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From Otto von Bismarck to “Harry and Louise,” the idea of universal health care has fueled public debate for more than a century. Ever since major European nations adopted compulsory coverage plans, the quest for national health insurance has vexed U.S. policymakers. Congress has tackled the issue nearly every decade, and the debate has featured a noteworthy cast of characters. Congressional leaders, Republicans, Democrats and socialists have all advocated some type of national health insurance program. But when the debate gets to Congress, attempts to enact comprehensive packages have largely failed after being hijacked by special interests. Alternative — and less comprehensive — measures carry the day.

Created by RollCall on Mar 6, 2009

Last updated: 03/12/10 at 05:49 AM

Tags: Health care Roll Call Congress legislation

• Obama Seeks Comprehensive Coverage
  2009

  President Barack Obama calls for comprehensive health care reform by year’s end and proposes a $634 billion reserve fund to begin to pay for it.

• Parties Again Add Health Care to Platforms
  2008

  The Democratic Party platform calls affordable health care a “basic right.” The Republican Party platform calls for health spending reform and improved insurance coverage options.

• Prescription Drugs Coverage Added to Medicare
  2003

  In the largest expansion of Medicare since 1965, Congress passes legislation to provide prescription drug coverage through the program.

• HIPAA Passed by Congress
  1996

  Congress enacts the Health Insurance Portability and Accountability Act to reform health insurance coverage for pre-existing conditions and to create tax-deductible medical savings accounts.

• Health Reform Fails in Congress
  1994

  On June 28, House Energy and Commerce Chairman John Dingell Jr. (D-Mich.) tells Speaker Thomas Foley (D-Wash.) that the committee will not be able to report a health reform measure. Sen. Daniel Patrick Moynihan (D-N.Y.) and Majority Leader George Mitchell (D-Maine) support alternative measures in the Senate. Sens. Bob Dole (R-Kan.) and Bob Packwood (R-Ore.) in July offer a GOP alternative that includes incremental reform. On Sept. 26, Mitchell abandons Senate reform efforts. Republicans take control of Congress in the November elections for the first time in 40 years.

• Clintons Launch Health Care Initiative
  1993

  On Sept. 22, President Bill Clinton delivers an address to Congress calling for health coverage reform. First lady Hillary Rodham Clinton begins a campaign for reform. The administration releases the Clinton Health Security Act in October, while Reps. Jim Cooper (D-Tenn.) and Fred Grandy (R-Iowa) introduce an alternative. The Health Insurance Association of America launches an ad campaign featuring “Harry and Louise” (pictured) to counter the Clinton plan.

• Congress Rejects Carter Plan
  1979

  President Jimmy Carter proposes a National Health Plan for comprehensive health care. Congress does not adopt the plan.

• Nixon Seeks Comprehensive Insurance
  1974

  On Feb. 6, President Richard Nixon proposes a Comprehensive Health Insurance Act after calling for universal access to health insurance in his last State of the Union address. The plan builds on existing private employer-based health insurance, adding subsidies for the self-employed and small businesses. Congress rejects the plan.

• Prepaid Health Programs Recognized
  1973

  Congress approves the Health Maintenance Organization Act, which recognizes prepaid health programs and provides early subsidies to create prepaid group practices. The act is modified in 1978, 1981 and 1983.

• Insurance Finds Place in Party Platforms
  1972

  Both Republican and Democratic Party platforms include national health insurance plans.

• Medicare, Medicaid Established
  1965

  Ways and Means Chairman Mills (pictured) substitutes his own health insurance proposal into this year’s effort to craft a health insurance measure. Congress approves the conference report, and Medicare and Medicaid is created. Johnson signs the legislation on July 30.

• LBJ Makes a Case for Medicare
  1964

  President Lyndon Johnson sends an address to Congress proposing a Medicare program.

• Kennedy Pushes Medicare Plan
  1962

  President John F. Kennedy addresses the nation from Madison Square Garden in May to advocate for a Medicare program. Anderson and Javits promote the measure in the Senate, but their legislative efforts fall short.

