1993 Clinton health care plan 1369907 224458958 2008-07-08T22:50:34Z Rjwilmsi 203434 no 'of' between a month and a year per [[Wikipedia:Manual_of_Style_%28dates_and_numbers%29#Longer_periods|MOS]] using [[Project:AutoWikiBrowser|AWB]] The '''Clinton health care plan''', sometimes called "'''HillaryCare'''" by opponents,<ref>{{cite book | last=Estrich | first=Susan | authorlink=Susan Estrich | title=The Case for Hillary Clinton | publisher=HarperCollins | year=2005 | isbn=0060839880}} p. 104.</ref><ref>{{cite book | last=Longman | first=Phillip | title=Best Care Anywhere: Why VA Health Care Is Better Than Yours | publisher=PoliPointPress | year=2007 | isbn=0977825302}} p. vii.</ref><ref>Gratzer, David. [http://www.weeklystandard.com/Content/Protected/Articles/000/000/005/617loflw.asp "The Return of HillaryCare"] ''[[The Weekly Standard]]''. 05/23/2005, Volume 010, Issue 34. Retrieved 2007-August-07.</ref> was a 1993 [[Health care reform in the United States|healthcare reform]] package proposed by the administration of [[Bill Clinton]], then [[President of the United States]], and created and chaired by the [[First Lady of the United States]], [[Hillary Rodham Clinton]]. == Background == The [[United States]] is the only wealthy, industrialized nation that does not provide [[universal health care]].<ref>[http://www.iom.edu/?id=17848 Insuring America's Health: Principles and Recommendations], Institute of Medicine at the National Academies of Science.</ref><ref>[http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm The Case For Single Payer, Universal Health Care For The United States].</ref> Although the United States has never had a universal health care system, it does have certain [[publicly funded health care]] programs that help to provide for the elderly and disabled (via [[Medicare (United States)|Medicare]]), military service families, veterans (via the [[Veterans Health Administration]]), and some of the poor (via [[Medicaid]]).<ref>[http://www.cms.hhs.gov/MedicaidGenInfo/ Overview - What is Not Covered], U.S. Department of Health & Human Services</ref> Additionally, federal law guarantees [[Emergency Medical Treatment and Active Labor Act|public access to emergency services]] regardless of ability to pay.<ref>Centers for Medicare & Medicaid Services. [http://www.cms.hhs.gov/EMTALA/ Emergency Medical Treatment & Labor Act.] Retrieved August 30, 2006.</ref> Bill Clinton had campaigned heavily on health care in the [[U.S. presidential election, 1992|1992 election]]. == Provisions == {{Expand|date=January 2008}} The Clinton health plan required each US citizen and permanent resident alien to become enrolled in a qualified health plan and forbade their disenrollment until covered by another plan. It listed minimum coverages and maximum annual out-of-pocket expenses for each plan. It proposed the establishment of corporate "regional alliances" of health providers to be subject to a fee-for-service schedule. People below a certain set income level were to pay nothing. The act listed funding to be sent to the states for the administration of this plan, beginning at $4.5 billion in 1993 and reaching $38.3 billion in 2003. == Task Force == [[Image:Clinton health care elderly.jpg|thumb|300px|right|caption|Bill Clinton made health care reform one of the highest priorities of his administration. He asked the First Lady to chair the Task Force on National Health Care Reform.]] Once in office, Bill Clinton quickly set up the '''Task Force on National Health Care Reform''', headed by [[First Lady of the United States|First Lady]] [[Hillary Rodham Clinton]], to come up with a comprehensive plan to provide [[universal health care]] for all Americans, which was to be a cornerstone of the administration's first-term agenda. A major health care speech was delivered by Clinton to a joint session of [[United States Congress|Congress]] on [[September 22]] [[1993]],<ref>Clinton, Bill. [http://www.clintonpresidentialcenter.org/legacy/092293-speech-by-president-address-to-joint-session-of-congress-as-delivered.htm Address to Joint Session of Congress as Delivered] ([[2003-09-22]]).