chapter  6
44 Pages

A Critical Phase

ByDavid G. Smith, Judith D. Moore

In the first two years of the Bill Clinton administration, Democrats controlled both houses of Congress and the presidency, but Medicaid was ignored as attention centered on larger items on the domestic agenda, national health insurance. Republican attacks upon Medicare and Medicaid began soon in the Balanced Budget Act of 1995, and made even incremental gains—anything beyond staving off eminent disaster—seem dangerously optimistic. The State Children's Health Insurance Program, enacted in 1997, was the biggest single expansion of eligibility for poor children since the beginning of the Medicaid program in 1966. The Senate Finance Committee is an enormously powerful and prestigious committee, with a considerable amount of autonomy and immunity from the crasser forms of partisan pressure or leadership diktats. John Chafee was chairman of the Subcommittee on Medicaid and Health Care for Low-Income Families, which he had urged the Finance Committee to establish despite the Senate's presumption against subcommittees.