• Bill to Help Elderly Approved
  1960

  House Ways and Means Chairman Wilbur Mills (D-Ark.) moves out of committee a bill that provides grants to states for low-income, elderly persons. Sens. John F. Kennedy (D-Mass.), Clinton Anderson (D-N.M.) and Jacob Javits (R-N.Y.) unsuccessfully attempt to modify the Mills bill to provide health insurance. The grant program becomes law in September.

• Health Benefits Become Tax-Exempt
  1954

  In January, the Internal Revenue Service exempts health benefits from taxable income. President Dwight Eisenhower proposes a federal reimbursement program to encourage more insurance companies to offer private health coverage.

• A New Plan, With Subsidies
  1952

  In April, Democrats Murray, Dingell, Minnesota Sen. Hubert Humphrey (pictured) and Rep. Emanuel Celler (N.Y.) introduce a national health plan that includes federal subsidies for private health insurance.

• Congress Considers Wagner-Murray-Dingell Again
  1946

  The Wagner-Murray-Dingell measure is reintroduced. During April hearings before the Senate Education and Labor Committee, the sponsors carefully avoid the word “compulsory” when discussing the legislation. Sens. Robert Taft (Ohio) and Joseph Ball (Minn.) and Rep. Margaret Chase Smith (Maine) offer a Republican alternative that provides grants to the states for medical care to the poor. The debate is repeated again in 1947 and 1949.

• Truman Calls for Health Insurance Program
  1945

  On Nov. 19, President Harry Truman’s health message to Congress encourages a health insurance program.

• Military Dependents Granted Health Care
  1943

  With the United States at war, Congress enacts the Emergency Maternal and Infant Care Program to provide maternity and children’s health care to military dependents. The program ends in 1949 and is replaced in 1956 by the Dependents Medical Care Act, the predecessor to current Civilian Health and Medical Program of the Uniformed Services.

• National Health Bill Fails to Win Committee Approval
  1939

  Sens. Robert Wagner (D-N.Y.), James Murray (D-Mont.) and Rep. John Dingell Sr. (D-Mich.) introduce a national health bill in February. After hearings from April to July, the measure dies in committee. The American Medical Association opposes the proposal.

• FDR Signs Social Security Act
  1935

  On July 15, Sen. Arthur Capper (R-Kan.) introduces a compulsory health insurance measure modeled after the ideas of New Deal-era social economist Abraham Epstein. On Aug. 14, President Franklin D. Roosevelt (pictured) signs into law the Social Security Act, which excludes health coverage.

• Baylor Creates Predecessor to Blue Cross
  1929

  Baylor University in Dallas, Texas, initiates a health program for its faculty, a predecessor to Blue Cross health insurance plans. The American Hospital Association supports the development of Blue Cross and private health insurance plans. Private hospital coverage between 1940 and 1950 rises from 9 percent to 57 percent.

• Harding Signs Maternal, Children's Health Bill
  1921

  On Nov. 23, President Warren Harding signs the Sheppard-Towner Maternity and Infancy Protection Act, which provides funds to the states to manage maternal and children’s health care programs. Funding for the program ends in 1929.

• New York Plan Defeated
  1919

  The New York Legislature defeats a health insurance plan.

• California Voters Knock Down Insurance Plan
  1918

  California voters defeat a health insurance program in an referendum in November.

• Commission on Mandatory Health Insurance
  1917

  In February, the House passes a bill, offered by New York Rep. Meyer London (Socialist), calling for a commission to make recommendations on mandatory health insurance.

• Debating Who Should Insure Workers
  1916

  The House Labor Committee holds hearings in April on health insurance. Samuel Gompers, head of the American Federation of Labor, argues that unions — not government — should insure workers. Gompers asserts that government insurance would undermine the “manliness” of workers.

• National Health Insurance Bill Proposed
  1915

  In November, the American Association for Labor Legislation proposes a “model bill” for compulsory national health insurance. The concept receives initial support from several states and the American Medical Association.

• Great Britain Creates National Health Plan
  1908

  Great Britain establishes a compulsory national health plan under the Liberal government of Herbert Asquith. The plan becomes law under the National Insurance Act of 1911.

• World’s First National Health Insurance Program
  1883

  Germany establishes the world’s first national health insurance program under Chancellor Otto von Bismarck. The program is financed by contributions from employers (one-third) and employees (two-thirds). The law sets minimum payments for medical treatments and sick pay.