The Clinton health care plan was a 1993 healthcare reform package proposed by the administration of President Bill Clinton and closely associated with the chair of the task force devising the plan, First Lady of the United States Hillary Rodham Clinton. Bill Clinton had campaigned heavily on health care in the 1992 U.S. presidential election. The task force itself was created in January 1993, but its own processes were somewhat controversial and drew litigation. Its goal was 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 President Clinton to the U.S. Congress in September 1993. The core element of the proposed plan was an enforced mandate for employers to provide health insurance coverage to all of their employees through competitive but closely regulated health maintenance organizations.
Opposition to the plan was heavy from conservatives, libertarians, and the health insurance industry. The industry produced a highly effective television ad, "Harry and Louise" ad", in an effort to rally public support against the plan. Democrats, instead of uniting behind the President's original proposal, offered a number of competing plans of their own. Hillary Clinton was drafted by the Clinton Administration to head a new Task Force and sell the plan to the American people, a plan which ultimately backfired amid the barrage of fire from the pharmaceutical and health insurance industries and considerably diminished her own popularity. By September 1994, the final compromise Democratic bill was declared dead by Senate Majority Leader George J. Mitchell.
The Clinton health plan required each U.S. citizen and permanent resident alien to become enrolled in a qualified health plan and forbade their dis-enrollment until covered by another plan. It listed the minimum coverage 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 $13.5 billion in 1993 and reaching $38.3 billion in 2003.
Once in office, President Clinton quickly set up the Task Force on National Health Care Reform, headed by 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 (Figure 2).
Hillary Rodham Clinton's leading role in this project was unprecedented for a presidential spouse. This unusual decision by President Clinton to put his wife in charge of the project has been attributed to several factors, sending the President's desire to emphasize his personal commitment to the enterprise.
Starting on September 28, 1993, Hillary Rodham Clinton appeared for several days of testimony before five congressional committees on health care. Opponents of the bill organized against it before it was presented to the Democratic-controlled Congress on November 20, 1993. The bill was a complex proposal running more than 1,000 pages, the core element of which was an enforced mandate for employers to provide health insurance coverage to all of their employees through competitive but closely regulated health maintenance organizations (HMOs).
Opposition to the Clinton plan was initiated by William Kristol and his policy group Project for the Republican Future, which is widely credited with orchestrating the plan's ultimate defeat through a series of now legendary "policy memos" faxed to Republican leaders. Conservatives, libertarians, and the health insurance industry proceeded to campaign against the plan, criticizing it as being overly bureaucratic and restrictive of patient choice. The conservative Heritage Foundation argued "the 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."
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.
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.