Betsy McCaughey was arguably instrumental in killing Clinton's health care reform efforts in 1993.

On September 7, 1993, the Clinton administration began briefing congressional staff members on its draft healthcare reform plan, which was soon leaked to interest groups and the press, with details and analysis of it first published by The New York Times and The Washington Post on September 11, 1993. McCaughey, skeptical of what had been reported about the Clinton health plan and accustomed as an 18th century historian to using primary sources,<24> asked for and received a copy of the draft health care reform plan from the office of U.S. Sen. Harris Wofford (D-PA) the following week.<25>

On September 22, 1993, U.S. President Bill Clinton delivered a nationally televised speech about his health care reform plan to a joint session of Congress. From September 28–30, 1993, First Lady Hillary Clinton testified about the health care reform plan before five congressional committees over three days. On September 30, 1993, the last day of Hillary Clinton's congressional committee testimony, The Wall Street Journal published an op-ed by McCaughey, who said she had read and reread the 239-page draft health care reform plan and concluded that the plan differed markedly from the Clinton White House's public statements and that the plan would in her opinion have "devastating consequences." <25>

On October 27, 1993, President Clinton presented his Health Security Act bill to the U.S. Congress in the Capitol's National Statuary Hall—the 1,342-page (in large print and double-spaced) bill was distributed to the press for free on two diskettes and went on sale at noon to the public in print for $45 from the Government Printing Office.

On November 20, 1993, after passage of NAFTA on the last day of the 1993 session of Congress, the Health Security Act was introduced in the U.S. House as H.R. 3600 by House Majority Leader Dick Gephardt (D-MO-3) with 99 cosponsors and introduced in the U.S. Senate as S.1757 by Senate Majority Leader George J. Mitchell (D-ME) with 28 cosponsors. On November 22, 1993, the Wall Street Journal published another op-ed by McCaughey, who said she had pored over the 1,342-page Health Security Act bill and concluded that its price controls would cause rationing and in her opinion was "dangerous."<26>