ABSTRACT
For Medicare and Medicaid, the year 1996 was something of a nonevent, an interlude between a historic battle and a major, though not grand compromise. But it was also a year of transition, moving on from partisan confrontation to wary collaboration and diminishing the scope of conflict so that compromise came more easily in 1997. This process of transition is interesting in itself and illustrates, as well, additional modes of legislative activity and policymaking that our tax dollars help support. A primary factor that led to the three-part reconciliation strategy was the continuing effect of the 1995 confrontation over Balanced Budget Act. In any major restructuring of Medicaid, the National Governors’ Association would be prominently involved, both in the development and the ultimate approval of the proposal. The Health Insurance Portability and Accountability Act of 1996 was one of those small legislative events that—like some minor military engagements—was more significant historically than anticipated.
