Medicare Meets the Marketplace: The Bush-Clinton Years

  • Donald F. Lavanty


Due to an economic downturn in the late 1980s and early 1990s, employers moved to adopt managed care plans which reduced costs but limited employee options. This era saw a period of reduced and managed benefits for employees and no coverage for those who were laid off. Democratic presidential candidate Bill Clinton put the issues of unemployment and healthcare on the national stage. Upon election, Clinton instituted a task force, headed by then-First Lady Hillary Clinton to develop a healthcare plan. Eschewing input from Congress and other stakeholders, the task force handpicked advisors and met in closed-door sessions, virtually guaranteeing opposition from all quarters. The negative national attention given the Clinton healthcare reform efforts resulted in political fallout during the 1994 midterm elections where control of both the House and the Senate went to the Republicans. In 1996, the Congress passed the Health Insurance Portability and Accountability Act (HIPAA), allowing employees to continue coverage when changing jobs. Additional progress was made near the end of the Clinton administration with the passage of the 1997 Balanced Budget Act, the enactment of Medicaid Part C, and the Children’s Health Insurance Program (CHIP), providing health insurance to children of parents below a certain income threshold.


Managed care Reengineering Clinton Health Access Initiative Health Insurance Portability and Accountability Act Patient’s Bill of Rights Medicare Part C 


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Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Donald F. Lavanty
    • 1
    • 2
  1. 1.Healthcare Management and Legal Studies School of Business and TechnologyMarymount UniversityArlingtonUSA
  2. 2.Law DegreeGeorge Washington UniversityWashington, DCUSA

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