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September 2, 2014

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’90s documents show Clinton health care concerns

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Gerald Herbert / AP

In this Jan. 27, 2014, photo, former Secretary of State Hillary Rodham Clinton speaks in New Orleans.

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In this Oct. 30, 2013, file photo, former President Bill Clinton speaks in Charlottesville, Va.

WASHINGTON — Bill Clinton's aides were concerned early in his presidency about his health care overhaul effort, led by his wife, that never passed and a need to soften the image of Hillary Rodham Clinton, according to documents released Friday. Mrs. Clinton now is a potential 2016 presidential contender.

The National Archives released about 4,000 pages of previously confidential documents involving the former president's administration, providing a glimpse into the struggles of his health care task force, led by the first lady, and other priorities such as the U.S. economy and the North American Free Trade Agreement.

Hillary Clinton's potential White House campaign has increased interest in Clinton Presidential Library documents from her husband's administration during the 1990s and her own decades in public service. A former secretary of state and New York senator, Mrs. Clinton is the leading Democratic contender to succeed President Barack Obama, though she has not said whether she will run.

Friday's documents included memos related to the former president's ill-fated health care reform proposal in 1993 and 1994, a plan that failed to win support in Congress and turned into a rallying cry for Republicans in the 1994 midterm elections. As first lady, Hillary Clinton chaired her husband's health care task force, largely meeting in secret to develop a plan to provide universal health insurance coverage.

White House aides expressed initial optimism about her ability to help craft and enact a major overhaul of U.S. health care.

"The first lady's months of meetings with the Congress has produced a significant amount of trust and confidence by the members in her ability to help produce a viable health reform legislative product with the president," said an undated and unsigned document, which was cataloged with others from April 1993. The document urged quick action, warning that enthusiasm for health reform "will fade over time."

But the documents also showed the growing concerns among Clinton's fellow Democrats in Congress. Lawmakers, it said, "going to their home districts for the August break are petrified about having difficult health care reform issues/questions thrown at them."

Administration officials also wanted to distance Hillary Clinton from a staff meeting on the touchy subject of making health care cost projections appear reasonable. Top aides wrote an April 1993 memo saying pessimistic cost-savings projections from the nonpartisan Congressional Budget Office were "petrifying an already scared Congress."

"CBO has the very real potential to sink an already leaking health reform ship," said the memo, signed by Clinton aides Chris Jennings and Steve Ricchetti, the latter now a top aide to Vice President Joe Biden. A White House and congressional meeting meant to "align budget assumptions with CBO" would be "all staff," the memo said, so "we do not believe it appropriate that Mrs. Clinton attend."

By September 1993, Mrs. Clinton acknowledged the obstacles in a Capitol Hill meeting with House and Senate Democratic leaders and committee chairs. "I think that, unfortunately, in the glare of the public political process, we may not have as much time as we need for that kind of thoughtful reflection and research," the first lady said, citing "this period of challenge."

The meetings also showed that Mrs. Clinton was doubtful that a health care law with a universal mandate — requiring people to carry health insurance — would be approved. "That is politically and substantively a much harder sell than the one we've got — a much harder sell," she told congressional Democrats in September 1993.

In 2007, when she ran for president, Clinton made the "individual mandate" a centerpiece of her "American Health Choices Plan," requiring health coverage while offering federal subsidies to help reduce the cost to purchasers.

The health care overhaul signed into law by Obama in early 2010 carried a mandate that all Americans must obtain health insurance or pay a fine.

The documents also include detailed media strategy memos written as aides tried to soften Mrs. Clinton's image.

Her press secretary, Lisa Caputo, encouraged the Clintons to capitalize on their 20th wedding anniversary as "a wonderful opportunity for Hillary" and also suggested she spend more time doing White House events celebrating first ladies of the past.

Placing Clinton in a historical context "may help to round out her image and make what she is doing seem less extreme or different in the eyes of the media," Caputo wrote in a lengthy August 1995 memo about courting better press coverage as the president looked toward re-election.

Caputo also proposed the "wild idea" of having Clinton do a guest appearance on a popular sitcom of the day, "Home Improvement."

Other documents offered a glimpse into the juggling of priorities early in Clinton's first term and administration concerns after Republicans took control of the House and Senate in the 1994 elections.

A July 1993 memo shared among Clinton's advisers sought guidance on how the administration should focus its attention on three major priorities: health care reform, the passage of the North American Free Trade Agreement and an initiative aimed at "reinventing government."

"The president has repeatedly promised that health care will come after the economic package passes," the memo from Clinton advisers Rahm Emanuel, Bob Boorstin, Mark Gearan and others said. "Surveys indicate that health care remains the second or third priority (behind job creation) for the vast majority of voters, but also that people fear reform is just another promise to be broken."

"Our core supporters are rapidly losing patience and could block passage by throwing their support to alternative plans," the memo warned.

Following the midterm losses, Clinton policy adviser William Galston wrote in January 1995, before the president's State of the Union address, that the public had "not given up on the Clinton presidency." But he warned the annual speech before Congress "may well be our last chance for a very long time to command the attention of the people as a whole. We cannot hold anything back."

The new documents offer only glimmers of Clinton's internal national security deliberations. The most detailed material, contained in files from then-national security speechwriter Paul Orzulak, show top Clinton officials wrestling with how to deal with China's emergence as a world financial power.

Notes from an undated meeting with National Security Adviser Samuel "Sandy" Berger show Berger pushing for China's membership in the World Trade Organization despite concerns about human rights abuses.

A series of emails pertaining to the 9/11 Commission's research into Clinton-era handling of al-Qaida attacks were all apparently withheld by Archives officials, citing national security and confidential restrictions. The only memo released was a single July 1998 email about whether to send a high-ranking diplomat to Minnesota with a presidential message to greet ailing Jordanian King Hussein. "Sounds like too much crepe hanging," said a dismissive official.

Associated Press writers Stephen Braun, Henry C. Jackson, Connie Cass in Washington and Jill Zeman Bleed in Little Rock, Ark., contributed to this report.

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