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pd25oc99 Statement on Signing Legislation Establishing Black Canyon of the...
Volume 35--Number 42 Pages 2065-2124 Week Ending Friday, October 22, 1999 Statement on the Vote in Indonesia To Accept the East Timor Referendum Results October 19, 1999 I welcome the historic decision by the People's Consultative Assembly of Indonesia to accept the results of the August 30 referendum in East Timor. The assembly's unequivocal action shows respect for the will of the people of East Timor. It is also an important step forward in Indonesia's own democratic transformation, which the United States strongly supports. Of course, much work remains to make sure that East Timor's transition succeeds. In the wake of the assembly's decision, the United Nations must establish a transition administration leading to East Timor's full independence. And Indonesia must take the necessary steps to ensure the safe return of all displaced East Timorese, including allowing the international community full access to displaced persons in west Timor. The United States is committed to helping the people of East Timor not only obtain the legal recognition of independence but also develop the institutions they need to thrive as an independent state. We are equally determined to help Indonesia achieve its goal of lasting democracy and prosperity. Today's action will bring both goals closer to fruition. <DOC> [Weekly Compilation of Presidential Documents] [frwais.access.gpo.gov] [Page 2088-2089] Monday, October 25, 1999 Volume 35--Number 42 Pages 2065-2124 Week Ending Friday, October 22, 1999 Statement on House Action on the ``Work Incentives Improvement Act'' October 19, 1999 I am extremely pleased that the House, by an overwhelming bipartisan vote today, passed legislation that will remove barriers to work for Americans with disabilities. Today's impressive vote for the ``Work Incentives Improvement Act'' sends a strong signal that all Americans, including people with disabilities, should have the opportunity to work. Now I call on Congress to finish the job so more Americans can start to work. My administration has helped create more than 19 million new jobs in the last 6\1/2\ years, and unemployment is at a 29-year low. Yet almost three out of four Americans with severe disabilities who want to work are not working. Since taking office, I have made empowering and promoting the independence of people with disabilities a priority. Central to this effort is taking down barriers to work for people with disabilities. One of the biggest barriers these Americans face is the fear of losing their health insurance when they get a job. Under current law, many people with disabilities cannot work and keep their Medicaid or Medicare coverage, creating a tremendous disincentive to work. The ``Work Incentives Improvement Act'' would help ensure that people with disabilities do not lose their health care when they gain a job. It would give workers with disabilities the option to buy into Medicaid and would extend Medicare coverage for people [[Page 2089]] with disabilities who return to work. The ``Work Incentives Improvement Act'' also modernizes the vocational rehabilitation system by creating a ``ticket'' that enables an SSI or SSDI beneficiary to go to either a public or private provider of vocational rehabilitation. In my State of the Union Address, 9 months ago, I urged the Congress to make this historic legislation a top priority, and I fully funded it in the budget I sent to Congress. Like the House, the Senate has overwhelmingly passed the ``Work Incentives Improvement Act,'' thanks to the leadership of Senators Jeffords, Kennedy, Roth, and Moynihan. The bill that passed today has flaws. These include limitations on the health options and inadequate and problematic financing provisions, particularly one affecting student loans. I urge the Congress to address these issues this year and send me this legislation. Americans with disabilities who want to work should not have to wait any longer for that opportunity. <DOC> [Weekly Compilation of Presidential Documents] [frwais.access.gpo.gov] [Page 2089] Monday, October 25, 1999 Volume 35--Number 42 Pages 2065-2124 Week Ending Friday, October 22, 1999 Notice--Continuation of Emergency With Respect to Significant Narcotics Traffickers Centered in Colombia October 19, 1999 On October 21, 1995, by Executive Order 12978, I declared a national emergency to deal with the unusual and extraordinary threat to the national security, foreign policy, and economy of the United States constituted by the actions of significant foreign narcotics traffickers centered in Colombia, and the unparalleled violence, corruption, and harm that they cause in the United States and abroad. The order blocks all property and interests in property of foreign persons listed in an Annex to the order, as well as foreign persons determined to play a significant role in international narcotics trafficking centered in Colombia, to materially assist in, or provide financial or technological support for or goods or services in support of, the narcotics trafficking activities of persons designated in or pursuant to the order, or to be owned or controlled by, or to act for or on behalf of, persons designated in or pursuant to the order. The order also prohibits any transaction or dealing by United States persons or within the United States in such property or interests in property. Because the activities of significant narcotics traffickers centered in Colombia continue to threaten the national security, foreign policy, and economy of the United States and to cause unparalleled violence, corruption, and harm in the United States and abroad, the national emergency declared on October 21, 1995, and the measures adopted pursuant thereto to respond to that emergency, must continue in effect beyond October 21, 1999. Therefore, in accordance with section 202(d) of the National Emergencies Act (50 U.S.C. 1622(d)), I am continuing the national emergency for 1 year with respect to significant narcotics traffickers centered in Colombia. This notice shall be published in the Federal Register and transmitted to the Congress. William J. Clinton The White House, October 19, 1999. [Filed with the Office of the Federal Register, 12:16 p.m., October 19, 1999] Note: This notice was published in the Federal Register on October 20. <DOC> [Weekly Compilation of Presidential Documents] [frwais.access.gpo.gov] [Page 2089-2090] Monday, October 25, 1999 Volume 35--Number 42 Pages 2065-2124 Week Ending Friday, October 22, 1999 Message to the Congress on Continuation of the National Emergency With Respect to Significant Narcotics Traffickers Centered in Colombia October 19, 1999 To the Congress of the United States: Section 202(d) of the National Emergencies Act (50 U.S.C. 1622(d)) provides for the automatic