutionize health care in the future.
  • The Clinton-Gore Administration took on the tobacco industry by developing the first-ever plan to protect our children from tobacco, and calling on Congress to affirm the FDA's authority to implement this plan. The Clinton-Gore Administration has also made our nation's health a priority by establishing smoke-free federal workplaces, raising the federal tobacco tax, and by giving the American people their day in court against the tobacco manufacturers who engaged in decades of deception about the dangers of tobacco.

Raising Immunization Rates to an All-Time High
Ensures a Healthy Future for All Children

"President Clinton and those in his administration have made immunizations a priority since day one.... By launching the Children's Vaccine Initiative seven years ago, the Clinton Administration has increased vaccination rates to an all-time high. As a result, many infants and children will not suffer from such preventable diseases as polio and measles."
Joe M. Sanders, Jr., M.D., Executive Director, American Academy of Pediatrics.

Improving the Nation's Health Care

  • Strengthened the Medicare Trust Fund: Medicare is in the soundest shape since 1975, with the life of the Trust Fund extended until 2025. In 1992, Medicare was expected to run out of money in 1999.
  • Number of Uninsured Declines: From 1998 to 1999, the number of Americans with health insurance rose by 1.7 million — two-thirds of them children. This is the first decline in the number of uninsured in at least 12 years.
  • More Children Have Health Insurance: 2.5 million additional children have access to health care because they have enrolled in the State Children's Health Insurance Program.
  • Immunizations at All-Time High: Childhood immunization rates are at an all-time high with more than 90 percent of America's toddlers receiving the most critical doses of each of the routinely recommended vaccines in 1996, 1997, and 1998.
  • Infant Mortality at All-Time Low: Infant mortality has declined by 15.2 percent since 1992.
  • Cancer Deaths Have Stopped Rising: For the first time, cancer death rates have stopped rising, despite a growing and aging population.
  • New AIDS Infections Declined: For the first time in the history of the AIDS epidemic, new AIDS infections declined, and the latest data available indicates a decrease in HIV/AIDS mortality of 42 percent.
  • Improved Food Safety: From 1997 to 1999, illness from the most common foodborne pathogens declined by 20 percent — which means nearly a million fewer Americans are suffering from foodborne illnesses each year. In addition, infections from E. coli O157:H7 are down 22 percent due to improved sanitation in slaughter and processing plants; and infections from Salmonella enteritidis are down 50 percent due, in part, to Administration efforts to decrease contamination in eggs.
  • Lowest Teen Birth Rate on Record: The teen birth rate is the lowest ever recorded, falling in each year of the Clinton-Gore Administration, for an overall decline of 18 percent from 1992 to 1999. The teen pregnancy rate is also at a record low.
  • Extended Protections to People in HMOs: Protections included in the Patients' Bill of Rights have been extended to 85 million people covered by Federal health plans, and Medicare and Medicaid.
  • Extended Insurance Coverage of Contraceptives: Insurance coverage of contraceptives has been extended to approximately 1.2 million women of childbearing age covered by federal health plans.
  • Record High Levels of Biomedical Research: NIH supports the highest levels of research ever on nearly all types of disease and health conditions, making new breakthroughs possible in vaccine development and use, the treatment of chronic disease, and prevention and treatment of diseases such as diabetes, osteoporosis, heart disease, cancer, and neurological diseases like Alzheimers and Parkinsons.

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