By James Rosen
In the first week of Bill Clinton’s presidency, White House aides drafted a roadmap for the approach to health care reform that would be undertaken by then-First Lady Hillary Clinton, including warnings about prickly lawmakers who would be key to the process.
An unsigned memorandum dated January 28, 1993 and entitled “Discussion with Hillary Clinton” – the document does not make clear if it is summarizing the contents of a discussion that was already held with Mrs. Clinton, or would soon be held with her – offered an early blueprint for her ultimately doomed health care reform effort.
The memo stated that the initiative should take the form of a “framework” rather than “a detailed bill,” citing the fact that other recent legislative efforts – tax reform under President Reagan in 1985, deficit reduction under President George H.W. Bush in 1990, among others – had been devised that way.
The memo also cautioned against adopting a “here’s the bill, there’s not much time, take it to the Floor quick” approach, saying such a tactic “might fail” because “many Members [of Congress] would feel excluded” and “interest groups will object that their concerns, even those that are small or reasonable, have been excluded from the hearing and markup process.”
A separate document, an undated memo that White House policy adviser Chris Jennings sent to Mrs. Clinton in advance of a critical session with lawmakers, sought to prepare the First Lady for potentially clashes, possibly owing to personalities. Jennings described Rep. Peter Stark (R-TX), then chair of the House Ways and Means Committee, as “one of the most knowledgeable and (sometimes) feared health care legislators on Capitol Hill.” Calling Stark a “fierce advocate” for his policy agenda, Jennings added that the Texan had been “paying a price” for his tenacity in that he was “probably one of the more disliked Members in the Congress.”
Similarly, Jennings warned the First Lady about Rep. Henry Waxman (D-CA), at the time the chair of a key subcommittee on the Energy and Commerce Committee, now serving out the end of his twentieth term, having announced his retirement. “Known as a Medicaid guru, Waxman has pushed for increased coverage for poor populations in the absence of a national health care program,” Jennings wrote. “Since his main thrust for increased coverage to the indigent has been turning Medicaid coverage options into mandates, Waxman is widely unpopular with states and Governors. Although not well-liked at the state level, he has tremendous respect among consumer interest groups.”