termination of a national emergency unless, prior to the anniversary date of its declaration, the President publishes in the Federal Register and transmits to the Congress a notice stating that the emergency is to continue in effect beyond the anniversary date. In accordance with this provision, I have sent the enclosed notice to the Federal Register for publication, stating that the [[Page 2090]] emergency declared with respect to significant narcotics traffickers centered in Colombia is to continue in effect for 1 year beyond October 21, 1999. The circumstances that led to the declaration on October 21, 1995, of a national emergency have not been resolved. The actions of significant narcotics traffickers centered in Colombia continue to pose an unusual and extraordinary threat to the national security, foreign policy, and economy of the United States and to cause unparalleled violence, corruption, and harm in the United States and abroad. For these reasons, I have determined that it is necessary to maintain in force the broad authorities necessary to maintain economic pressure on significant narcotics traffickers centered in Colombia by blocking their property subject to the jurisdiction of the United States and by depriving them of access to the United States market and financial system. William J. Clinton The White House, October 19, 1999. <DOC> [Weekly Compilation of Presidential Documents] [frwais.access.gpo.gov] [Page 2090-2091] Monday, October 25, 1999 Volume 35--Number 42 Pages 2065-2124 Week Ending Friday, October 22, 1999 Letter to Congressional Leaders on Medicare Reform October 19, 1999 Dear Mr. Chairman: (Dear Senator Moynihan:) It was a pleasure to meet with you and Senator Moynihan earlier this month to discuss our mutual commitment to strengthening and modernizing Medicare. It continues to be my hope that the Congress will take action this year to, at minimum, make a downpayment on needed reforms of the program. I look forward to working with you toward that end. In 1997, the Medicare trustees projected that Medicare would become insolvent in 2001. Working together across party lines, the Congress passed and I enacted important reforms that contributed towards extending the life of the Medicare trust fund to 2015. As with any major legislation, the Balanced Budget Act (BBA) included some policies that are flawed or have had unintended consequences that are posing immediate problems to some providers and beneficiaries. In addition, the program faces the long-term demographic and health care challenges that will inevitably result as the baby-boom generation ages into Medicare. As we worked together in 1997 to address the immediate threat to Medicare, we must work together now to address its short-term and long-term challenges. Preparing and strengthening Medicare for the next century is and will continue to be a top priority for my Administration. For this reason, I proposed a plan that makes the program more competitive and efficient, modernizes its benefits to include the provision of a long- overdue prescription drug benefit, and dedicates a portion of the surplus to help secure program solvency for at least another 10 years. However, I also share your belief that we need to take prompt action-- whether in the context of broader or more limited reforms--to moderate the excessive provider payment reductions in the BBA of 1997. I believe that legislative modifications in this regard should be paid for and should not undermine the solvency of the Medicare trust fund. You have requested a summary of the administrative actions that I plan to take to moderate the impact of the BBA. In the letter that you sent to me last Thursday, you also asked about four specific issues related to payment for hospital outpatient departments, managed care, skilled nursing facilities, and disproportionate share hospitals. Attached is a summary of the over 25 administrative actions that my Administration is currently implementing or will take to address Medicare provider payment issues. The Department of Health and Human Services is taking virtually all the administrative actions possible under the law that have a policy justification, which will accrue to the benefit of hospitals, nursing homes, home health agencies, and other providers. We are finishing our review of our administrative authority to address the 5.7 percent reduction in hospital outpatient department payments. We believe that the Congressional intent was to not impose an additional reduction in aggregate payments for hospitals and I favor a policy that achieves this goal. The [[Page 2091]] enactment of clarifying language on this subject would be useful in making clear Congressional intent with regard to this issue. I have attached a letter from Office of Management and Budget Director Jack Lew, which was sent at the request of Congressman Bill Thomas, detailing how such language would be scored by OMB. With regards to managed care, we share your commitment to expanding choice and achieving stability in the Medicare+Choice marketplace. The BBA required that payments to managed care plans be risk adjusted. To ease the transition to this system, we proposed a 5-year, gradual phase- in of the risk adjustment system. This phase-in forgoes approximately $4.5 billion in payment reductions that would have occurred if risk adjustment were fully implemented immediately. The Medicare Payment Advisory Commission and other experts support my Administration's risk adjustment plan. Consistent with this position, most policy experts believe that a further slowdown of its implementation is unwarranted. However, we remain committed to making any and all changes that improve its methodology. Moreover, as you know, any administrative and legislative changes that increase payment rates to providers in the fee- for-service program will also increase payments to managed care plans. On the issue of skilled nursing facilities, we agree that nursing home payments for the sickest Medicare beneficiaries are not adequate. I intend to take all actions possible to address this. Administratively, we can and will use the results of a study that is about to be completed to adjust payments as soon as possible. While we believe that these adjustments must be budget neutral, we are continuing to review whether we have additional administrative authority in this area. Finally, it appears that there has been confusion about the current policy for disproportionate share hospital (DSH) payments. Hospitals across a considerable number of states have misconstrued how to calculate DSH payments. The Department of Health and Human Services (HHS) has since concluded that this resulted from unclear guidance. Thus, as reported last Friday, HHS will not recoup pass overpayments and will issue new, clearer guidance as soon as possible.
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