</ref> with an overwhelmingly positive response.<ref name="PBS_Timeline">[http://www.pbs.org/newshour/forum/may96/background/health_debate_page1.html "Events leading up to Clinton's Healthcare Address to Congress,"] Timeline from [[PBS]]'s ''The System''. Accessed June 10, 2007.</ref><ref name="Cohn_TNR">[[Jonathan Cohn|Cohn, Jonathan]]. [http://www.tnr.com/doc.mhtml?i=20070604&s=cohn060407 "Hillary was Right - The [[health care]] plan that dares not speak its name,"] ''[[The New Republic]]'', June 5, 2007. Accessed June 8, 2007.</ref> In that speech, President Clinton explained the problem as follows: {{cquote|Millions of Americans are just a pink slip away from losing their health insurance, and one serious illness away from losing all their savings. Millions more are locked into the jobs they have now just because they or someone in their family has once been sick and they have what is called the preexisting condition. And on any given day, over 37 million Americans -- most of them working people and their little children -- have no health insurance at all. And in spite of all this, our medical bills are growing at over twice the rate of inflation, and the United States spends over a third more of its income on health care than any other nation on Earth.}} Hillary Clinton's leading role in this project was unprecedented for a presidential spouse.<ref>Hodgson, Godfrey. ''[http://books.google.com/books?id=_S-5zbeget8C&pg=PA349&dq=unprecedented+and+%22health+care%22+and+%22hillary%22+and+clinton&num=100&sig=hCwWdLoliElAjkQcibWJO8nCWCw The Gentleman from New York: Daniel Patrick Moynihan: a Biography]'', page 349 (2000): "Hillary Clinton was out in front on this project to a degree unprecedented among presidential wives."</ref><ref name="Bok">Bok, Derek. [http://books.google.com/books?id=hIo6Lo0vA3cC&pg=PA96&dq=unprecedented+and+%22health+care%22+and+%22hillary%22+and+clinton&num=100&sig=GJnVaqcCnzqRRTZbDaaAh82Ij9w#PPA96,M1 "Political Leadership in the Great Health Care Debate of 1993-1994"] in ''Public Discourse in America: Conversation and Community in the Twenty-First Century'' by Stephen P. Steinberg, Judith Rodin, page 96 (2003): "the President took the unprecedented step of naming his wife."</ref> This unusual decision by President Clinton to put his wife in charge of the project has been attributed to several factors, including the President's desire to emphasize his personal commitment to the enterprise.<ref name="Bok" /> ===Litigation=== The First Lady's role in the secret proceedings of the Health Care Task Force also sparked litigation in the U.S. Court of Appeals for the D.C. Circuit, in relation to the Federal Advisory Committee Act (FACA) which requires openness in government. The Clinton White House argued that the [[wikisource:Constitution of the United States of America#Section 3 2|Recommendation Clause]] in Article II of the U.S. Constitution would make it unconstitutional to apply the procedural requirements of FACA to Hillary's participation in the meetings of the Task Force. Some constitutional experts argued to the court that such a legal theory was not supported by the text, history, or structure of the Constitution.<ref name="amicus brief">{{cite web |url=http://papers.ssrn.com/sol3/papers.cfm?abstract_id=971067 |title=Amicus Brief of J. Gregory Sidak in Association of American Physicians & Surgeons v. Hillary Rodham Clinton |work=Social Science Research Network |first=J Gregory |last=Sidak |date=1993|accessdate=2007-08-21}}</ref> Ultimately, Hillary Clinton won the litigation when the D.C. Circuit ruled narrowly that the First Lady of the United States can be deemed a government official (and not a mere private citizen) for purposes of not having to comply with the procedural requirements of FACA.<ref>''[http://www.aapsonline.org/clinton/AAPS/APPOPIN.PDF Association of American Physicians and Surgeons, Inc. v. Hillary Rodham Clinton]'', 997 F.2d 898 (D.C. Cir. 1993).