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grateful to you for helping us to create it and for helping us put it 
into effect. But as your president said, somewhere between 10 and 11 
million children in America still lack health insurance. That's way over 
15 percent. The majority could be covered under either CHIP or Medicaid.
    We've still got 2 or 3 million kids out there who are Medicaid-
eligible who aren't covered--if we can get word out to their families 
and sign them up. We know that children who lack health insurance have 
higher rates

[[Page 2012]]

of treatable conditions like asthma, ear infections, vision problems. We 
know when a child can't see a blackboard clearly or hear the teacher 
precisely or pay attention to anything other than his or her own pained 
breathing, the kids aren't going to be able to learn.
    CHIP and Medicaid can change all that for millions of people. And 
when we passed the CHIP program, we thought it would insure 5 million 
people, if we could also get the Medicaid insurance rates up, and solve 
at least half the problem. Now, 2 years later, we've only insured a 
million. But it was only this year, to be fair, that all 50 States had 
their programs in place. So we're now at the take-off point, and we will 
be judged--you and I and all of us--on how well we do from here on out.
    This year--or last year, I established an inner-agency task force to 
come up with some innovative strategies to get the word out to parents 
about CHIP and Medicaid. Today I'm releasing their first annual report, 
which details a lot of promising outreach efforts. Just for example, the 
Department of Agriculture, which administers the school lunch program, 
has added information on CHIP and Medicaid to applications it sends to 
every school district in America. Millions of parents who fill out their 
school lunch forms now will have a chance to learn about these health 
    Other promising innovations are also in the works. Thousands of 
AmeriCorps and Vista volunteers who deal directly with low-income 
families every day will soon have information in their training manuals 
on how to enroll children in CHIP and Medicaid. Tens of millions of 
elderly Americans who may have grandchildren eligible for CHIP and 
Medicaid will soon be able to read about these programs in the annual 
letters they receive from Social Security and Medicare.
    But as the Vice President has been saying for months and months and 
months, if we're going to bring health care coverage to more children, 
we have to start with where the children are--in the schools. That's why 
today, I am issuing an Executive order to the Secretaries of Education, 
Agriculture, and Health and Human Services, directing them to find the 
most innovative school-based strategies now being pursued at the State 
and local level, to report back to me in 6 months on how we can 
replicate them in every community in the country.
    I'm also sending a letter to States, clarifying that they can use 
the CHIP fund for school-based outreach efforts. And we're going to 
dedicate over $9 million in new research grants to find out what 
outreach methods in schools or elsewhere work best. I believe these 
things will go a long way toward bringing health coverage to our 
children. But we need help from the churches, from the YMCA's and the 
YWCA's, from all the community organizations. And we need help from all 
the physicians and the public health units throughout our country.
    It is simply inexcusable that we're sitting here, and have been, 
with the money for 2 years to provide health insurance to 5 million 
kids, and 80 percent of them are still uninsured. And it is conceivable 
that we could do better than 5 million children with the money 
appropriated if we had effective enough outreach.
    And to those of you who see a lot of people whose parents' first 
language is not English, I know we have trouble there. But I would 
implore you, do what you can, when you go back home, with your local 
groups and your local medical societies and your local health clinics 
and your local schools, to get them to do this. There is no stigma 
associated with this. Most people will walk through a wall to get their 
kids decent health care coverage if they know it is available.
    This is simply a question--the average person who's not covered by 
this doesn't know CHIP from block. [Laughter] Or Medicaid from Lego, or 
whatever. You know, we've got to deal with people that--you know, most 
normal people worry about their lives, not Government acronyms. And 
we're dealing with--a lot of these folks don't know anything about this. 
And you can help to make sure, in your community, that the schools and 
the community groups and the religious organizations and everybody, is 
doing their outreach on this. It is profoundly important.
    Now, let me just say this last point. If every child eligible for 
CHIP and Medicaid were enrolled, there would still be millions who

