In Ezra’s article on the individual mandate, he mentions the key role played by Sen. John Chafee:
The mandate made its first legislative appearance in 1993, in the Health Equity and Access Reform Today Act—the Republicans’ alternative to President Clinton’s health-reform bill—which was sponsored by John Chafee, of Rhode Island, and co-sponsored by eighteen Republicans, including Bob Dole, who was then the Senate Minority Leader.
After the Clinton bill, which called for an employer mandate, failed, Democrats came to recognize the opportunity that the Chafee bill had presented. In “The System,” David Broder and Haynes Johnson’s history of the health-care wars of the nineties, Bill Clinton concedes that it was the best chance he had of reaching a bipartisan compromise. “It should have been right then, or the day after they presented their bill, where I should have tried to have a direct understanding with Dole,” he said.
It’s worth noting that Dole later abandoned the Dole-Chafee bill as he came to understand its cost, but that’s a secondary issue. What is interesting is that Sen. Chafee’s plan was the brainchild of a gifted young staffer named Laurie Rubiner, as Steve Clemons recounted back in 2007:
Before joining New America, Rubiner worked in a number of key policy and advocacy roles — but it was her work for the late Senator John Chafee (R-RI) where she conceived under the Senator’s name and at his direction a health care plan that would maintain private sector deployment of health care services as the backbone of America’s health system, avoid the single payer debate that divides that policy community, and be universal.
Rubiner brought her work to New America — and the DNA of her efforts exists in all of the significant “test efforts” of comprehensive health care coverage — including in Republican Arnold Schwarzenegger’s proposal for California, Democrat Gavin Newsom’s in San Francisco, and Republican Mitt Romney’s in Massachusetts.
Now, Hillary Clinton has brought the sensibility of the Chafee/Rubiner health care proposals into her own plan for the country and demonstrated considerable political bravery and sensitivity in doing so.
The New York Times profiled Rubiner that same year:
Ms. Rubiner, a health care expert who, with policy director Neera Tanden, helped shape the $110 billion-a-year health program her boss unveiled this week in Iowa, signed on as Mrs. Clinton’s legislative director in 2005 after a decade in a similar role for John H. Chafee, the consensus-inclined Republican senator from Rhode Island. He was a moderate Republican, to be sure, but Republican nonetheless (also a great admirer of Mrs. Clinton).
Before finding a political mentor in Mr. Chafee, Ms. Rubiner, who grew up in Michigan — her mother was an artist; her parents owned a gallery — made her Capitol Hill debut as a Barnard undergraduate, interning for another, albeit higher profile Republican senator: Bob Dole.
“I’m a firm Independent,” says Ms. Rubiner, 45, who is more issues-driven than partisan-prone. “ I don’t see a lot of daylight between Hillary Clinton and John Chafee on the things I care about.”
One suspects that many left-of-center readers will lament that there is considerable daylight between the domestic policy views of the Republican mainstream of 2012 and Hillary Clinton. But Rubiner, who now works for Sen. Richard Blumenthal (D-CT) after having previously served as the vice president of public policy at the Planned Parenthood Federation of America and legislative director for Sen. Hillary Clinton (D-NY), is perhaps not best understood as an entirely non-ideological or post-ideological participant in public policy debates, but rather as someone we could reasonably characterize as liberal or social-democratic in her views. In a more recent article, she described her political evolution to Deirdre Shesgreen:
Rubiner got her start in politics by “happenstance,” she says, soon after she graduated from college. A family friend offered her an internship with then-Sen. Bob Dole, a Republican from Kansas who eventually went on to become the Senate Majority Leader and run for president, unsuccessfully, against Bill Clinton.
She loved the work, if not Dole’s politics. “When I came of age politically… I figured out he wasn’t really consistent with my views,” she said. “But he was a wonderful man, very funny, and very good to me… It was a great introduction to politics.”
She was much more in tune with her next boss, the late Sen. John Chafee, a moderate Republican from Rhode Island. She spent nine years as his legislative assistant, focusing on health care and women’s issues, among other things.
After a brief respite from Capitol Hill, she returned in 2005 to work as then-Sen. Hillary Clinton’s top legislative and policy aide. In that role, Rubiner helped craft the health care reform proposal that Clinton made a centerpiece of her 2008 presidential bid.
So basically it seems that Republicans who are focused on health policy have gone from something like Laurie Rubiner’s position to something like James Capretta’s position. This probably does reflect the fact that some Republicans have changed their mind. But I suspect it is more a reflection of the fact that different Republicans are focused on health policy now than in the past as people like Laurie Rubiner have ceased to be Republicans and as more Republicans have started to focus on health policy.