</ref> In 1993, the [[Association of American Physicians and Surgeons]], along with several other groups, filed a lawsuit against Hillary Clinton and [[Donna Shalala‎]] over closed-door meetings related to the health care plan. The AAPS sued to gain access to the list of members of the task force. Judge [[Royce C. Lamberth]] found in favor of the plaintiffs and awarded $285,864 to the AAPS for legal costs; Lamberth also harshly criticized the Clinton administration and Clinton aide [[Ira Magaziner]] in his ruling.<ref>[http://query.nytimes.com/gst/fullpage.html?res=9405E5DA1E3FF93AA25751C1A961958260 Judge Rules Government Covered Up Lies on Panel], By Robert Pear. From the ''New York Times'', [[December 19]] [[1997]]; accessed [[January 3]] [[2008]].</ref> Subsequently, a federal appeals court overturned the award and the initial findings on the basis that Magaziner and the administration had not acted in bad faith.<ref>[http://query.nytimes.com/gst/fullpage.html?res=990DE7DB1F38F936A1575BC0A96F958260 Court Clears Clinton Aide In Lying Case], by Neil A. Lewis. Published in the ''New York Times'', [[August 25]] [[1999]]. Accessed [[January 3]] [[2008]].</ref> == Debate == [[Image:Clinton health 1993.jpg|thumb|200px|left|caption|Former U.S. Surgeon General [[C. Everett Koop]] with then-First Lady Hillary Clinton in the fall of 1993 promoting [[Bill Clinton|President Clinton's]] Health Security Act.]] Starting on [[September 28]], [[1993]], Hillary Clinton appeared for several days of testimony before five congressional committees on health care.<ref name="PBS_Timeline"/> Opponents of the bill organized against it before it was presented to the [[United States Democratic Party|Democratic]]-controlled Congress on [[November 20]], [[1993]].<ref name="PBS_Timeline"/> The bill was a complex proposal running more than 1,000 pages, the core element of which was an enforced mandate for [[employer]]s to provide [[health insurance]] coverage to all of their employees through competitive but closely-regulated [[health maintenance organization]]s (HMOs). The full text of the [[November 20]] bill (the "Health Security Act") is available online.<ref> [http://thomas.loc.gov/cgi-bin/query/z?c103:H.R.3600.IH: H.R. 3600, Health Security Act] ([[1993-11-20]]).</ref> [[American conservatism|Conservatives]], [[libertarian]]s, and the insurance industry staged a campaign against the "Health Security" plan and criticized it as being overly bureaucratic and restrictive of patient choice.<ref>Moffit, Robert. [http://www.heritage.org/Research/HealthCare/tp00.cfm "A Guide to the Clinton Health Plan"], [[Heritage Foundation]] ([[1993-11-19]]): <blockquote>[T]he Clinton Administration is imposing a top-down, command-and-control system of global budgets and premium caps, a superintending National Health Board and a vast system of government sponsored regional alliances, along with a panoply of advisory boards, panels, and councils, interlaced with the expanded operations of the agencies of Department of Health and Human Services and the Department of Labor, issuing innumerable rules, regulations, guidelines, and standards.</blockquote></ref> The effort included extensive advertising criticizing the plan, including the famous ''[[Harry and Louise]]'' ad paid for by the Health Insurance Association of America, which depicted a middle-class couple despairing over the plan's supposed complex, bureaucratic nature.<ref name="Cohn_TNR"/><ref name="Hernandez_NYT_1995">Hernandez, Raymond and Pear, Robert. [http://www.nytimes.com/2006/07/12/nyregion/12donate.html?ex=1310356800&en=0882715139712152&ei=5088&partner=rssnyt&emc=rss "Once an Enemy, Health Industry Warms to Clinton,"] ''[[The New York Times]]'', July 12, 2006. Accessed June 9, 2007.</ref> ''[[Time (magazine)|Time]]'', ''[[CBS News]]'', ''[[CNN]]'', the ''[[Wall Street Journal]]'' and the ''[[Christian Science Monitor]]'' ran stories questioning whether there really was a health-care crisis.<ref>[http://www.time.com/time/magazine/article/0,9171,980129,00.html "The Rise and Fall of the Political Catchphrase,"] ''[[Time (magazine)|Time]]'', February 14, 1994. Traces the origins of the Republican counter-argument "there is no health care crisis." Accessed June 8, 2007.