There’s some irony in Governor Chafee’s appointment on Thursday of Christine Ferguson as director of Rhode Island’s new Health Benefits Exchange, the agency that will run the state’s Affordable Care Act health insurance marketplace.
In the 1990s, Ferguson worked for Chafee’s father, Republican U.S. Sen. John Chafee, as a health policy advisor. In that role, she was a key architect of the Health Equity and Access Reform Today Act of 1993, Chafee’s GOP alternative to President Clinton’s health reform legislation.
“Christine Ferguson of my staff and Sheila Burke of Senator [Bob] Dole’s staff have been absolutely essential in preparing this legislation,” Chafee said on the Senate floor when he introduced the bill in November 1993. “Without their knowledge and drive and energy, we would not have this bill today.”
At the center of Chafee’s 1993 bill was a provision requiring every American to purchase health insurance by January 2005 – an individual mandate. The same policy has now become anathema to conservatives, who are hopeful the U.S. Supreme Court will rule it unconstitutional before the end of this month.
Ferguson may be one of the few constants in the two-decade health care debate – someone who put forward an individual mandate as a Republican aide in the 1990s and will now run an insurance exchange reliant on the mandate, put into law by a Democratic president and implemented by a center-left independent governor.