[[Page 2013]]

lacked coverage. You know it, and I do, too. You know that I and Hillary 
and the Vice President, we have always believed it is wrong for any 
American, much less any child, not to have affordable, quality health 
care. I know that the American Academy of Pediatrics believes that. I 
will keep working to change that as long as I am President. I will keep 
looking for ways to end this unconscionable and growing gap of uninsured 
    Our hospitals will continue to have problems--and again, I would 
say, this has nothing to do--and you can help us with this--this has 
nothing to do with the Government taking over health care. The 
Government's not taking over health care in the CHIP program or Medicare 
or Medicaid.
    If we'd let these people--next to the kids, the fastest growing 
group of uninsured people are 55 to 65 years old, who retire and can't 
get employment-based health insurance anymore. We ought to let them buy 
into Medicare. You know, I get into all these fights with the insurance 
companies--and I hate to fight with them all the time--but the truth is, 
America has a system of financing health care that dictates high levels 
of uninsured, which dictates enormous burdens on the health care system 
of the country and burdens on everybody that buys insurance.
    And they can deny otherwise as long as they want to, but all you 
have to do is look around at other examples, and you know it's simply 
not true. There is no other conceivable explanation. It is the system by 
which we finance our care which has got us in the fix we're in now.
    And so we are trying to do this, and we are trying to do the bill 
for the disabled, and there are lots of other things we can do. But if 
you look at everything we do that's going to make a difference, it's 
because we have changed the financing. And those are facts, and you can 
get them out there.
    For the last 6\1/2\ years, I have had the great honor to serve as 
President of this country. I have about a year and 4 months left, maybe 
a little more. I've worked hard to turn this country around and then to 
keep the American people always thinking about tomorrow, about the 
challenges and the opportunities of the new century and the new 
    Well, now we have turned America around. And the great test is 
whether we are going to take this moment and shape our tomorrows. That's 
what you do every day, every time you take some preventive measure, 
every time you do something to help a child. There may be some screaming 
and crying, but you know they're all going to be better off tomorrow.
    I just would like to see all of us here in Washington take the same 
attitude toward the future of all our children's tomorrows that you take 
toward each child's tomorrow. If we do, America's best days lie in the 
new millennium.
    Thank you very much.

Note: The President spoke at 11:37 a.m. at the Washington Convention 
Center. In his remarks, he referred to Dr. Joel J. Alpert, president, 
and Dr. Donald E. Cook, president-elect, American Academy of Pediatrics.

[Weekly Compilation of Presidential Documents]

[Page 2013-2015]
Monday, October 18, 1999
Volume 35--Number 41
Pages 1991-2064
Week Ending Friday, October 15, 1999
Memorandum on School-Based Health Insurance Outreach for Children

October 12, 1999

Memorandum for the Secretary of Health and Human Services, the Secretary 
of Education, the Secretary of Agriculture

Subject: School-Based Health Insurance Outreach for Children

    The lack of health insurance for millions of Americans remains one 
of the great challenges facing this Nation. To help address this issue, 
I worked with the bipartisan Congress to create the Children's Health 
Insurance Program (CHIP), the single largest expansion of children's 
health insurance in 30 years. The 1997 Balanced Budget Act allocated $24 
billion over 5 years to extend health care coverage to millions of 
uninsured children in working families. CHIP builds on the Medicaid 
program, which currently provides health coverage to most poor children, 
and together, these programs could cover most uninsured children.
    Yet too few uninsured children eligible for CHIP or Medicaid 
participate. Barriers to enrollment include parents' lack of knowledge 
about the options; cultural and language

[[Page 2014]]