</ref> [[Op-ed]]s were written against it, including one in ''[[The Washington Post]]'' by [[University of Virginia]] Professor Martha Derthick that said: {{cquote|In many years of studying American social policy, I have never read an official document that seemed so suffused with coercion and political naivete ... with its drastic prescriptions for controlling the conduct of state governments, employers, drug manufacturers, doctors, hospitals and you and me.<ref>[[George Will|Will, George]]. [http://www.washingtonpost.com/wp-dyn/content/article/2006/11/09/AR2006110901875.html?nav=rss_opinion/columns "Inoculated for Exuberance?"] ''[[The Washington Post]]'', November 10, 2006. Accessed June 9, 2006.</ref>}} U.S. Senator [[Daniel Patrick Moynihan]] qualified his agreement that "there is no health care crisis" by stating "there is an insurance crisis" but also indicated "anyone who thinks [the Clinton health care plan] can work in the real world as presently written isn't living in it."<ref>Kramer, Michael. [http://www.time.com/time/magazine/article/0,9171,980052,00.html "The Political Interest,"] ''[[Time (magazine)|Time]]'', January 31, 1994. "Slowly but surely, Bill Clinton's health-care plan is headed for the triage unit." Accessed June 8, 2007.</ref> Meanwhile, Democrats, instead of uniting behind the President's original proposal, offered a number of competing plans of their own. Some criticized the plan from the left, preferring a [[Canada|Canadian]]-style [[single-payer health care|single payer]] system. == Defeat == In August 1994, Democratic [[Senate Majority Leader]] [[George J. Mitchell]] introduced a compromise proposal that would have delayed requirements of employers until 2002, and exempted small businesses. However, "Even with Mitchell’s bill, there were not enough Democratic Senators behind a single proposal to pass a bill, let alone stop a filibuster."<ref>Pantel, Kant and Rushefsky, Mark. [http://books.google.com/books?id=wGEsQ_fXA9AC&pg=PA108&lpg=PA108&dq=mitchell+and+%22september+26+1994%22+and+health&source=web&ots=NuDif3Cuk8&sig=1BJAbQYGL8cgm8NqSm3_b3PLemk#PPA108,M1 Politics, Power, and Policy Making: The Case of Health Care Reform in the 1990s] (1997).</ref> A few weeks later, Mitchell announced that his compromise plan was dead, and that health care reform would have to wait at least until the next Congress. The defeat weakened Clinton politically, emboldened Republicans, and contributed to the notion that Hillary Clinton was a "big-government liberal" as decried by conservative opponents.<ref name="NYT_Evolution">[http://www.nytimes.com/2005/07/13/nyregion/13hillary.ready.html?ex=1278907200&amp;en=ca200c39b840ad53&amp;ei=5090&amp;partner=rssuserland&amp;emc=rss "The Evolution of Hillary Clinton,"] ''[[New York Times]]'', July 13, 2005. Accessed June 8, 2007.</ref> The 1994 mid-term election became a "referendum on big government — Hillary Clinton had launched a massive health-care reform plan that wound up strangled by its own red tape."<ref>Thomas, Evan. [http://www.msnbc.msn.com/id/15674090/site/newsweek "Decline and Fall"], ''Newsweek''. {[[2006-11-20]]).</ref> In that 1994 election, the [[Republican revolution]], led by [[Newt Gingrich]], gave the GOP control of both the House of Representatives and the Senate for the first time since the [[83rd United States Congress|83rd Congress]] of 1953–1954, ending prospects for a Clinton-sponsored health care overhaul. Comprehensive reform aimed at creating universal health care in the United States has not been seriously considered by Congress since. == Controversy in retrospect and perspective == In 2004, as a U.S. senator from New York, Hillary Clinton argued in the ''[[The New York Times]]'' that the current health care system is unsustainable, and she offered several solutions.<ref>[[Hillary Rodham Clinton|Clinton, Hillary Rodham]]. [http://query.nytimes.com/gst/fullpage.html?res=9A00E7DE1E38F93BA25757C0A9629C8B63&sec=health&pagewanted=all "Now Can We Talk About Health Care?"] ''[[The New York Times]]'', April 18, 2004. Accessed June 8, 2007.