This year’s elections, the U.S. Supreme Court’s “Obamacare” decision and the economy appear likely to determine whether we will be looking at a repeat of Washington state’s 1990s health care reform experience.

After the 1992 elections, comprehensive health care reform, known as the Washington Health Services Act, was enacted by the 1993 state legislature. Reforms were far reaching and were to be implemented over several years, like the current reforms. Similarly, the 1993 version relied upon government-mandated coverage that applied first to employers and then to individuals. An Employee Retirement Income Security Act (ERISA) waiver was needed, which was plausible because the 1992 election produced Democratic control of Congress, including Washington’s delegation.

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