Ferguson (r) with Costantino and Roberts

“Is this the happiest day of my life? Pretty much!”

That’s what a smiling Christine Ferguson told me at a press conference this morning when I asked how it felt Thursday to see the health policy she developed as a senior aide to the late U.S. Sen. John Chafee upheld as constitutional by the U.S. Supreme Court.

Ferguson, who started working for Chafee’s son on Monday as head of Rhode Island’s new health insurance exchange, said unequivocally that President Obama’s signature accomplishment is what she drafted for Republicans two decades ago. ”It is based on the John Chafee bill of 1993,” she said. “It is pretty much exactly how we envisioned it.” She added: “I think it’s a great day.”

Ferguson was a key architect of the Health Equity and Access Reform Today Act of 1993, introduced by the senior Chafee that year as the Republican alternative to the Clinton administration’s so-called “Hillarycare” proposal. (Oddly enough, Hillary Clinton’s 1993 proposal was crafted in partnership with a Rhode Islander, too – Ira Magaziner of Greenhouse Compact fame.)

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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.

• Related: Today marks the first anniversary of – ‘Chafeecare’ (March 23, 2011)

The late John Chafee makes a prominent cameo in this week’s New Yorker, as Ezra Klein writes about how the individual health-insurance mandate went from Republicans’ preferred policy to conservative heresy.

Klein notes the mandate made its first legislative appearance in the Health Equity and Access Reform Today Act of 1993, which Rhode Island’s Republican U.S. Senator proposed in November 1993, during the fight over President Clinton’s health care bill – and it’s been part of the debate ever since:

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. …

Ten years later, Senator Ron Wyden, an Oregon Democrat, began picking his way back through the history — he read “The System” four times — and he, too, came to focus on the Chafee bill. …

What is notable about the conservative response to the individual mandate is not only the speed with which a legal argument that was considered fringe in 2010 had become mainstream by 2012; it’s the implication that the Republicans spent two decades pushing legislation that was in clear violation of the nation’s founding document. …

Senator Orrin Hatch, who had been a co-sponsor of the Chafee bill, emerged as one of the mandate’s most implacable opponents in 2010, writing in The Hill that to come to “any other conclusion” than that the mandate is unconstitutional “requires treating the Constitution as the servant, rather than the master, of Congress.”

Now, 19 years after John Chafee first proposed a federal individual mandate for health insurance, the country is waiting to find out whether the U.S. Supreme Court will declare his idea unconstitutional.

• Related: Today marks the first anniversary of – ‘Chafeecare’ (March 23)

Long before he was Governor Chafee’s operations chief as director of administration, Richard Licht was Rhode Island’s Democratic lieutenant governor and a credible U.S. Senate challenger to Chafee’s father John in 1988. (Frank Licht, Richard’s uncle, had booted John Chafee from the governor’s office 20 years before.)

Chafee beat Licht by nine points that November, but this CNN clip – with footage of a youthful Mr. Licht – shows the lieutenant governor was taken seriously and the race was seen as “a dog fight”:

(Can anybody figure out what thoroughfare that is at the start of the CNN clip?)

It’s a safe bet Lincoln Chafee never planned to be in New Hampshire today getting out the vote for Mitt Romney’s presidential campaign. Four decades ago, though, their fathers were joined at the hip ahead of the first-in-the-nation primary.

From 1966 to 1968, Rhode Island’s then-governor, John Chafee, played a pivotal role in marshaling support for the doomed presidential bid of his fellow liberal Republican, Gov. George Romney of Michigan. The very different roads their sons traveled subsequently are a reminder of the GOP’s transformation in the years since.

Both Chafee and Romney were first elected governor in 1962 and easily reelected two years later despite a Democratic landslide for candidates from LBJ on down. As leaders of the GOP’s apparently ascendant moderate wing, they were involved with the Ripon Society, a centrist Republican think tank that criticized Goldwater’s campaign.

The pair won resounding reelection victories again in 1966, a banner year for Republicans, and Chafee emerged immediately as one of Romney’s strongest backers for president – as well as a potential vice presidential nominee in his own right. He even penned the foreword to a biography of the Michigan governor.