</ref> Her article also mentioned areas of agreement with one-time opponent Newt Gingrich, and likewise Gingrich has expressed agreement with Senator Clinton on some aspects of health care, including a bill to modernize medical record keeping.<ref>[http://www.washingtonpost.com/wp-dyn/content/article/2005/05/11/AR2005051101846.html "Gingrich, Clinton Collaborate on Health Care Bill,"] ''[[Associated Press]]'' in the ''[[Washington Post]]'', May 12, 2005. Accessed June 10, 2007.</ref><ref>[[Dana Milbank|Milbank, Dana]]. [http://www.washingtonpost.com/wp-dyn/content/article/2005/07/21/AR2005072102272.html "The Reformer and the Gadfly Agree on Health Care,"] ''[[Washington Post]]'', July 22, 2005. Accessed June 10, 2007.</ref> In 2005, referring to her previous efforts at health care reform, Hillary Clinton said "I learned some valuable lessons about the legislative process, the importance of bipartisan cooperation and the wisdom of taking small steps to get a big job done."<ref name="NYT_Evolution"/> Again in 2007, she reflected on her role in 1993-1994: "I think that both the process and the plan were flawed. We were trying to do something that was very hard to do, and we made a lot of mistakes."<ref>Toner, Robin and [[Anne Kornblut|Kornblut, Anne]]. [http://www.nytimes.com/2006/06/10/washington/10hillary.html?ei=5070&en=b3e5eae2515beefd&ex=1181361600&pagewanted=print "Wounds Salved, Clinton Returns to Health Care,"] ''[[The New York Times]]'', June 10, 2006. Accessed June 8, 2007.</ref> Hillary Clinton received hundreds of thousands of dollars in campaign contributions from doctors, hospitals, drug companies, and insurance companies for her 2006 re-election in the Senate, including several insurance companies that were members of the Health Insurance Association of America that helped defeat the Clinton Health Plan in 1994.<ref name="Hernandez_NYT_1995"/> [[Charles N. Kahn III]], a Republican who was executive vice president of the Health Insurance Association in 1993 and 1994, refers to his previous battles with Clinton as "ancient history," and says "she is extremely knowledgeable about health care and has become a Congressional leader on the issue."<ref name="Hernandez_NYT_1995"/> In the years since the Clinton effort of 1993-1994, a combination of factors have kept health care off the top of the agenda. For example, politicians have not been eager to confront the forces that successfully frustrated the Clinton effort, and [[health maintenance organization]]s have been able to limit cost increases to some extent.<ref name="Krugman">Krugman, Paul, and Wells, Robin. [http://www.nybooks.com/articles/18802 "The Health Care Crisis and What to Do About It"], New York Review of Books, March 23, 2006.</ref> The Clinton health care plan remains the most prominent national proposal associated with Hillary Clinton, and may have influenced her prospects in the 2008 presidential election. There are some similarities between the Clinton Health Plan and Republican [[Mitt Romney]]'s health care plan that has been implemented in Massachusetts,<ref name="Cohn_TNR"/><ref>Cannon, Michael. [http://article.nationalreview.com/?q=ZTZlZWMzYjRmZTg5YzVhYTE2ZjNlMGI1MGU1NzRmZWI= "What Mitt and Hillary Have in Common,"] ''[[The National Review Online]]'', June 5, 2007. Accessed June 8, 2007.{{blockquote|If I were advising Sen. Clinton, I would be urging her to boast that her approach to health-care reform enjoys support from conservatives like the Heritage Foundation and Gov. Romney. If I were advising Gov. Romney, I would prescribe a severe case of amnesia and a health-care agenda that actually reduces the role of government.}}</ref> though Romney has since distanced himself from Clinton on the issue, in particular arguing that his plan calls for more control at the state level and the private market, not from the federal government.<ref name="Romney: Clinton health care plan is 'bad medicine'">, [http://politicalticker.blogs.cnn.com/2007/09/17/romney-clinton-health-care-plan-is-bad-medicine "Romney: Clinton health care plan is 'bad medicine'"], ''[[CNN Political Ticker]]'', [[2007-09-17]]. Accessed [[2007-09-20]].