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Human Development unit urges NLC to back Clinton health care proposal.

NLC's Human Development Steering Committee agreed to recommend NLC approval of the outline of President Clinton's health reform proposal. The decision was made during deliberations last week at the committee's meeting in Alexandria, Va. While generally approving the tenets of the plan, the committee also identified eleven specific areas which require action to better meet the needs in America's cities and towns.

The Committee agreed with the plan's premise of providing universal care, but urged NLC to continue to work with the administration and Congress to change other provisions which were not acceptable to the committee.

In particular, the committee targeted the plan's unequal employer mandate on municipalities. The plan prescribes a 7.9 percent of payroll cap for private employers, and specifically does not provide this protection for municipalities.

The committee identified eleven areas, including the employer mandate issue, in a proposed resolution, where plan improvements are urged. Other target areas for improvement include: enhancements in substance abuse programs, improved access for geographically remote towns and their citizens, stronger protections against discrimination based on pre-existing medical conditions, the non-incorporation of undocumented individuals into the plan and stronger avenues of redress if state governments exercise their authorities under the plan in a discriminatory manner as in the drawing of health alliance boundaries.

Led by newly-appointed its chair, Mayor Dorothy Inman-Crews of Tallahassee, the committee spent the bulk of its time reviewing the health plan elements which have been revealed to date, identifying issues which NLC should follow closely as the plan evolves during lengthy Congressional deliberations, and urged NLC to continue informing cities about the plan and its impacts on cities.

Strengths of Health Proposal

Components of health care reform which were strongly endorsed by the group are those which promise universal access to care, the move toward a comprehensive benefit package and the role of the proposal in placing the health care reform at center stage for national consideration.

In addition to their overall evaluation that the proposal moves constructively in the direction of NLC's adopted goals and objectives for health care reform the committee is recommending policy language advocating that city and town governments be treated in the same manner as private employers under the employer mandate of the plan.

Municipal Employers Not to Be Protected

In this plan, the administration proposes not to afford municipal employers the same protection from health care costs as other employers. The committee was distressed to learn this fact in questioning administration spokesperson, Larry Levitt, who appeared at the meeting.

Specifically, municipal employers are not currently expected to have a federal cap placed on maximum employer contributions to health care costs, although Levitt said there is some continuing discussion on this subject. When asked why a distinction was drawn between: (1) private employers and (2) state and local employers, Levitt said "you have a way of raising money." Committee members responded by explaining the tax caps and balanced budget requirements that their cities are forced to operate under. (See related story on NLC letter to the President Clinton)

Other Actions

The Human Development Committee will be recommending as policy the major points of an NLC Task Force on Federal Policy and Family Poverty, will be recommending that sexual orientation be added to NLC policies on non-discrimination and will be recommending an emphasis next year on the topic of city roles in education as part of NLC's Youth, Education and Families theme.
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Title Annotation:National League of Cities
Author:Peterson, Doug
Publication:Nation's Cities Weekly
Date:Oct 11, 1993
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