Bill Clinton: “Well, they will do one thing for sure and another thing, maybe. And let me try to be explicit about that. There are--in…”

“Well, they will do one thing for sure and another thing, maybe. And let me try to be explicit about that. There are--in New York, as nearly as I can tell--I've studied these figures over the last several years for your State; this year I think the Medicaid budget went up something like 15 percent. If our plan passes and Medicaid is folded into the health care system generally--that is, people on Medicaid will go into large purchasing groups, along with folks from small businesses and medium-sized businesses and others, and the working poor, many of whom get Medicaid supplements in this State and others-- that's quite a large part of your burden--will be paid for in a completely different way, that is, employers, employees in a Federal discount, then the rate of increase in Medicaid costs will be dramatically less than it is now. So over the next 4 or 5 years you will save quite a lot of money. In addition to that, the hospitals here who have large Medicaid burdens will be better off because the Medicaid population will be in with the whole population, and the reimbursement rate will be the same for everybody. So that will take a significant burden off the hospitals with high Medicaid costs here. Now, the other big issue in New York has been, is it fair for New York to have a 50-50 match when Mississippi gets an 80-20 match? Maybe New York should pay more than Mississippi because there are more wealthy people here. But there is also a huge poor population here. In other words, is it fair to have this match rate based overwhelmingly on the, essentially, the average income of a State, the per capita income? We have a commission that is meeting on that, which is supposed to make a report to us in, I think, 1995, next year, about how to change it. There's no question that the formula should be changed and that States like New York with high per capita incomes but huge numbers of poor people are not treated quite fairly under a formula that only deals with per capita income. And that's going to happen next year. But we reasoned, and I think properly so, that in order to pass a change in a formula like that, we needed to have an adequate study, we needed to have an alternative, and we needed not to mix it up in the whole question of providing health care coverage for all Americans, which we're having a hard enough time passing as it is. So we put in this system to review it, come back in '95 and deal with it. So I think that that will also happen. I think you will get some relief there. But just passing the bill will save you a ton of money on Medicaid over the next 5 years. [A city councilman asked about provisions to help cities deal with the health care needs of illegal aliens.]”