</ref> In September 2007, former Clinton Administration senior health policy advisor [[Paul Starr]] published an article named "The Hillarycare Mythology",<ref name="tap091407">[[Paul Starr]], [http://www.prospect.org/cs/articles?article=the_hillarycare_mythology "The Hillarycare Mythology"], ''[[The American Prospect]]'', [[2007-09-14]]. Accessed [[2007-09-18]].</ref> where he asserted that Bill Clinton, not Hillary Clinton, was the driving force behind the plan at all stages of its origination and development; that the task force headed by Hillary Clinton quickly became useless and was not the primary force behind formulating the proposed policy; and that "Not only did the fiction of Hillary's personal responsibility for the health plan fail to protect the president at the time, it has also now come back to haunt her in her own quest for the presidency."<ref name="tap091407"/> == References == {{reflist|2}} == External links == * [http://inside.c-spanarchives.org:8080/cspan/cspan.csp?command=dprogram&record=198827147 C-SPAN3 Programming from 1993-94 on the Clinton Health Care Plan] ''[[C-SPAN]]'', Accessed [[June 8]], [[2007]]. * Robin Toner, [http://query.nytimes.com/gst/fullpage.html?sec=health&res=9F0CEEDB113BF931A1575AC0A965958260 " Clinton's Health Plan; Poll on Changes in Health Care Finds Support Amid Skepticism,"] ''[[New York Times]]'', [[September 22]], [[1993]]. Accessed [[June 8]], [[2007]]. * [http://www.annals.org/cgi/content/full/119/9/945 "The Clinton Health Care Plan: Fundamental or Incremental Reform?"] ''Annals of Intern Med'', 1993;119(9):945-947. Accessed [[June 8]], [[2007]]. * [[William Kristol]], [http://www.ashbrook.org/publicat/onprin/v2n1/kristol.html "How to Oppose the Health Plan - and Why,"] ''[[Ashbrook Center]]'', January 1994. Accessed [[June 8]], [[2007]]. * [http://findarticles.com/p/articles/mi_m3225/is_n1_v49/ai_14786294 "AAFP calls Clinton health care plan a 'starting point for reform,"] ''Findarticles.com'' reprinting ''[[American Family Physician]]'', January 1994. Accessed [[June 8]], [[2007]]. * Robert Pear, [http://query.nytimes.com/gst/fullpage.html?sec=health&res=9E06E6D61230F931A15752C0A962958260 "Health Care Plan Isn't Cast in Stone,"] ''[[New York Times]]'', [[January 22]], [[1994]]. Accessed [[June 8]], [[2007]]. * [[Donna E. Shalala]], [http://www.os.dhhs.gov/news/policy/94012501.txt "Let's Face It, There Is a Health Care Crisis,"] ''U.S. Department of Health and Human Services''. Reprinted from ''[[The Washington Post]]'', [[January 25]], [[1994]]. Accessed [[June 8]], [[2007]]. * [[Adam Clymer]], [http://query.nytimes.com/gst/fullpage.html?res=9C03E5D71739F93AA15752C0A962958260 "Hillary Clinton Tells Doctors Crisis in Health Care Is Real,"] ''[[New York Times]]'', [[January 29]], [[1994]]. Accessed [[June 8]], [[2007]]. * [http://www.time.com/time/magazine/article/0,9171,980129,00.html "The Rise and Fall of the Political Catchphrase,"] ''[[Time (magazine)|Time]]'', [[February 14]], [[1994]]. Traces the origins of the Republican counter-argument "there is no health care crisis." Accessed [[June 8]], [[2007]]. * Raymond Hernandez and Robert Pear, [http://www.nytimes.com/2006/07/12/nyregion/12donate.html?ex=1310356800&en=0882715139712152&ei=5088&partner=rssnyt&emc=rss "Once an Enemy, Health Industry Warms to Clinton,"] ''[[The New York Times]]'', [[July 12]], [[2006]]. Accessed [[June 9]], [[2007]]. * [[Jonathan Cohn]], [http://www.tnr.com/doc.mhtml?i=20070604&s=cohn060407 "Hillary was Right - The health care plan that dares not speak its name,"] ''[[The New Republic]]'', [[June 5]], [[2007]]. Accessed [[June 8]], [[2007]]. {{Hillary Rodham Clinton}} [[Category:1993 in the United States|Clinton health care plan]] [[Category:Clinton Administration initiatives|Health Care Plan]] [[Category:Healthcare policy in the United States]] [[Category:Hillary Rodham Clinton|Health Care plan]] [[Category:United States proposed federal legislation]] [[Category:Healthcare in the United States]] [[Category:Clinton administration controversies]] [[Category:Health care reform|Clinton health care plan]]