barriers; complicated application and enrollment processes; and the 
``stigma'' associated with so-called welfare programs. The Vice 
President and I have made removing these barriers to enrollment a high 
priority. In 1997, I launched a major public-private outreach campaign 
called ``Insure Kids Now.'' Foundations, corporations, health care 
providers, consumer advocates, and others have participated through 
activities such as setting up enrollment booths at supermarkets and 
promoting the national toll-free number
(1-877-KIDS NOW) on grocery bags, TV and radio ads, and posters. In 
addition, we created a Federal Interagency Task Force on Children's 
Health Insurance Outreach in February 1998, which has implemented over 
150 new activities to educate and train Federal workers and families 
nationwide about the availability of Medicaid and CHIP.
    Today I am directing the Secretaries of Health and Human Services, 
Education, and Agriculture to focus children's health insurance outreach 
on a place where we know we can find uninsured children: schools. State 
experience indicates that school systems are an ideal place to identify 
and enroll uninsured children in Medicaid or CHIP because schools are 
accepted by parents as a conduit for important information. In addition, 
health insurance promotes access to needed health care, which experts 
confirm contributes to academic success. We have learned that children 
without health insurance suffer more from asthma, ear infections, and 
vision problems--treatable conditions that frequently interfere with 
classroom participation; and children without health insurance are 
absent more frequently than their peers. As we strive for high standards 
in every school and classroom, it is essential that we help families 
ensure their children come to school ready to learn.
    Therefore, I hereby direct you, in consultation with State and local 
agencies, to report to me a set of recommendations on specific actions 
to encourage and integrate health insurance enrollment and outreach for 
children into schools, consistent with the mission of your agency. This 
report shall include:
<bullet>    Specific short- and long-term recommendations on 
            administrative and legislative actions for making school-
            based outreach to enroll children in Medicaid and CHIP an 
            integral part of school business. These may include:
<bullet>    Technical assistance and other support to school districts 
            and schools engaged in outreach;
<bullet>    Suggestions on how to effectively use the school lunch 
            program application process to promote enrollment in health 
            insurance programs;
<bullet>    Lists of practices that have proven effective, such as 
            integration of outreach and enrollment activities into 
            school events such as registration, sports physicals, and 
            vision and hearing testing; and
<bullet>    Model State CHIP and Medicaid policies and plans for school-
            based outreach.
<bullet>    A summary of key findings from the national and regional 
            conferences scheduled for this fall on the topic of school-
            based outreach. These conferences will bring together 
            national and State education officials, Medicaid and CHIP 
            directors, public policy experts, and community-based 
            organizations to examine the use of schools to facilitate 
            the enrollment of children in Medicaid and CHIP; evaluation 
            tools to monitor the effectiveness of current school-based 
            outreach efforts; and best practices in school-based 
            outreach and enrollment for children's health insurance.
<bullet>    Recommendations on methods to evaluate CHIP and Medicaid 
            outreach strategies in schools. Performance measures should 
            be an integral part of school-based CHIP and Medicaid 
            outreach strategies, as they can inform policy-makers on the 
            effectiveness of these strategies, as well as help to 
            identify areas of improvement.
    I direct the Department of Health and Human Services to serve as the 
coordinating agency to assist in the development and integration of 
recommendations and to report back to me in 6 months. The recommended 
actions should be consistent with Medicaid and CHIP rules for coverage 
of appropriate health- and outreach-related activities. They should be 
developed in collaboration with

[[Page 2015]]

State and local officials as well as community leaders and should 
include recommendations on fostering effective partnerships between 
education and health agencies. These recommended activities should be 
complementary, aggressive, and consistent with my Administration's 
overall initiative to cover uninsured children.
                                            William J. Clinton

[Weekly Compilation of Presidential Documents]

[Page 2015]
Monday, October 18, 1999
Volume 35--Number 41
Pages 1991-2064
Week Ending Friday, October 15, 1999
Statement on World Population Growth

October 12, 1999

    Today we mark the day that the world's population reportedly reaches 
6 billion. It took just 12 years--from 1987 to today--for the world's 
population to expand from 5 to 6 billion people. We should be thankful 
that people today live longer and healthier lives than ever before. But 
over the next few years, this rapid growth and its effect on our 
environment and quality of life will pose difficult challenges for all 
of us.
    In 1994 the United States helped forge a consensus at the 
International Conference on Population and Development in Cairo, Egypt, 
on a comprehensive approach to stabilizing world population growth. We 
agreed to work with other nations to help prevent the spread of HIV/
AIDS, to improve the status of women, to enhance educational 
opportunities for children, and to support voluntary family planning and 
related health care.
    My administration has made important strides in meeting these 
objectives. At home, we have increased funding for family planning and 
reproductive health services, which have helped reduce teen pregnancies 
and abortions. Overseas, we have invested more than $5.5 billion in over 
100 countries on health and population initiatives and on women's 
    We have also worked to protect our environment and ensure that it 
can sustain the development needs of a growing population. We are 
learning that technology can help developing countries grow while 
bypassing some of the environmental costs of the industrial age. We must 
promote that technology so that we can address both climate change and 
the challenge of providing clean energy for all the world's citizens.
    Finally, we have recognized that the best way to stabilize 
population growth is to fight poverty and to build healthy, growing 
economies in the developing world. The debt relief package the world's 
wealthiest nations agreed to in Cologne this year will help us do that. 
Last month, I went even further, announcing that the United States will 
forgive 100 percent of the debt owed us by the world's least developed 
countries if they will use the savings to address basic human needs. And 
I committed the United States to a new effort to accelerate the 

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