'90s documents show Clintons' health care concerns

February 28, 2014 - 5:35 PM
Clinton Documents

FILE - In this Jan. 27, 2014 file photo, former Secretary of State Hillary Rodham Clinton speaks in New Orleans. The National Archives plans to release about 4,000 pages of previously confidential documents involving former President Bill Clinton's administration. Some of the topics include the president's health care task force and the 9/11 Commission Report. The papers could shed light on Clinton's presidency and provide insight into a future presidential candidate: former first lady Hillary Rodham Clinton. (AP Photo/Gerald Herbert, File)

WASHINGTON (AP) — Bill Clinton's aides revealed concern early in his presidency about the health care overhaul effort led by his wife, Hillary Rodham Clinton, and later about what they saw as a need to soften her image, 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 ultimately unsuccessful struggles of his health care task force, led by the first lady, and other Clinton priorities such as the U.S. economy and a major 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."

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. It noted the first lady had an "aversion to the national Washington media."

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

As the first lady began her bid for a Senate seat from New York in July 1999, adviser Mandy Grunwald coached her with "style pointers" and tips for handling "annoying questions" from the media without appearing testy. Grunwald said she was sure to be asked about her husband's Senate impeachment trial earlier that year.

The advice: "Be real" and acknowledge "that of course last year was rough."

As for Clinton himself, by the end of his presidency he showed frustration with his proposed farewell speech to the nation. He told aides that he didn't think the drafts included enough of his administration's accomplishments.

"Doesn't anybody care about me?" he asked aides during his final days in office.

On the health care effort, 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, predicting it could send "shock waves" through the "currently insured population."

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.

In another document, Clinton's advisers flirted with the same type of overpromising language that Obama later used about allowing people to keep their doctors under the reforms. A Clinton-era memo noted that the policy promised people could "'pick the health plan and the doctor of your choice.' This sounds great and I know that it's just what people want to hear. But can we get away with it?"

The documents offer cameo appearances by several Obama officials during their younger days. Speechwriter Jeff Shesol appeared frustrated in the spring of 1998 when describing Clinton adviser Rahm Emanuel, who later served as Obama's White House chief of staff and is now Chicago's mayor. Emanuel, Shesol wrote, "is gonna complicate all our lives."

Clinton aide Paul Begala, now a top Democratic strategist, was "wrong half time, glib," Shesol wrote.

In another document, future Supreme Court Justice Elena Kagan, then a White House lawyer, advised Clinton's team to be "non-defensive" in dealing with tobacco companies involved in the government's settlement in May 1998. "Let them know they shd be leery of (expletive) with this. In those words."

In 2000, National Security Adviser Samuel "Sandy" Berger told his speechwriter to cite the accomplishments of young government-service aides instead of Silicon Valley "whiz kids" like Steve Jobs and Bill Gates. "Stick with public service," Berger scrawled in notes on the margins. "How old is Susan Rice?" he added, referring to the then-assistant secretary at state for African Affairs who is now Obama's national security adviser.

The new documents offer 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 Berger show the Clinton national security adviser 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.

Other documents released Friday 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 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.

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