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A year ago today, President Obama signed the late U.S. Sen. John Chafee’s health care reform plan into law.

Sure, most people know the legislation as the Affordable Care Act – or, in less supportive circles, “Obamacare.” But when you get away from all the partisan bickering over the law, its actual nuts and bolts bare a striking similarity to the Health Equity and Access Reform Today Act of 1993, which the Rhode Island Republican proposed during the heat of President Clinton’s fight over health policy.

Don’t believe me? Check out this Kaiser Health News chart comparing John Chafee bill’s with competing Republican and Democratic proposals from 2009. As Kaiser’s Maggie Mertens pointed out in a February 2010 interview with one of Chafee’s co-sponsors, former Sen. Dave Durenberger of Minnesota:

In fact, the key provisions in the Chafee bill may seem familiar, as they bear a strong resemblance to those in the current Democratic Senate bill, and now in President Barack Obama’s proposal. A mandate that individuals buy insurance, subsidies for the poor to buy insurance and the requirement that insurers offer a standard benefits package and refrain from discriminating based on pre-existing conditions were all in the 1993 GOP bill.

Durenberger says the reason many of these ideas have been shunned by today’s Republicans, even called unconstitutional by some, is that political times have changed. “The main thing that’s changed is the definition of a Republican,” he said.

The bill Chafee crafted wound up being Democrats’ last, best hope for passing something comprehensive by the summer of 1994. “I trust John Chafee,” Sen. Ted Kennedy told fellow Democrats even as the legislation’s prospects dimmed. In the end, though, his bill died along with every other effort to pass major health legislation during that Congress.

Chafee’s ideas didn’t die, though – his top health policy aide, Laurie Rubiner, went on to work for Hillary Clinton, helping shape the health plan that Clinton unveiled during her presidential campaign – which also influenced Obama’s.

The American Enterprise Institute’s Norm Ornstein, an authority on all things congressional, emphasized the link between Chafee’s proposal and Obama’s amid the long legislative battle of 2009-10. “It is basically a marriage between Mitt Romney’s Massachusetts-care, and even more the John Chafee-David Durenberger-Chuck Grassley-Bob Dole alternative of 1993-’94 built around managed competition,” he told PBS’s Charlie Rose. (Orrin Hatch and Richard Lugar were also Chafee co-sponsors, at least initially.)

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At his press conference the day after the election, I asked Lincoln Chafee whether he had considered how different his governorship will be from his father’s, considering that John Chafee governed during the economic boom of the 1960s. Chafee paused briefly and said he didn’t remember the economy being particularly great when his dad was governor, then went on to say Rhode Island’s current situation is the worst since the Great Depression.

I found Chafee’s statement a little odd – the U.S. economy expanded continuously all the way from early 1961 to late 1969, a nearly nine-year streak that wasn’t matched until the 10-year expansion of the 1990s. Chafee was only 10 years old when his dad took office, though, so it was hard to fault him if he didn’t remember the time that well.

But then I read this in yesterday’s Providence Journal (emphasis mine):

John Chafee dealt with a tough economy in the 1960s, said [former Democratic Gov. Philip W. Noel], but not with the kind of jarring blow to local prosperity that Noel faced as governor when much of the Navy establishment departed in the 1970s.

“Young Lincoln Chafee faces an economic shambles, bigger than anything his father had to deal with, and probably bigger than I faced,” said Noel. …

John Chafee broke into elective politics in 1956 at age 34, winning the first of three terms in the Rhode Island House, where he rose to the post of minority leader. He was elected governor in 1962 and reelected in 1964 and 1966 –– different times than these.

“Rhode Island’s economy was not good, but the state did not have anywhere near the accumulated challenges that we face today– the burden of pension debt, the reliance on gaming for revenues, and so on,” recalled Bruce M. Selya, a longtime political associate and fundraiser for Chafee.

With all due respect to Noel and Selya, I’m pretty sure their memories are failing them here. Let’s look at the evidence.

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