Impact of tobacco industry and other corporations in the defeat of the 1994 Clinton health care plan
Abstract
Abstract
Background: The primary reason cited by many scholars for the defeat of the Clinton Administration’s 1994 health
care reform bill has long been identified as Health Insurance Association of America and National Federation of
Independent Businesses opposition to the bill. Given this predominant consensus combined with sizeable proposed
funding for the bill by a large tobacco product tax, this manuscript examined what the tobacco industry’s role was
in whole or part in defeating the Clinton health care bill.
Methods: This research occurred through crosschecking internal tobacco industry documents and Clinton White
House documents.
Results: Prior to the passage of the bill, the tobacco industry accepted a compromise of 45 cents per pack increase
phased in over five years. Due to this compromise, the industry or third party allies had no role in the ultimate
defeat in the bill.
Conclusions: The primary reason for the bill’s ultimate defeat was general business (but not tobacco industry and
third party ally) opposition, the bill running out of time, and conflicting bills. Secondary reasons for the bill’s defeat
included issues with: employer mandates, high taxes on insurance plans, impacts on medical research and
education, Congressional attention to other issues, election year politics, and possible future excise tax possibilities.
Citation
Michael Givel, "Impact of Tobacco Industry and Other Corporations in the Defeat of the 1994 Clinton Health Care Plan," BMC Public Health (2017) 17:591