In the wake of the White House’s health care summit, reconciliation is still seen as the likely route that congressional leaders and their liberal allies will take to jam Obamacare through Congress. Congressional Democrats and President Barack Obama already are using the summit as a public relations vehicle to help fast-track the Senate health care bill through a parliamentary process used primarily for budgetary issues.

But beware Plan B — the more “modest” plan. There’s a surer, well-worn path that the Clinton Administration took after the collapse of Hillarycare in 1994: A careful, well-coordinated, step-by-step march to the Left on federal health care policy.

The Republican congressional victory in 1994, even though it reflected public revulsion at the Clinton Administration’s proposed takeover of the private health care system, did not change the fundamental direction of federal health policy. It only changed the degree and velocity of liberal policy success. The Clinton team started taking baby steps to expand federal control over health care financing and delivery, lulling often clueless congressional Republicans into cooperation with long-term consequences for doctors and patients. In some cases, the GOP majority enacted provisions of the Clinton health bill word for word.

In fact, much of today’s health care landscape reflects the enormous policy success the Clinton Administration achieved during the 1990s in the wake of the legislative failure of Hillarycare:

  • Unprecedented statutory interference with the doctor-patient relationship — restricting private contracting — in Medicare in 1997
  • The frustrating regulatory burden imposed on doctors through the  Health Insurance Portability and Accountability Act in 1996
  • The creation of the State Children’s Health Insurance Program (SCHIP), which has now become a roaring entitlement, costing billions more in taxes and crowding out private health coverage as Congress pushes eligibility up the income scale

Through all of this, Republicans in Congress dismissed or ignored the warnings of conservative health policy analysts and economists, and instead cooperated with President Clinton or played an ineffective defense.

Congressional conservatives should ponder liberals’ past incremental health care successes. It may help them prepare for what may lay ahead. Rest assured that Team Obama is keeping options open.

According to the Wall Street Journal, while no final decisions have been made, “the smaller plan’s outlines are in place in case the larger plan fails.” Those smaller bills could include:

  • Mandating that insurance companies allow “children” up to 26 years old to be on their parents’ health plans.
  • Expanding Medicaid and SCHIP beyond the massive expansions that were enacted in 2009. Medicaid expansion has been a favored coverage form by liberal Democrats.

As Heritage’s Stuart Butler recently noted in the New England Journal of Medicine, small changes to the nation’s $2.5 trillion health-care system can have dramatic results:

History shows that changing even seemingly minor features of legislation or administrative decision making with regard to health care can have major — and sometimes unintended — consequences for the system’s evolution.

Conservatives in Congress have ample policy proposals to expand patient choice and improve market competition. There is no reason why they should carefully develop and implement a grand legislative strategy of incremental conservative reform.

Co-authored by Marguerite Higgins.